Making great strides

11 March 2016

Making-great-stridesWhether it’s a bad bunion, nail infection, heel pain or you’re suffering from the complications of diabetes, Kent Community Health NHS Trust’s (KCHT) Podiatry Team is at the top of its game for solving your foot care problems.

Our surgery

With her headphones firmly in place and an episode of Homes Under the Hammer on the telly, it was almost possible for landlady Christine Watson to believe she was relaxing at home.

But the 64-year-old was about to go under the knife of Jonathan Larholt, a highly-skilled podiatric surgeon with Kent Community Health NHS Trust, who was correcting a painful bunion on her left foot.

And Christine wasn’t in one of our major hospitals, but just minutes from her home in the spotless £1.5 million Day Surgery Unit at the Queen Victoria Memorial Hospital in Herne Bay.

The eight-bed unit opened four years ago and is staffed by the trusted, 10-strong community theatre team which perform a range of corrective surgery for conditions such as bunions, hammer toes and other foot and toe deformities.

Unable to wear shoes because of the pain, Christine had been slipping on a pair of flip-slips behind the bar of the Huntsman and Horn, in Broomfield, for the past two years until her GP referred her to KCHT’s Podiatry Service.
But just over an hour after the op, Christine was back with her husband Eddie at her side, bunion removed and a cast
protecting her foot.

She said: “It was absolutely fantastic; first class and all on my doorstep. I had no idea you could have surgery here.
I arrived at 8.15am, was in theatre by 10am and I’ll be home by lunchtime.

“I admit I was a bit nervous at first, but the team put me at ease. The telly was great because I didn’t want to watch
or hear what was happening.

“I have to come back in two weeks to have the cast removed, but I would definitely consider having the other bunion removed too.”

While a general anaesthetic isn’t necessary for these procedures, by the end of the year an anaesthetist will be joining
the team for patients who would prefer to be sedated during the operations.

Our clinics

Retired bus driver Jim Davey has been coming to the podiatry clinic in Herne Bay for the past five years as he suffers from poor circulation.

The 72-year-old granddad, who started smoking at the age of 12, has had seven toes amputated because of the habit. Smoking is harmful to the blood circulation to your feet and can result in poor blood flow and parts of the foot dying.

Each week, Jim visits podiatrist Caroline Du Toit, Clinical Lead for Minor Surgery and Physical Therapies, or other colleagues from the Podiatry Team, who have all had three years degree-level training.

The Kent-wide team specialises in all aspects of foot health, from common foot problems such as in-growing nails and nail deformities, corns and calluses to more complicated conditions resulting from the complications of diabetes, peripheral vascular disease and all forms of arthritis.

The team treats both children and adults.

Podiatry is offered at 49 locations across Kent. Patients can self-refer, ask their GP or healthcare professional for a referral, or use the Choose and Book system (www.chooseandbook.nhs.uk).

At the first appointment, the team will assess and diagnose the condition and then put together a treatment plan,
which can include exercise, advice on changes to footwear or tips on how to care for their feet.

For some people, the assessment may include having insoles, to support the foot and help reduce pain or to
correct gait. For Jim, it means Caroline cutting away the bad tissue from his feet and applying a wound dressing to clean and treat any ulcers; preventing infection and attempting to reduce the likelihood of further amputations.

Caroline said: “Smoking, like diabetes, can limit the blood supply to your feet and cause a loss of feeling. This can mean foot injuries do not heal well, and the lack of feeling means you may not notice if your foot is sore or injured.”

Head of Service, Cathy Bellman, said: “In an average lifetime, a person will walk about two-and-a-half times around the
world – so we put our feet under great stress, which can result in numerous debilitating complications.

“Our aim is to maintain mobility, alleviate pain and reduce the risk of infection and ulceration. For patients with high-risk medical complaints or complex foot problems, this can mean acting quickly to prevent amputation.

“We also hold specialist biomechanical clinics where we can analyse the way people walk or run by using pressure monitors or a treadmill. Doing this enables us to study any abnormal movement and assess the effectiveness of insoles.”

It’s this clinic that has helped eight-year-old Lola, who has Beck Wiedemann Syndrome, which was diagnosed at birth.
Mum Marie explained: “Basically it means her left side of her body is bigger than the right. At the moment, her left leg
is six centimetres longer than the right, so walking is a problem. She has to have a raised shoe and an orthotic in the shoe to help her.

“It’s an unusual condition and what I have been most impressed by is the team’s determination to try different treatment optionsm until they’ve got it right for her. She’s more comfortable now.”

Our LAB – Innovation in the world of orthotics (that’s insoles to you and me)

KCHT’s orthotics laboratory, hidden away inside the Queen Victoria Memorial Hospital in Herne Bay, produces more than 6,500 insoles, padding and arch supports giving pain relief to thousands of patients across Kent.

Insoles (or orthotics) are placed into a patient’sshoe to re-align their foot, take pressure off vulnerable areas or to help the problems experienced by children during development.

Podiatry Technician Rob Solliey explained: “Diabetic patients, for example, can often end up with very deformed feet; something called a Charcot foot.

Walking on this deformed foot, can eventually cause an ulcer and, if this goes unchecked, may lead to amputation. But we can create an insole to increase the weight bearing areas of their feet and help reduce pressure sores and stop that
happening.”

The present technology uses the latest computer assisted design and technology for producing insoles. However, for the past year, housed in a drawer marked top secret, is the result of a year’s research. The service has “patent pending” for cutting-edge insoles made using 3D printing.

The technique will replace most existing traditional methods of making insoles, be more efficient and accurate and result in a better outcome for patients.

Jit Olk, Production Improvement and Development Manager, explained: “This method not only saves money but reduces the steps in the process meaning the insoles are much quicker to produce.

“The accuracy of 3D printing means that we can detail down to 14 micron, which is not something we can do with
current techniques. There is no waste and the beauty of this for patients is if they need a replica insole, we can simply print a new one.”

The new technique will mean even better insoles for patients and create a finished product, Branded Stride, (UK Patent Application No 1221135.5). The team hopes to be using the new technique within a year.

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