Foot and Ankle Disorders

The aim of this observational study is to: (1) describe current knowledge and practices related to foot care in care homes; (2) understand how care home staff, residents and/or family caregivers perceive foot care knowledge and practices. For the first study, the investigators are conducting a survey, and this will involve recruiting care staff working in care homes, managers of care homes, and staff in regular contact with care home residents (e.g. clinicians). The second study will involve interviews with care home staff (carers, care home managers and health professionals) and care home residents and/or their family representative.

Surgical site infections (SSIs) make about 31% of all nosocomial infections and they are the most common hospital-acquired infection. For foot and ankle elective interventions, SSI rate is reported between 0.4% and 3.6%. This study will investigate the effectiveness of skin cleaning with isopropyl alcohol and scrubbing with chlorhexidine soap before standard skin preparation in reducing microbial load and surgical site infections for elective foot and ankle surgeries. Current standard of care includes skin preparation with iodine or chlorhexidine solution prior to sterile draping and the start of surgery. Standard of care will be applied to all patients. The use of an additional "pre-scrub" with isopropyl alcohol and scrubbing with chlorhexidine soap will be applied to the experimental group. The control group will receive only the standard of care skin preparation with iodine or chlorhexidine solution prior to draping.