DIABETIC FOOT 1-CONCEPT: It is the set of occured alterations in the foot of the carrier of DM, decurrent of neuropatias, micron and macrovasculopatias and increase of the susceptibilidade the infection, which had to the biomechanic alterations, that take the deformities. The neuropatia leads to a insensibilidade, that is, to the loss of protective sensation e, subsequently, to the deformity of the foot, with the possibility to develop an abnormal march. 2-CLASSIFICATION: ) Neuropatias b) Angiopatia c) Infections 3-FATORES OF RISK) the Alterations of sanguine circulation b) inadequate Shoes c) stuck Nails d) Calosidade e) Fictions f) Deformities (joanetes, fingers in hammer form, overlapped and in claws, proeminence of heads of the metatarsos. 4-INSPECTION MONOFILAMENT: Nine points in region plantar and one in the dorsal one must be tested. In the region plantar: 1, 3 and 5 fingers; 1, 3 and 5 metatarsianos heads; lateral regions of the half foot and in dorsal region between 1 and 2 fingers. The incapacity of the patient to feel the filament of 10 g in four or more points, enters the ten tested points the protection absence in the feet.
As to use the monofilament: It shows to the filament to the patient and wall lamp it in its hand so that it recognizes the type of stimulaton. It requests the patient to keep the closed eyes during the test. It has asked for to the patient to give attention and simply to answer ' ' sim' ' when feeling the filament. When applying the monofilament, perpendicularly keeps it to the tested surface, a distance of 1-2 cm; with a soft movement, it makes to bend over itself it on the skin and removes it. The total duration of the procedure, the contact with the skin and the removal of the monofilament, does not have to exceed two seconds? If the monofilament to slide for the side, disrespects the eventual reply of the patient and has tested local the same again later? It uses a sequence to perhaps in the test places? Having ulceradas areas, necrticas, cicatriciais or hiperceratticas, it has tested perimeter of the same one? If the patient not to answer to the application of the determined filament in one local one, continues the fortuitous sequence and comes back later to that place to confirm.