Wednesday , December 13 2017
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New Shoes Weren’t Made for Walking

Female, 32 years of age, type 1 diabetes, presented with Stage II partial thickness ulcer between 1st and 2nd toe R foot, and several Stage I areas on both feet. She had recently traveled and had bought several pair of new shoes for her trip.

Assessed the wounds. Patterns seemed to follow patterns of friction and pressure from shoes. Asked her about her shoes. One of the pair of shoes were thongs. The “strap” between her toes obviously caused the wound. She does have sensation, but admitted she did not have an extra pair of shoes to change into when she felt pain, so kept wearing the thongs all day. The good news is, she did stop wearing them after that first day. The wounds could have been worse. Further avoidance of thongs, any pressure on the areas and keeping the area clean and dry healed the wound. Had she not had sensation or some sense to change her shoes to stop further friction and pressure, it could have been worse, possibly an infection and more.
Lessons learned:
  • Always teach your patients about foot care, which includes prevention.
  • During foot assessment, if redness or wound noted, assess shoes too. They are often the culprit.
  • Prevention includes wearing shoes that fit, are protective, and do not cause obvious friction such as thongs.
  • Include foot wear when teaching your patients about travel. Teach to always bring along tried and trusted shoes. If you bring new shoes, break them in before the trip to make sure they don’t cause problems, and still carry your tried and true with you to change into if you do notice a problem, such as pain or redness.
Anonymous
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