S

saline, for wound cleansing 80 sandals 18 Sanders, Lee ix 'sausage toe' 109,127,128 scapegoating, after amputation 181 scope of problem vii-viii Scotchcastboot 69,73 screening, foot 17,35 screw fixation mid-foot arthrodesis 216 Weil shortening osteotomy 195 sensory neuropathy 9-10 sensory symptoms 2 sepsis, systemic 108-9,124 septic arteritis 144, ¡45,165, ¡67 Serratia 115,144 sesamoidectomy 192-3,194 shin spots 3 shoes advice on buying 18-19 bespoke 36,72

after total-contact casting 68 blisters related to 72,73 persuading patients to wear 38 principles of prescribing 36-7 dressing 70 half 71

from high-street shops 18,36 mail-order 18,36 modular 36 nail penetration 37,44

see also puncture wounds special 36

reasons for not wearing 38—9 refusal to wear 39 stock 36,73

principles of prescribing 36-7 temporary ready-made 36,70-1,73 types 36-7 weight-relief 70-1 silver compounds 80 simvastatin 42 sinuses diagnosis 64,65 management 128,129,185 as sign of infection 105,106 skin breakdown 3,13,62

see also ulcers colour 7 dry 3,4,9,25 examination 3-4 fissures see fissures history-taking 1-2 inflammatory disease 3-4,26-8 malignancy 26-7,98-9 temperature see temperature, foot skin grafts after surgical debridement 158-9 arterial bypass with 165,167 thermal burns 94 ulcerated foot 78

slough 63,73,161-2 small-fibre neuropathy 11 small vessel disease 141,144 smell in larva therapy 161 ulcers 64 smoking, reduction 30 social factors, major amputation 174 socks advice on buying 18 examination 10 stump 177 sodium fusidate 115,116 in cellulitis 119-20 in osteomyelitis 127 in renal failure 118,119 soft tissue infections, extensive deep 107,108 incision and drainage 187 magnetic resonance imaging 112-13,114 management 124,125,129-30,131 soft tissues gas in 103,104,109,185-6 injury, differential diagnosis 53 repair of deficits 153 spinal cord stimulation 50 Sporanox Pulse 22 squamous cell carcinoma 26-7,98 stage 1 foot see normal foot stage 2 foot see high-risk foot stage 3 foot see ulcerated foot stage 4 foot see infected foot stage 5 foot see necrotic foot stage 6 foot see unsalvageable foot staging 1,13-14 Staphylococcus aureus 115

combined with Streptococcus group B 102,103,106 deep soft tissue infection 124

methicillin-resistant see methicillin-resistant Staphylococcus aureus severe cellulitis 125,127 statins 30,42,115 Streptococcus 115 anaerobic 103-4 groupB 115

combined with Staphylococcus aureus 102,103,106 osteomyelitis 112 severe cellulitis 120,121 group F (milleri group) 115 stroke, overwhelming necrosis after 173-4 stump callus 178 fractures 178 infections 179 ischaemia 179 oedema 177,178 pain, residual 181 problems 177-9 ulceration 179 volume fluctuation 178 subungual exostosis 23 subungual haematoma 4,5,23 subungual melanoma 23,24,98-9 subungual necrosis 23

sunburn 45,46 surgery 183-219

in Charcot's osteoarthropathy see under Charcot's osteoarthropathy deformity related to previous 7 elective 184

emergency (emergent) 184 extensive deep soft tissue infections 125 goals 185

indications in infection 117,129-30 precipitating Charcot's osteoarthropathy 133 principles 184-5 procedures 185-200 prophylactic 184

see also amputations; specific procedures surgical debridement 130—3

cellulitic foot with subcutaneous necrosis 126,127,130 extensive deep soft tissue infections 113,124,125 necrotic foot 151,152-9 operative technique 132,153 postoperative care 132-3,135, 153 preoperative preparation 130-2,153 repair of tissue deficits 153 see also ray amputations; toe amputations swabs/curettings, deep ulcer 74,80-1,111 sweating excessive 28 loss of 9 swelling/oedema 5—6,9 around ulcers 64 bullae and 88

in Charcot's osteoarthropathy 52 forefoot 55 high-risk foot 44 neuropathic 5,44 stump 177,178 tight bandaging 96 Symes amputation, terminal 201-2 sympathectomy, chemical 85 sympathetic overactivity, in hypoglycaemia 30

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