Soaking Before Foot & Nail Care
Foot soaking before the care of feet and nails is common. So common, in fact, that most patients expect it. For many, the soaking part of the foot care routine is a time to feel cared for and pampered, an unfortunately rare occurrence for many elderly with foot problems and diabetic patients. However, while the soaking may feel like a treat, it can open a door to various serious issues. Among these are the dangers of infection, hypothermia, and falls. While the temperature of water used for soaks is typically low enough to prevent burns, it can still cause significant discomfort or pain to those with nerve damage. Additionally, elderly patients are at an increased risk of falling when getting in or out of the tub. For diabetic patients, soaking can cause problems by drying out the skin and nails, making them more susceptible to fungal infections. Finally, while patients may think that soaking will help to clean their feet, it can actually do more harm than good by washing away essential oils and leaving the skin vulnerable to bacteria and fungus. As a result, it is important to weigh the risks and benefits of foot soaks before including them in your foot care routine.
Infection
When it comes to foot care, infection control is always a top priority. One of the most common ways to clean and disinfect feet is through soaking in a tub or container. However, this method can actually increase the risk of infection if proper guidelines are not followed.
First and foremost, it is important to make sure that any container used for soaking is properly disinfected between each treatment. This can be difficult to do when disinfection soak times are typically
10 minutes, as recommended by most EPA-registered disinfectant products. In addition, if a disposable plastic barrier is not used to prevent direct contact with the container, there is a risk of prolonged wet disinfection, which can also lead to infection. For these reasons, it is best to avoid foot soaking as part of your foot care routine.
Injury Risk
When a patient leaves your healthcare facility, you want them to have a positive experience that will encourage them to return in the future. Unfortunately, if you aren't careful, you could inadvertently put your patients at risk by teaching them bad habits. For example, many patients enjoy soaking their feet and will often continue this practice at home. However, elderly foot care at home without proper instruction could result in injury. Inexperienced patients may soak for too long or use chemicals that are harmful to their skin. Those with diabetic neuropathy in their feet might not be able to properly gauge the temperature of the water and could burn themselves.
Additionally, soaking at home carries the risk for infection because proper disinfection of the container may not have occurred. As a healthcare professional, it's important to be mindful of the example you are setting for your patients. By taking care to provide clear and concise instructions, you can help ensure that they stay safe and healthy, both inside and outside of your facility.
Debridement
Although soaking the feet has been a traditional approach to foot care treatment, it is of no benefit; in fact, it can lead to
maceration and worsening infection. Even during normal debridement, it can be difficult for a foot care nurse to differentiate between the callus and normal skin, because as layers of the callus are removed, softer skin is continually exposed. It takes a few minutes before the newly exposed soft skin hardens again, but if the foot has been soaked, even callused skin remains soft, making it nearly impossible to differentiate between tissue planes. This can lead to unnecessary removal of healthy tissue and an increased risk of infection. In addition, soaking can actually cause the callus to become larger and thicker by causing the accumulation of additional dead skin cells.
Dry Skin
When cleansing the feet, it is important to avoid prolonged exposure to soaps and water, as this can strip vital oils from the skin and disrupt its delicate pH balance. Many patients will already be suffering from sensitive, dry, or thinning skin, so it is not advisable to soak the feet in water. Instead, wash them unsubmerged with soap and water, then rinse. Advise your patients to use a gentle soap such as Dove at home; this soap has been designed to restore skin's pH balance. This will help to keep the feet healthy and prevent further problems.
Patients who have been soaking their feet regularly may be hesitant to give up this habitual activity. Soaking feet has likely become a part of their routine with you, their foot care specialist, and provides them pampering they might not otherwise receive. However, it is important to wean patients off of soaking and convert them to a healthier alternative for several reasons. First, soaking increases the risk of infection. Second, soaking has a drying effect on the skin, which can lead to cracking and other problems. Third, conveying your concern about their health is an important part of providing quality care. Finally, offering patients an alternative to soaking will show that you are invested in their well-being. By following these steps, you can help your patients make the transition to a healthier foot care routine.
Foot Soaking Alternative
Alternative treatments such as cold therapy, massage, and stretching exercises are often recommended. Cold therapy helps to reduce inflammation and pain by constricting blood vessels and numbing the nerves. A moisturizing lotion massage can also help to relieve pain by improving circulation while breaking up knots of tension. Finally, stretching exercises help to lengthen the muscles and improve range of motion. While these alternatives may not be as relaxing as a warm foot soak, they are much safer for diabetics and elderly patients.
Directed by
Podiatric Physician
Wound Care
High Risk Foot