Foot Care

People with peripheral vascular disease often take to sleeping in a chair with their legs hanging down, which causes ‘dependency oedema’. They should be encouraged to sleep with their legs as flat as possible. A reclining chair is more beneficial, or sleeping with the foot of the bed slightly raised.

Care of the legs and feet is essential for people with PVD affecting the lower limbs. This is to prevent wounds as much as possible, which may in turn develop into ulcers which could become infected. Pre-existing ulcers could also become infected, and lead to gangrene. It is vital to prevent and treat ulcers and infection with meticulous care.

The following points apply:

• A podiatrist should cut the nails and treat corns, calluses and dry skin.
• Special shoes may be needed to prevent undue pressure on any part of the foot, and to aid walking. Shoes should have adequate room so that the foot and toes are not squashed.
• The patient should not walk around in bare feet or sandals.
• Shoes, socks and tights should not be too tight and therefore constrict blood supply.
• The feet and sock/ stockings should be kept clean and dry.
• Particularly dry skin should be treated with cream regularly.
• Ulcers must be kept clean and if necessary treated for infection, (using antibiotic ointment and oral antibiotics), with regular checks on the progress of healing.
• Non-healing ulcers should be treated with complete bed rest, with the feet lower than the heart, to ensure the best blood supply possible to the feet; and pressure must not be allowed to bear on any part of the feet, thus avoiding the formation of pressure sores.

Amended April 2008