Patient Education

If you or a loved one experience difficulties due to wound management issues, the following information may be helpful to you:

Off-Loading Safety and Prevention for Diabetics
Safety Precautions for the Elderly Skin Care
Take Care of Your Feet Tips for foot Wear for Diabetics
Are You At Nutritional
Risk?
Your Doctor Says…You Have to Lower Your Cholesterol
Amputation Prevention Fact Sheet Charcot Joint Disease
General Foot Care Guidelines
Coping With Loss of Sensation
Dealing With Pain

Skin Care

Why is Skin Important?
Our skin is almost indestructible.  It is constantly being renewed, and has both protective and adaptive properties.  Some of its functions include:

  • The prevention of fluid loss
  • Temperature regulation by evaporation of perspiration and heat storage
  • The production of vitamin D, the excretion of metabolic wastes
  • Identifying the sensations of touch, pain, temperature and pressure
  • The ability to use/absorb some drugs like steroids and hormones
  • Prevent allergic reactions

What Factors Influence Skin?
Age, physical limitations, disease(s), trauma, nutritional state and hygiene all affect the appearance, condition, health, suppleness and integrity of your skin.  The natural aging process results in your skin becoming thinner, less elastic, more tissue-paper like, and more easily damaged  during your daily activities.

Underlying medical conditions, or the medications used to treat them (such as diabetes, kidney or liver problems, heart, blood vessel and lung disease), can increase the risk of bruising, trauma, drying, splitting, cracking or peeling.

Then, sensitive, fragile skin can be jeopardized by simply bumping or brushing up against an object or scratching or rubbing an itching area.  If dryness, chapping or peeling are also present, a broken area may result and become an open sore.  If there is an underlying disease present, the sore can increase in size, and become infected.  It can cause much physical discomfort and be quite costly.

Physical limitations can result in skin care problems if mobility is restricted or severely hampered.  This happens to persons with total body or long leg casts, traction, strokes, hip joint replacement, arthritis, or other disabling conditions. 

What are some common skin care problems that need attention?
If not properly treated, the following list of problems may lead to broken skin, ulcerations, infections and chronic wounds.  If any of the following happens to you, consult your doctor:

  • Development of a wound, especially on the lower leg or foot
  • Dry, cracked, peeling skin
  • Blisters
  • Bumps with pus
  • Dermatitis (dry or weeping)
  • Allergic reactions
  • Multiple or extensive skin tears
  • Fissures of the skin on the feet, especially the heels

What is the correct way to cleanse and moisturize the skin?
Cleansing of the skin needs to be done with gentle care and a pH balanced product to prevent trauma, and the drying/stripping of natural oils.  Moisturizing and/or lubricating the skin after bathing, or at other times during the day, and at bedtime will help increase the skin’s softness and suppleness.  It also decreases the risk of maceration, trauma, friction, itching and general discomfort.

Cleansing products:

  • May be in a cream, foam, gel, liquid, bar or lotion form
  • May be soap-based or non-soap-based
  • May be medicated and available by prescription only
  • Need to be natural with minimal to no preservatives
  • May require water for application and rinsing.  Use lukewarm or room temperature (never hot) water
  • Need to be removed gently and thoroughly

Moisturizing/Lubricating products:

  • May be creams, lotions, barriers or sealants
  • Need to be natural (beeswax, vitamin E, etc.) with no preservatives
  • Should not include alcohol in any form (it dries the skin)
  • Should be used in a layered effect to maximize moisture retention in the skin cells/layers
  • May have a silicone or petrolatum base that acts as an occlusive barrier against moisture loss, chemical irritation and friction
  • May have a lanolin base (watch for skin sensitivity)
  • May contain up to 95% water
  • May contain perfumes (made from coal tars, seed kernels) and dyes that frequently irritate sensitive skin
  • May contain urea and lactic acid (alpha-hydroxy acid).  The alpha-hydroxy acid in higher concentration may cause stinging of diabetic skin
  • May contain menthol, camphor or mint to provide a sensation of comfort and coolness

Skin Care Do’s

  • Check your skin daily for dryness, cracks, cores, bruises, reddened areas and blisters
  • Cleanse the skin with a mild, pH-balanced product.  Remember, some people do not require overall cleansing on a daily basis
  • Use warm to touch (on elbow or inner wrist) bathing water
  • Treat the skin gently without stretching, tugging or pulling
  • Remove all residue of the cleanser from the skin
  • Use a very soft nail brush for nails and crusty skin
  • Dry all skin folds and creases with special attention to the area between, under and around the toes
  • Moisturize the skin after cleansing.  Leave a light film of moisture on the skin just prior to applying lotion or cream
  • Lubricate dry skin with a heavy (barrier) product after moisturizing
  • Wear soft clothing.  Wear white socks for feet and gloves for hands, if indicated, for extra protection at night
  • Use baking soda or equivalent powders for foot care if perspiration is a problem.  It will help with odor and moisture control.  Sprinkle on hands, dusting off excess and gently rubbing onto the skin

Skin Care Don’ts

  • Don’t neglect new areas of irritation, soreness or discomfort on the skin
  • Don’t soak for more than ten minutes in the tub
  • Don’t bathe in hot water
  • Don’t use abrasive or rough washcloths on the skin
  • Don’t apply lotion or creams between, under or around the toes or nails
  • Don’t use lanolin, coal tar or petrolatum based products if you have sensitive skin
  • Don’t use skin care products with alcohol and/or extensive lists of preservatives
  • Don’t apply tape of any kind to dry, sensitive or fragile skin