Aim and equipment (1/17)
The aim of carrying out a foot screening is to identify the presence of risk factors for diabetic foot complications which could lead to ulceration and subsequent amputation such as – Neuropathy, Peripheral Arterial Disease (PAD), Significant structural abnormalities, Significant callus, previous ulceration and the inability to self care. These risk factors should be explained to the individual in a way that they understand them and know what they mean to them.
The only piece of equipment that is required to carry out a simple, evidence based, foot screening is a 10g monofilament. The monofilament used should be of good quality such as those manufactured by Bailey Instruments or Owen Mumford and should be used and replaced as per manufacturers instructions to ensure that the monofilament remains accurate. The length of time a monofilament will remain accurate will vary according to it’s frequency of use but Bailey Instruments and Owen Mumford recommend changing the monofilament after approximately 6 months of use. Many clinics use monofilaments much longer than this which can result in less accurate testing.
The Neurothesiometer is a device that tests an individual’s vibration perception threshold (VPT) and monitors diabetic neuropathy by measuring vibration sense. The device graduates in vibration intensity which ranges from 1 – 50 volts.
If a value of <25 volts is entered in the box provided on the SCI-Diabetes form individuals risk will not change but if a value of >25 volts is entered then the individuals risk will change in the same way as if they could not feel 8/10 of the monofilament sites.
Some clinics use the Neurothesiometer as part of the screening process but although it can be used it is not routinely required for screening but can be useful as part of a more ‘in depth’ assessment in specialist centres.