Foot Care Specialists Research Articles

Epidemiological case-control study on contact sensitisation in female foot care specialists with occupational contact dermatitis: Patch test data of the Information Network of Departments of Dermatology (IVDK), 2008 to 2022.

Mainly women work as foot care specialists (FCS). They are at risk to develop occupational dermatitis (OD). The objective of this study is to describe the contact sensitisation pattern of female FCS with OD. In a retrospective study, patch test and clinical data collected by the Network of Departments of Dermatology (IVDK) from 2008 to 2022 were analysed. Data of 116 female FCS with OD were compared with data of 13 930 female patients with OD working in other professions and 78 612 female patients without OD. Hand dermatitis (93.1%) was significantly more common and face dermatitis (0.9%) significantly less common in female FCS with OD compared to other female patients with or without OD. Frequent suspected allergen sources were disinfectants, gloves, leave-on and nail cosmetics. Occlusion and wetness were important co-factors. The most common diagnoses were irritant contact dermatitis (26.7%) and allergic contact dermatitis (21.6%). No sensitisation to any of the baseline series allergens was significantly more frequent in female FCS with OD than in the two control groups. However, sensitisations to allergens which FCS are abundantly exposed to, including fragrances, preservatives, rubber ingredients and disinfectants, were most common. FCS should be aware of the OD risk and prevention should be promoted.

Evaluation of the wear-and-tear scale for therapeutic footwear, results of a generalizability study.

Therapeutic footwear is often prescribed at considerable cost. Foot-care specialists normally assess the wear-and-tear of therapeutic footwear in order to monitor the adequacy of the prescribed footwear and to gain an indicator of its use. We developed a simple, rapid, easily applicable indicator of wear-and-tear of therapeutic footwear: the wear-and-tear scale. The aim of this study was to investigate the intra- and inter-rater reliability of the wear-and-tear scale. A test set of 100 therapeutic shoes was assembled; 24 raters (6 inexperienced and 6 experienced physiatrists, and 6 inexperienced and 6 experienced orthopaedic shoe technicians) rated the degree of wear-and-tear of the shoes on the scale (range 0-100) twice on 1 day with a 4-h interval (short-term) and twice over a 4-week interval (long-term). Generalizability theory was applied for the analysis. Short-term, long-term and overall intra-rater reliability was excellent (coefficients 0.99, 0.99 and 0.98; standard error of measurement (SEM) 2.6, 2.9 and 3.9; smallest detectable changes (SDC) 7.3, 8.0 and 10.8, respectively). Inter-rater reliability between professions, experience and inexperienced raters, and overall was excellent (coefficients 0.97, 0.98 and 0.93; SEM 4.9, 4.5, and 8.1; SDC 13.7, 12.4 and 22.5, respectively). The wear-and-tear scale has excellent intra-rater, inter-rater, and overall reliability.

Retrospective review of forefoot amputations at a Veterans Affairs hospital and evaluation of post-amputation follow-up

Background Forefoot amputations in diabetic and vascular patients often are followed by subsequent amputations. We evaluated the outcomes of forefoot amputations and the efficacy of our care in preventing subsequent amputations. Material and Methods Charts of all patients undergoing forefoot amputations were reviewed. Comorbid conditions, subsequent amputations, and the nature of pre- and post-amputation care were noted. A subset of patients followed more than 2 years post-amputation was studied to evaluate post-amputation care. Results Of the 81 patients, 26% underwent subsequent forefoot amputations and 37% underwent subsequent proximal amputations. Forty-one patients followed more than 2 years were divided into 2 groups: those followed closely by foot-care specialists and those followed by primary care providers. The former group experienced fewer amputations, but the difference was not statistically significant. Conclusions Previous forefoot amputation is a high-risk factor for repeat amputations. Our post-amputation care did not effectively reduce subsequent amputations.