Name of the Procedure:

Routine Foot Care by a Physician for a Diabetic Patient with Diabetic Sensory Neuropathy Resulting in a Loss of Protective Sensation (LOPS)

Summary

In this procedure, a physician provides specialized foot care for diabetic patients who have lost their ability to feel pain due to sensory neuropathy. The care includes treatments like nail trimming, callus removal, and local care of any superficial wounds that do not extend beyond the muscle and fascia.

Purpose

This procedure addresses the foot health problems associated with diabetes, particularly in patients who have lost their sensation (LOPS) due to neuropathy. The goal is to prevent complications such as infections, ulcers, and further complications that could lead to amputations.

Indications

• Diagnosed diabetic sensory neuropathy resulting in loss of protective sensation (LOPS)
• Presence of superficial wounds that need local care
• Recurrent issues such as ulcers, calluses, or infections

Preparation

• No specific fasting or dietary requirements
• Regular blood sugar monitoring
• Basic foot hygiene should be maintained

Procedure Description

1. Initial Assessment: The physician examines the foot to assess existing issues such as wounds, calluses, or infections.
2. Clean and Sanitize: The foot is cleaned and sanitized.
3. Nail Care: Trimming or debridement of nails that may pose a risk.
4. Callus Removal: Removal of callus using sterilized instruments.
5. Wound Care: Local care of any superficial wounds. The depth and severity of each wound are evaluated, and appropriate dressings are applied.
6. Education: The patient is educated on maintaining foot health.

Tools and Equipment:

• Sterilized trimming instruments
• Antiseptics
• Dressings and bandages

Anesthesia/Sedation:

• Typically none, unless extensive wound care is required.

Duration

The procedure generally takes about 30 to 45 minutes, depending on the extent of care needed.

Setting

This procedure is usually carried out in an outpatient clinic or a physician's office.

Personnel

• Physician or podiatrist
• Medical assistant or nurse

Risks and Complications

• Minimal risk when done properly
• Rare possibilities of infection or minor bleeding
• Proper management includes prompt care and antibiotics if an infection occurs.

Benefits

• Reduced risk of foot ulcers and infections
• Prevents severe complications, possibly avoiding amputations
• Immediate relief from discomfort caused by calluses or poorly trimmed nails

Recovery

• Most patients can resume normal activities immediately after the procedure.
• Patients should adhere to daily foot care routines as advised.
• Follow-up appointments may be scheduled for continuous care.

Alternatives

• Self-Care: With training, some patients might manage their own foot care.
  • Pros: Cost-effective
  • Cons: Higher risk if not done correctly
• Over-the-Counter Products: Using callus removers or foot creams.
  • Pros: Easily accessible
  • Cons: Less effective and might not be safe without professional supervision

Patient Experience

• During: Minimal discomfort; some may feel pressure during nail trimming or callus removal.
• After: Most patients experience relief from symptoms like pain or discomfort. Any pain is usually mild and manageable with over-the-counter pain relievers.
• Pain Management: Proper foot care itself acts as a preventive measure for pain, with rare necessity for additional pain management.