NEUROPATHIC NEUROPATHIC TREATMENTTREATMENT

Choose proper orthotics/inserts/shoesChoose proper orthotics/inserts/shoes Total contact castingTotal contact casting Off-load ulcersOff-load ulcers Proper wound and skin careProper wound and skin care Callus careCallus care Patient educationPatient education

ORTHOTICS/INSERTS/SHOESORTHOTICS/INSERTS/SHOES

Inspect patient’s shoes Inspect patient’s shoes for uneven wear for uneven wear patternspatterns

Numerous design Numerous design features for shoes features for shoes including:including: Soft, breathable leatherSoft, breathable leather High tops High tops Rocker soles/bottomRocker soles/bottom Extra-depth toe poxExtra-depth toe pox Extra-wide shoesExtra-wide shoes Flared lateral sole Flared lateral sole

Photos from Photos from www.alimed.comwww.alimed.com

TOTAL CONTACT CASTINGTOTAL CONTACT CASTING

Decreases plantar Decreases plantar pressure by increasing pressure by increasing weight bearing over weight bearing over entire lower extremityentire lower extremity

Only experienced Only experienced professionals should professionals should perform this technique - perform this technique - NOT for the novice!NOT for the novice!

OFF-LOAD ULCERSOFF-LOAD ULCERS

Off-loading or pressure downloading is Off-loading or pressure downloading is the cornerstone for prevention/treatment the cornerstone for prevention/treatment of neuropathic ulcers of neuropathic ulcers

By off-loading tissues, By off-loading tissues, pressure/shear/friction forces are pressure/shear/friction forces are eliminated, thus preventing or limiting eliminated, thus preventing or limiting tissue damagetissue damage

PROPER WOUND AND SKIN PROPER WOUND AND SKIN CARECARE

Debride and follow moist wound healing Debride and follow moist wound healing principlesprinciples

Hydrate the skinHydrate the skin

CALLUS CARECALLUS CARE

Soften hardened skinSoften hardened skin Debride or Pare Debride or Pare

CallusCallus #10 scalpel#10 scalpel Callus reducer (dry Callus reducer (dry

tool) on dry callustool) on dry callus Pumice stone (wet Pumice stone (wet

tool) on wet callustool) on wet callus

Photos from Photos from www.drugstore.comwww.drugstore.com and and www.shopping.comwww.shopping.com

PATIENT EDUCATIONPATIENT EDUCATION

Proper foot Proper foot inspectionsinspections

Skin careSkin care Safety to Safety to

compensate for lack compensate for lack of sensationof sensation

Photo from Photo from www.medlineplus.govwww.medlineplus.gov