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Home Monitoring of Foot Skin Temperatures to Prevent Ulceration

Discussion in 'Diabetic Foot & Wound Management' started by admin, Oct 25, 2004.

  1. admin

    admin Administrator Staff Member

    Members do not see these Ads. Sign Up.
    From the latest issue of Diabetes Care

    What say you?
  2. Byron Perrin

    Byron Perrin Member

    Home monitoring- previous research

    I haven't got in the full text yet but the results reported in the abstract are quite exciting. In my brief reading of Paul Brand's work he was one of the first to consider this in the eighties or earlier. Does anyone know why this aspect of self-monitoring has taken so long to get some interest?

  3. nina rojas

    nina rojas Welcome New Poster

    HI, during 1991 I saw Dr Michael Edmons from the Kong´s at London, using skin termometer looking for the changing of the temperature of the skin.

    It is really usuful
    Dr Nina Rojas
  4. Craig Payne

    Craig Payne Moderator

  5. Armstrong

    Armstrong Member


    I appreciate the comments regarding thermometry in the high risk diabetic foot. While there is an emerging body of evidence that this seems to be an effective surrogate marker for inflammation (and therefore pre-ulceration), most centers do not use the technology. This is mainly because of two related issues:

    1. Prevention does not yet "pay" in many parts of the world and therefore:
    2. Companies that could make these dermal thermometers concentrate on making devices that are generally used in more acute-care scenarios for which there is an established market.

    I, for one, look forward to the time when this is not the case. However, it will take administrators (rather than practitioners) with vision to change this paradigm.



    David G. Armstrong
    Professor of Surgery
    Chair of Research and Assistant Dean
    Dr. William M. Scholl College of Podiatric Medicine at
    Rosalind Franklin University of Medicine and Science

    Center for Lower Extremity Ambulatory Research (CLEAR)
    at Rosalind Franklin University of Medicine and Science
    North Chicago

  6. Tuckersm

    Tuckersm Well-Known Member

    I was intersted in why the 4 degree F was used as the temp differential to indicate a possible problem. Was it arbitory or is their some evidence behind it?
  7. Armstrong

    Armstrong Member


    This is an excellent question.

    4 degrees F (2 degrees C) was a figure that was used by the group who pioneered thermometry, led by Paul Brand. This was based largely on empiricism.

    Studies that we performed in the 1990s seemed to lend credence to the observation that 4 degrees is the lower limit of the 95% confidence interval that defines the presence of pathology (when compared to the same site on the other limb).

    It is entirely possible that data may emerge in the future to further enhance precision of this measurement.

    DG Armstrong
    Chicago, IL
  8. AALang

    AALang Member


    Do you have any idea of the cost of one of these infra red thermometers?
  9. C Bain

    C Bain Active Member


    Time for stupid question: Where can I get hold of one of these thermometers? I have been using industrial contact thermometers but not with very good results!! These cost £200 plus, granted this was bought for checking Autoclaves and hot air sterilies a few years back now, however.

    colin Bain.
  10. Tuckersm

    Tuckersm Well-Known Member

    Cost of Skin Temp Measurement Devices

    In Australia a device is available from Otto Bock, that is accurate to 0.1 degrees Celcius, at a price of A$1500. Less accurate devices are available from electronics shops starting at bout A$100
  11. johnmccall

    johnmccall Active Member


    Does anyone know where can dermal thermometers be bought in the UK ?

  12. C Bain

    C Bain Active Member

    Home Monitoring - Skin Temperatures.

    Infrared Thermometer - UK.
    I have found an address - http://www.thermometersdirect.co.uk/
    This address is for UK only, and has a whole range of thermometers for sale. I am going to try an ordinary one which seems reasonably accurate! (TN1 - GBP £21.99 - Ref.102427).

    Colin Bain.
    Last edited: Dec 21, 2004
  13. johnmccall

    johnmccall Active Member

    Thanks for that Colin!
  14. sandra.jones

    sandra.jones Member


    Hello All,
    Genius timpanic thermometers can be operated in a surface mode and may be useful in assessing skin temperature. Our Medical Physics department have recommended I try one. They are available from TYCO, 154 Fareham Road, Gosport, Hampshire, england, PO13 0AS, tel.no. 013429 224114.
    My information is that the company is currently offering 'buy one get one free' and the price is approximately #125 + VAT (that should be pounds, my key won't work for some reason!).

  15. admin

    admin Administrator Staff Member

    An article in a recent issue of Wounds, reproduced in full at Medscape (free log in needed to access) shows how intervening in the increased temperature may have in ulcer prevention:
    Temperature Modulation of Pressure Ulcer Formation: Using a Swine Model
    Full text of article
  16. C Bain

    C Bain Active Member

    Temperature Changes in the Ear!

    Hi All,

    There is an article in Yahoo! News today(19/4/5) on "........can measure tiny changes in eardrum temperature caused by an increased flow of blood to the side of the brain used to concentrate on a task............" It used an adapted hard hat to hold and position the thermometers. So feet are not the only thing using temperature evaluation as indicators to date!


    Source Sydney (Reuters). Nicolas Cherbium, (Australian National University) a quoted source!

    I wonder whether any one has any results from the use of Infrared Thermometers to date on the feet. I have watched a small number of my Diabetics' feet improve as I observed the same on the Thermometer! In some cases their general health improved and I have been able to almost predict the reading of temperature ratio drop before taking the reading! I do not have enough patients to say that these observations are anything more than anecdotal to date, however?

    Anyone else tried the 'RATIO SYSTEM' out on the feet with Infrared Thermometers?



    P.S. The hard hat wont go over the Right Hallux!
    Last edited: Apr 20, 2005
  17. C Bain

    C Bain Active Member

    Unexpected Side-effect in the Taking of Foot Temperatures!?

    Hi All,

    The use of the Infra-red Thermometer has had a very unexpected side effect on my diabetic and poor circulation patients! Firstly, however, I have as a point of interest standardized my readings on the following Complex Number format:- Rxdeg.Cent./TD/ydeg.Cent.L where some are obvious, and some not so obvious! The Format being similar to a out of Phase Complex-number, [Old 'J'-notation Electrical Engineering or 'i' if you are pure maths.!].

    Briefly the Complex-number has the following Elements,

    R = Rightfoot.

    xdeg.C. = Right temperature in Centigrade variable with time.

    // = Separators dividing the three parts of the Complex-number.

    TD. = Temperature difference of Right and Left.

    ydeg.C. = Left temperature in Centigrade variable with time.

    L = Leftfoot.

    I have standardized on this Complex-number because it helps me when I am with my patients to automatically record their temperatures and monitor them from month/six weeks to month/six weeks!

    Obviously as time goes by result are plotted to help pick out variants and improvements or deterioration! The magic numbers 2.0 to 2.0Plus for TD. signal that I should be looking again carefully and closely at the patient to see if there is anything new or different about him/her to cause the high result!
    Do I pay the patient an early visit or have him/her checked out with doctor/nurse/support team if diabetic?
    The numbers 1.0 to zero denotes balance in foot circulation? Achievable? And at this stage in the experiment, what does it mean, does it matter?

    The Complex-number is recorded at the time on the patient's Medical Record and immediately afterwards in the Medical Diary!

    The very,very interesting side effect of this simple double temperature measurement has been almost without fail for both men and women,

    1. A steady calming effect on their demeanour, more so than usual before normal chiropody is started!

    2. A gratuities attitude developed towards me, possibly, "You know I think he actually does care!"

    3. Being thanked even when I have shown concern over reading and advised the patient to talk to her G.P./Health Professional.

    I have come to the conclusion that this can only be a modern day 'Placebo Effect' working to the general good of the patient!

    I do hope that something positive may come out of these readings through experimentation here and elsewhere otherwise I may become an expert in Placebo and judging from what happen in the previous Thread on this I might have to arrest myself! The Placebo Effect appears to be part of the treatment rather than just experimental recording of temperature variants!



    P.S. By the way I have picked as standard an area approx. 2.54cms. in from the dorsum lateral side of the foot and up 2.54cms. from the 4th. M.P.J. over the 4th. Dorsal M.P.J. Artery area! Picked as the possible furthest point away from the Heart!

    P.P.S. Another question to be considered is if the Placebo Effect is calming the patient down will the temperature vary accordingly in the readings???
    I know from my own experience when the nurse advances towards me with a hypodermic syringe, my blood pressure automatically goes up. Heat raised for fight or flight!!! (It's called fear!!! The opposite to what the patient is experiencing here I hope, or is she?).
  18. C Bain

    C Bain Active Member

    Cooling the Foot?

    Hi All,

    'Cooling the Foot to Prevent Diabetic Foot Wound.' by Admin. in this Forum.

    This should I believe be read as a point of interest and possible application with this Thread,(Posting)??? What do you think?


  19. lancar

    lancar Welcome New Poster

    Dear All!

    Has anyone of you heard about the Swedish SpectraSole Indicator. It obviously consists of two heat sensitive plates in an insulating binder. It gives instant colour images of the heat distribution in each foot. If there are temperature differences between left and right foot, they will be immediately visible.

    Please see www.spectrasole.com for more information.

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