The multidisciplinary diabetic foot clinic is in charge of the treatment and prevention of diabetic foot wounds in order to avoid amputation.
In diabetic patients, the nerves of the feet may be so badly affected that they become numb. As a result, the patient may burn his feet in hot water without feeling it. This also means that wounds are not noticed until it is too late. The number of amputations is still very high because foot problems in patients with diabetes are often considered serious when it is too late.
In addition to nerve damage, diabetes often causes a blockage of the blood vessels of the lower limbs, so that there is little supply of blood with nutrients and oxygen to the wound. Therefore, the healing of wounds is usually difficult or even impossible if a blood vessel correction is not carried out in time.
Since February 2002, patients with diabetes and foot problems can visit the Multidisciplinary Diabetic Foot Clinic at the Jan Yperman Hospital.
Two diabetologists, a podiatrist (Annelies Six), an orthopaedist, three vascular surgeons, a wound care nurse (Filiep Manderyck), a diabetes educator (Annelies Barbez), an orthopaedic shoemaker and a shoe technician work in the clinic.
Together with the podiatrist, the vascular surgeons and the orthopaedists, Dr. An Nollet obtained the HIHDI recognition for managing a Multidisciplinary Diabetic Foot Clinic in the Jan Yperman Hospital in 2009. This makes the Ypres foot clinic one of the 36 recognised third-line clinics for diabetic foot in Belgium.
You will first be examined by the podiatrist, the wound care nurse and a diabetes educator. The medical file is prepared together with the endocrinologist. Additional examinations are requested. It will be checked which other disciplines you will have to see. Our podiatrist visits everyone. She takes care of your feet and teaches you how to do this yourself.
Because good blood circulation is essential in wound healing, you will be examined by a vascular surgeon (for each new wound). If necessary, an additional duplex ultrasound will be performed. In case of arterial problems, treatment options (preferably minimally invasive or endovascular treatment) will be discussed.
If your feet have fallen arches, calluses will form at the places of overpressure. Cracks may appear in this process, which may result in wounds due to a superinfection. Therefore, orthotics or (semi-)orthopaedic shoes should be prescribed in good time. This done by the orthopaedist. The attending orthopaedic shoemaker or shoe technician takes the measurements and provides the pressure relief orthotics and/or footwear. Sometimes the orthopaedist will carry out a surgical correction, e.g. in the case of a severe form of hallux valgus or a hammertoe that is the cause of a recurrent wound.
Of course, we not only try to heal wounds, but also to prevent them. The podiatrist in particular tries to give the patient as many tips as possible.
First of all, the importance of good foot hygiene is emphasised. Patients are asked to wash their feet daily and check for wounds. It is explained to them that they should cut their toenails 'straight' (not in a nice little curve!) otherwise they will grow into the skin.
We also advise against wearing open shoes: if a small stone goes unnoticed in the shoe, this can have serious consequences for people with sensory disorders.
On Thursday afternoons, patients with diabetes and foot problems can visit the Multidisciplinary Diabetic Foot Clinic.
All consultations take place by appointment through the Endocrinology-Diabetology secretariat.
Patients with foot wounds who do not have diabetes mellitus can visit our wound care clinic.
Podiatrist Annelies Six
Wound care nurse
Nurse Annelies Barbez
Shoe technician Loïc Scheire
