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Pre-operative Assessment of the Diabetic

Discussion in 'Diabetic Foot & Wound Management' started by JaY, May 10, 2010.

  1. JaY

    JaY Active Member


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    I am trying to devise a screening/assessment protocol for diabetic patients before they undergo nail surgery. Please feel free to give me ideas of what I should be testing before I undertake this kind of surgery on my diabetic patients. e.g. HbA1C, random blood glucose, etc... If you can, please provide a reference with your idea.
     
  2. Gibby

    Gibby Active Member

    I'd suggest something like we use here, which is based on what I learned in school and in residency. Base the evaluation on the 4 basic areas- vascular, neurologic, orthopedic, dermatologic. For simple nail procedures, a basic assessment of vascular status is always needed. Because our clinic is part of a major medical school training program, we always have lots of pre-operative testing, labs, x-rays, etc.... but in private practice, I don't really order very much. A wise older doc once taught me, "do not order any tests unless you are prepared and trained to act on them or correct them." If someone has markedly elevated A1C, for example, I do not change their insulin regimen, but refer them directly to the endocrinologist.... Best of luck.
    -John
     
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