If a person has diabetes and reduced sensation in their feet, the appearance of callous on load-bearing surfaces (where the foot touches the ground) is a warning sign of pressure & shear trauma. This can lead to foot ulceration. Removing callous is essential for the health and function of the foot and lower limb.
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So this foot's a good example of a foot that has loss of fatty padding or atrophy, so therefore we've got exposed metatarsal heads here, which is an increased forefoot pressure area for callus build up, which can potentially cause breakdown and ulceration. And these feet, in particular, have had sites previously of callus breakdown and ulceration, especially here at this second. What we do is we maintain the callus, prevent it from building up regularly every six weeks. if for some reason this foot wasn't seen regularly, this callus would build up here and eventually break down and ulcerate. And as you can see at this area, we already have bruising developing because you'll have callus buildup, bruising develop, and then the tissue breakdown underneath, which then will cause the ulcer. So what I'm gonna do to prevent that is just to bride some of the callus away back to nice healthy viable flexible elastic skin. So as you can see it's non-harmful for the patient, this is all non-viable callus, there's no nerve endings in this tissue. So I use a lot of skin tension and feel with my blade as we don't want to go into that dermal layer. So, so now you can see we've no longer got any yellow bits of hard skin. the skin's nice and pink and perfused underneath and it's now nice and flexible so therefore we've got no pressure areas.
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