Zespół stopy cukrzycowej to jedno z najpoważniejszych powikłań cukrzycy, które może doprowadzić do amputacji. Ważną rolę w profilaktyce ZSC odgrywa odpowiednia pielęgnacja stóp prowadzona przez pacjenta. Co należy w niej uwzględnić?
- Prawidłowe mycie stóp
Osoba cierpiąca na cukrzycę powinna zwracać szczególną uwagę na prawidłową higienę stóp. Stopy należy myć codziennie, ale istotne jest, by czynność ta nie trwała zbyt długo, ponieważ może to doprowadzić do nadmiernego rozmiękczenia lub zmacerowania skóry. Stóp nie należy również moczyć w wodzie (np. w misce). Optymalny czas mycia stóp to 2-3 minuty. Po umyciu stopy należy dokładnie osuszyć, również w przestrzeniach między palcami.
- Prawidłowa pielęgnacja paznokci
Do obcinania paznokci osoba z cukrzycą nie powinna stosować nożyczek, ponieważ istnieje duże ryzyko skaleczenia nimi. Paznokcie powinny być obcinane prosto i niezbyt krótko, z zachowaniem zasad aseptyki (narzędzia używane do obcinania należy poddać dezynfekcji przed użyciem). Po obcięciu paznokci warto użyć pilnika, by wygładzić ostre krawędzie.
- Regularna kontrola stanu stóp
Osoba z cukrzycą powinna codziennie sprawdzać stan skóry na stopach, ponieważ nawet drobne skaleczenie lub odcisk może doprowadzić do powstania rozległych ran. W przypadku zaobserwowania owrzodzenia ranę należy przemyć solą fizjologiczną, zabezpieczyć ją jałowym gazikiem i zgłosić się do lekarza. Nie należy stosować plastrów i maści na odciski ani przekłuwać pęcherzy lub innych zmian skórnych igłą. Niewskazane jest również pozostawienie zmiany do samodzielnego wygojenia.
- Dobór odpowiedniego obuwia
Buty noszone przez osobę z cukrzycą powinny być wykonane z miękkiego, naturalnego, przepuszczającego powietrze materiału. Niewskazane jest obuwie z mocno zwężanymi noskami, ciasno sznurowane lub w jakikolwiek inny sposób uciskające stopę. Nadmierny ucisk i tarcie może doprowadzić do powstania ran i owrzodzeń. Istotne jest również, aby buty były odpowiednio wyprofilowane i stabilne (nierównomierne rozłożenie nacisku w obrębie podeszwy stopy może spowodować odciski i modzele).
Duże znaczenie ma również rodzaj noszonych skarpet. Powinny być wykonane z bawełny i bezuciskowe (skarpety wykonane ze sztucznych materiałów mogą powodować nadmierną potliwość stóp, a w konsekwencji zwiększać podatność na otarcia i zakażenia grzybicze).
- Wykonywanie badań przesiewowych
Osoby z cukrzycą powinny regularnie wykonywać badania przesiewowe w kierunku czynników etiologicznych zespołu stopy cukrzycowej, które pozwolą na oszacowanie ryzyka rozwoju ZSC. Do badań tych należą m.in. USG dopplerowskie tętnic kończyn dolnych oraz badanie oceniające stopień neuropatii czuciowo-ruchowej. Istotnymi elementami badań przesiewowych są również badania pedobarograficzne (analiza rozmieszczenia obciążeń na podeszwie stopy) oraz ocena ruchomości stopy i stawu skokowego, a także analiza chodu i kinematyki miednicy.
Źródła: diabetologiaonline.pl, diabetyk.org.pl, centrumpodologiczne.pl
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