Complex of medical services for diabetic foot is special diabetic department (medical cabinet) in private clinic for clients with diabetes mellitus and problems with lower extremities who are undergoing treatment in the clinic or are sent for additional examination from other clinics.
In special diabetic department Client can get complete assessment of the state of lower extremities with an assessment of the condition of the skin, screening methods for examining the vessels of the lower extremities and determination of the neurological state of the limb. Client can get sub-correction (medical pedicure) in order to prevent the occurrence of trophic ulcers of the lower extremities in special diabetes room.
In order to diagnose ischemic, neuropathic and neuro-ischemic forms of diabetic foot syndrome (DFS), systolic blood pressure on the shoulders and lower third of the lower leg is determined using a mini-go-stopler (The Multi Dopplex II with a 8 MHz sensor) with a wide cuff sphygmomanometer.
The Multi Dopplex II
Also pulsation in the foot arteries of small and medium caliber and in arteria dorsalis pedis is determind.
Technique of study lower extremities vessels with the Mini-Depopler apparatus
The stone-brachial index was calculated as the quotient of dividing BP (blood pressure) of the lower leg by a similar indicator of the brachial artery.
KPI = BP of the leg / BP of the shoulder
Peripheral sensitivity is examined using specific neurological tests. Tactile sensitivity is determined using a monofilament standardized equivalently of a pressure up tp 10 g / cm2 (Semmens-Weinstein), pain sensitivity using a Neuropen neurological needle, temperature sensitivity using an Tip-term thermocylinder, vibration sensitivity using a Riedel Seifert graduated tuning fork, 128 Hz.
Achilles reflex was evaluated by a standard method using a neurological hammer.
Riedel Seifert graduated tuning fork, 128 Hz
pain - using a blunt needle
Dull needle for determining pain sensitivity Neuropen
tactile - with the help of Semmes-Weinstein monofilaments, which create a local pressure with a capacity of 10 g per m2
Monofilament Semmes-Weinstein
temperature - by alternately applying a special cylinder with cold and warm poles
Device thermal tip-term
Diagnosis of the motor form of peripheral neuropathy is carrying out with its clinical manifestations: paresthesia, pain in the lower extremities at rest, prevailing at night, calf muscle cramps.
The results of the examination of the patient were entered into the registration cards of foot pathology in patients with diabetes mellitus.
