Scenario: A 65 year old diabetic female has been seeing a podiatrist to have her calluses trimmed. One day the podiatrist trimmed a callus to close to the skin and caused an infection which led to the amputation of her second digit.
A callus can occur due to friction and pressure on the foot. The callus is the body’s way of protecting its skin. For example a seasoned guitarist will develop calluses on his/her fingers due to the hours of friction and pressure from practicing. These calluses toughen the skin so that the musician can tolerate the hours of practice. The same thing happens with the foot. If the foot rubs against the shoe or has an increased amount of pressure in certain areas then a callus will develop. In diabetic patients this chronic pressure cab cause an ulcer to develop underneath the callus. The ulcer can then become infected and thus the risk of amputation increases.
Trimming the calluses regularly is a way to prevent ulcerations from happening in the future. Good nutrition and vitamin supplements also have a benefit to proper healing. Good circulation is also a crucial piece to the healing of the wound and callus. If the doctor or the patient accidentally insults the skin then immediate wound care is necessary. Antibiotics may be prescribed but proper offloading with a boot or cast may be required as well.
Using diabetic shoes to decrease pressure and friction to the foot is also a great way to help prevent future problems.