Lower Extremity Amputation Prevention

Self-Test Foot Screening

• printer-friendly Self-Test Foot Screening
• Instrucciones Para El Auto Examen

Every person who has diabetes can and should have a foot screen. The self-test foot screen was developed to be carried out by the patient or by a relative, friend or neighbor. This is the simplest screen and requires no expertise but does involve a minimal amount of training.

LEAP recommends that individuals with diabetes be screened for loss of protective sensation on an annual basis. LEAP recommends that patients who believe they have discovered a loss of sensation should see their health care provider as soon as possible.

1. Hold the red filament by the paper handle, as shown in Step1.
2. Use a smooth motion to touch the filament to the skin on your foot. Touch the filament along the side of and NOT directly on an ulcer, callous, or scar. Touch the filament to your skin for 1-2 seconds. Push hard enough to make the filament bend as shown in step
3. Touch the filament to both of your feet in the sites circled on the drawing below.
4. Place a (+) in the circle if you can feel the filament at that site and a (-) if you cannot feel the filament at that site.
5. The filament is reusable. After use, wipe with an alcohol swab.

Diabetic Foot Screen Test Sites
If you have a (-) in any circle, please take this form to your health care provider as soon as possible.

• If you are able to feel the filament in the indicated sites, there should be no risk of ulceration or subsequent deformity. You are advised only to monitor your feet on a regular basis (monthly) using the filament.
  
• If you are unable to feel the filament it indicates a need for further evaluation by a health-care professional, and for education regarding skin inspection, skin care and protective footwear in order to prevent ulceration, deformity and ultimately amputation.