Causes and Prevention of Diabetic Foot Skin Breakdown

As the number of persons with diabetes increases, there is an increased incidence of foot skin breakdown and lower extremity amputations. Approximately 44%–85% of those amputations can be prevented. Prevention requires an understanding of the causes of diabetic foot skin breakdown and the measures necessary for prevention. As rehabilitation nurses, we care for patients with strokes, hip fractures, spinal cord injuries, or joint replacements, who are diabetic and are at risk for foot skin breakdown. We also care for patients with amputations who are at risk for skin breakdown of the remaining foot. This article identifies the causes of foot skin breakdown, such as neuropathy, peripheral vascular disease, trauma, and infection. Discussion includes patients who are at risk, the foot areas at risk, preventive measures, and patient and family education for the prevention of foot skin breakdown in the diabetic patient.