He will delay some time so that the aged people if guide for what he is being made. To prevent to ask on the sensitivity of the monofilament in the place not to induce the reply. In the presence of calluses/calosidades, to evaluate the surrounding region, therefore the patients probably will not feel the monofilament in these regions. Without risk of danger additional: To elaborate a individualizado plan of handling that includes orientaes on cares with the feet. b) At risk: Set appointments consultations of revision to each 6 months with a team to multidiscipline able to manejar the diabetic foot. In each consultation it must: To inspect both the feet – to assure care of identified problems when indicated. To evaluate the footwear that the patient uses to supply orientaes adjusted.
To improve the knowledge of the patient on as to take care of of its diabetic foot c) High risk: Set appointments consultations of revision to each 3-6 months with a team to multidiscipline able to manejar the diabetic foot. In each consultation it must: To make orientaes how much to the use of special shoes when indicated. To consider the necessity of vascular evaluation or guiding for specialist, to evaluate and to assure the supply of a more intensive orientation on cares with the diabetic foot. d) With presence of ulcerao or infection: To direct a team to multidiscipline of attention to the diabetic foot in a stated period 24-hour to manejar the wounds adequately, with dressing and indicated desbridamento as: To evaluate the indication of sistmica antibioticoterapia for celulite or ssea infection; the treatment of first line consists of generic penicillins, macroldeos, clindamicina and/or metronidazol, as indicated, and ciprofloxacina or amoxicilina-clavulanato as antibiotics of second line. To investigate the comprometimento of the bone for the osteomielite suspicion, enclosed radiology and images, magnetic and bipsia resonance when indicated. To assure an adequate control of glicemia.
To direct for ortopdicos cares special (podlogo and shoes), and a quarrel individualizada on the prevention of recurrences, after the ulcer to have healed. Orientaes educational basic for the auto-cares of the feet. To examine the feet, if daily necessary to ask for helps the familiar one or to use mirror. To inform the doctor will have calluses, cracks, alterations of color or ulcers. To dress half clean, always preferential woollen, cotton, without rubber band. To pave shoes that do not press, of soft or weaveeed leather, not to use shoes without stockings. New shoes must be used to the few, to use initially in house for some hours per day. To never walk bare-footed same in house. To wash the feet daily, with water morna and neutral soap, to prevent hot water, to dry the feet well, especially between the fingers. After to wash the feet, to use a hidratante cream the lanolina base, petroleum jelly eliminates or glycerin, not to use between the fingers? To cut to the form nails straight line, horizontally. Not to remove calluses or stuck nails in house; to look team of health for orientation.