Diabetes foot screening : current practice and the future

Abstract

Everyone agrees that diabetic patients foot screening is important as it has been reported to be the cornerstone to saving the high risk foot. It stands to reason, however that for it to be effective it must be performed correctly and appropriately if patients are to be correctly identified as high risk and ensured that they do not ‘slip through the net’. This clearly requires a clear skill set that must be learned through appropriate specialised training utilising evidence-based practice that goes far beyond that of basic clinical skills and that of a simple examination with a 10 g monofilament or pulse palpation to detect sensory or circulatory deficits. For, if one thinks about it, when assessing pulse palpation, what can this test tell us? Detecting a pulse does not necessarily imply that everything is in order — on the other hand, are we going to wait until the patient does not have a pulse before taking action? [excerpt]