Implementation of temperature measurements to prevent foot ulcers

One of the most common complications in diabetes patients is the development of a foot ulcer (incidence 34 per cent). A foot ulcer can lead to infection, amputation and a reduced quality of life, and thus places a significant burden on both the patient and the Dutch healthcare system. It is known that the risk of ulceration is high among patients who have already had a foot ulcer; as many as 40 per cent develop another ulcer within one year of recovery. Preventing the development of (re-)ulceration is therefore important \[Bus 2021\].

Detecting foot ulcers at an early stage using skin temperature

One of the most common causes of foot ulcers is excessive pressure, which may go unnoticed due to the presence of neuropathy. It is also suggested that an increase in local skin temperature, resulting from tissue inflammation caused by mechanical stress, may be a precursor to a foot ulcer. Patients themselves can detect an increased local skin temperature at home by using a thermometer. If an increased skin temperature is detected, timely intervention can be undertaken by reducing activities that place pressure on the foot and/or by reducing pressure through podiatric intervention \[Bus 2021\].

Practice-oriented research

At present, it is not known for whom, when, to what extent, and with what measuring equipment temperature measurements can best be applied in practice. That is why the project: “_Implementing skin temperature measurements of the foot in the home setting within the current care process_” has been set up. Rondom is carrying out this project in collaboration with other foot and wound care organisations on behalf of the Homeland Academic Workplace.

Through brainstorming sessions with the project group, a focus group with diabetes patients and questionnaires completed by patients, podiatrists and informal carers, the requirements that the assessment tool must meet were identified. Market research was carried out based on this list of requirements. However, no existing tool was found to fully meet all the requirements. It was therefore decided to proceed with the assessment tools that at least meet the core requirements. These tools have recently been tested in podiatry practice, and the results are currently being analysed.

Would you like to read more about this research project? Read here the article about the first phase of the project.

Network partner: Academic Workplace Homeland

Rondom Podotherapeuten is a network partner of the Homeland academic workshop. The aim of this academic workshop is to establish a knowledge and research infrastructure for assistive care relating to pressure-relieving treatment in the home environment for people with diabetes and other sensory disorders who have a chronic foot ulcer or are at high risk of developing one. The ultimate aim is to achieve better assistive care at home, thereby preventing amputations, saving costs and enabling users to maintain their quality of life for longer.

Source: Bus, S. A., Aan de Stegge, W. B., van Baal, J. G., Busch-Westbroek, T. E., Nollet, F., & van Netten, J. J. (2021). Effectiveness of at-home skin temperature monitoring in reducing the incidence of foot ulcer recurrence in people with diabetes: a multicentre randomised controlled trial (DIATEMP). BMJ Open Diabetes Research & Care, 9(1), e002392. https://doi.org/10.1136/bmjdrc-2021-002392