Training modules (NHS England)



04: The procedure (NHS England)

Aim and equipment (1/16)

Aim

The aim of carrying out a foot screening is to identify the presence of risk factors for diabetic foot complications which could lead to ulceration such as – Neuropathy, Peripheral Arterial Disease, Significant structural abnormalities, Significant callus, previous ulceration and the inability to self care.

Equipment

The only piece of equipment that is required to carry out a simple, evidence based, foot screening is a 10g monofilament. The monofilament used should be of good quality such as those manufactured by Bailey Instruments or Owen Mumford and should be used and replaced as per manufacturers instructions to ensure that the monofilament remains accurate. The length of time a monofilament will remain accurate will vary according to it’s frequency of use but Bailey Instruments and Owen Mumford recommend changing the monofilament after approximately 6 months of use. Many clinics use monofilaments much longer than this which can result in less accurate testing. The monafilament should always be replaced if bent.

Monofilament

Neurothesiometer

The Neurothesiometer is a device that tests a patient´s vibration perception threshold (VPT) and monitors diabetic neuropathy by measuring vibration sense. The device graduates in vibration intensity which ranges from 1 – 50 volts.

The Neurothesiometer is not recommended by NICE for use as part of the screening process, but can be useful as part of a more ‘in depth’ assessment in specialist centres.