SUGAR

Issue 1/2014 

FUSSPFLEGE 

AKTUELL 

The 

magazine 

for the practice 

SUGAR 

AND ITS CONSEQUENCES 

New knowledge on the treatment 

and prevention of diabetic foot 

istockphto | domin_domin 

Technology CURRENT 

NEW: Treatment chair MYA 2 - practice 

equipment with back training 

Medicine CURRENT 

GEHWOL Diabetes Report 2014: 

Little awareness of risk 

Practice CURRENT 

Health Report Diabetes 2014: 

Update on Diabetic Foot Syndrome

Contents 

New Year‘s Greetings............................... 3 

Product offer 

Annual listing for 2014 

GEHWOL‘s yearly product range 

Innovations to the fourth 

power for your success....................... 4–5 

As if in cotton 

Disinfectants - 

stock up now and save!.......................... 6 

Technology offer 

Blub blub 

The power of tiny bubbles: 

ELMASONIC S podo basic ..................... 7 

Practice equipment with back training 

EUROCLINIC treatment chair MYA 2 

with foot care cabinet JUPITER 

DUOMATIC S 2 or S 2 MINI............ 8–12 

Instrument offer 

The perfect twist 

Scalpel handle BB063R from 

GERLACH TECHNIK ............................ 13 

Expert knowledge CURRENT 

Innumerable causes 

Nails with a yellowish discolouration.... 14 

Collecting fungi? 

Foot fungus prevention 

is still important.................................... 15 


A healthy state 

Guest contribution by 

Dr. med. Renate Wolansky on 

the subject of diabetes.................... 16–17 


GEHWOL Diabetes Report 2014.... 18 –19 

Ware knowledge CURRENT 

Lasting joy 

Tips on instrument care........................ 20 

Long-lived cushions 

Material properties............................... 21 

Care consultation CURRENT 

“Yes, you can“ 

An outlined consultation on 

the subject of corns............................... 22 

Recommendation wanted 

Consulting expertise ............................. 23 


Health Report Diabetes 2014 

Update on Diabetic Foot Syndrome....... 24 

From outlandish to calculable 

Beauty trends............................................. 25 

Marketing CURRENT 

Emotion sells 

Customer satisfaction............................... 30 

Practice equipment with back training 


Health Report Diabetes 2014 

10 + 2 = more profits 

Better back relief, more patient comfort, greater 

efficiency with faster, functionally supported 

work. That‘s what the new treatment chair MYA 2 

offers, also in combination with the highly 

proven cabinet and device unit JUPITER 

DUOMATIC - an attractive perspective. 

Page 8–12 

The new scalpel handle BB063R in the product range 

of GERLACH TECHNIK sets new standards in scalpel 

technology. The indentations offer the foot care pro a 

perfect grip. The round handle of the blade holder makes 

it especially easy and secure to guide, and easy to turn 

with the fingers. This is also confirmed by users who use 

the new scalpel holder in their practice. 

Page 13 

Despite dropping numbers of major amputations, the 

risk of an amputation is still about 20 times higher in 

persons who have diabetes. This warning was issued 

by the recently published German Health Report on 

Diabetes 2014. FUSSPFLEGE AKTUELL summarises 

the most important results for you. 

Page 24 

With special GEHWOL offers, you often profit from 

buying rebates on care products. Even with regular 

orders, you receive a natural rebate of 20 percent 

for each unit of 12 items. As a foot care pro, you 

can use this in your daily product sales to increase 

profits. You have several options here. 

Page 31 

Imprint 

Please order via the publisher 

Publisher: FUSSPFLEGE AKTUELL is published on behalf of Eduard Gerlach GmbH, Bäckerstraße 4–8, 32312 Lübbecke, 

Telephone: 05741 330-0, Fax: 05741 347300, E-Mail: info@gehwol.de, Internet: www.gehwol.de 

Editing staff and publisher: Dorothea Küsters Life Science Communications GmbH, Leimenrode 29, 60322 Frankfurt am Main, 

Telephone: 069 61998-0, Telefax: 069 61998-10, E-Mail: info@dkcommunications.de, Internet: www.dkcommunications.de; 

Editorial management: Dorothea Küsters (responsible), Dirk Fischer; Editing staff: Stefan Dudzinski-Lange, Stefan Dietrich, 

Jana Zieseniß 

Graphic concept and implementation: PUNKTUM Werbeagentur GmbH, Bad Vilbel 

All rights reserved. Reprints, also in excerpts, are only permitted with the approval of the publisher and citing sources. 

Rights of translation and other uses reserved. We assume no liability for unsolicited manuscripts, discussion copies etc.. 

If FUSSPFLEGE AKTUELL cannot be published or supplied, this shall not result in legal claims against the publisher. 

Legal venue: Frankfurt am Main. 

2 

FUSSPFLEGE AKTUELL 1/2014

Editorial 

Shoulder to shoulder 

Dear foot care pros, 

the dictum about the consistency of change 

is surely often true. But what the service 

branch around foot care health is currently 

experiencing will surely take your breath 

away. Past years were and are marked by 

massive change, whether it is due to the 

continuously stricter hygiene requirements 

or the constant effort to render this occupation 

more professional at a new level. 

With all changes, there is a need for stable 

anchors which reliably guide the way 

to the future; partners who think in a 

needs-oriented manner and support foot 

specialists in their daily work. And there‘s 

more: We have to stand shoulder to shoulder 

with you because your everyday work 

must constantly become more efficient to 

secure sales and income. Here‘s the 

example of practice equipment: The credo 

“Few can afford the cheap“ applies. Hygiene 

and products - in all of these fields, the 

quality of the utilised devices, materials, 

instruments and furnishings in particular 

pays off. 

You are not alone 

In line with our tradition, we see ourselves 

as being bound to quality. Among other 

things, ergonomics, value, solidity and 

efficiency are criteria for product development 

and when searching for 

suppliers. But product quality 

also means that we won‘t 

leave you after the sale. 

Our field services are 

available to you as a 

reliable contact, as 

always, and often 

provide more than 

many would think: 

They pass on experiences, 

structure and 

set-up, support in 

encouraging sales, hygiene 

regulations and especially 

provide consulting services. 

Furthermore, foot care chairs, 

cabinets and devices can be viewed 

and tested in the show rooms. 

Shoulder to shoulder also means that you 

can offer your customers a unique product 

series such as GEHWOL FUSSKRAFT. Aside 

from their exclusive availability, their 

special feature lies in their value. As a foot 

care pro, you are working with professional 

products and can always advise your 

customers with an orientation of solving 

their problems. And the foot care customers 

has a chance to take the same products 

home which are used by professional foot 

care pros. Exclusivity therefore comes from 

the experience and expertise which only 

you can give your customers for our 

products. 

Needs met 

With the expansion of the FUSSKRAFT 

product range and the innovative Soft Feet 

line, Gerlach also takes changing customer 

wishes into account. Both the GEHWOL 

FUSSKRAFT Soft Feet Cream and the new 

GEHWOL FUSSKRAFT Soft Feet Scrub 

combine modern ingredients with a 

pleasant scent without leaving the quality 

claim behind. The Soft Feet series is the 

result of a clearly increasing spa orientation 

of foot care practices. 

This trend is unbroken. In particular, 

younger target groups also understand 

now more than ever that beautiful 

feet must also be healthy feet. 

Consequently, more than 

before, there is now a 

willingness to invest 

more into care. Since 

the Soft Feet products 

meet precisely this 

need, we would like 

to let you know here 

that there will be 

another new product 

in the innovative Soft 

Feet line in the year 2014. 

The results of the Beauty Forum 

Award show that we are on the right 

path with the qualitative expansion of our 

product range. Since the competition 

Jobst-Peter Gerlach-von Waldthausen 

which was held by the expert journal 

Beauty Forum, Eduard Gerlach GmbH has 

been Number One for many years in the 

section of “Best Complete Provider“. The 

Readers‘ Choice Award 2013/2014 of the 

same medium, in which 22,000 readers 

make the decision as a jury and which has 

alternated yearly with the Beauty Forum 

Award, impressively confirmed this again 

by choosing the treatment unit AT/NT 

Clean from GERLACH TECHNIK for first 

place. 

In this sense, we wish you a successful year 

in 2014! 

Yours, Eduard Gerlach GmbH 

FUSSPFLEGE AKTUELL 1/2014 

3

Products CURRENT 

GEHWOL‘s yearly product range 

Innovations to the fourth 

power for your success 

Customer wishes and technical options change constantly. This also affects the foot care market. With 

GEHWOL products, you can continuously present innovations to your customers. In this way, you ensure 

that your professional work can also be optimally supported at home. In the innovations by GEHWOL, 

new developments such as the Soft Feet line and advances in product design and packaging interact 

as perfectly as a transmission. To give your 2014 sales year the right drive as well, four attractive offer 

packages await you. 

Modern communications for an 

innovative product line 

The Soft Feet product line is a total success - and not just in foot care practices. 

Positive comments are also piling up on the internet. This is ensured by 

GEHWOL‘s modern communication methods for the market introduction of 

the Soft Feet Cream and Scrub. What makes more sense than having the 

innovations tested by internet users who are interested in beauty 

and care, and talk to others about it? This is why we founded 

the GEHWOL testers‘ club (www.fussvital.info/Testerclub). 

Elina, for instance, reaches the conclusion in the test 

report on her internet blog that she can recommend 

both products based on their care performance. 

She also praises the practical 

flap closure of the scrub tube, 

which can be used easily even 

with wet hands, unlike a can. 

The online communications are 

flanked by a dedicated Facebook 

page (www.facebook.com/softfeet) 

on which more than 1000 internet 

users show their sympathy for the 

products with a “Like“. A microsite 

(www.fussvital.info/softfeet) also 

bundles all test reports published 

on the internet in addition to information 

about the Soft Feet 

products. In this way, the more 

than 120 members of the exclusive 

GEHWOL tester club become 

brand name messengers and ensure 

your sales success as a foot care 

pro - just like classic forms of 

advertising. 

4 


Products CURRENT 

fotolia | djama 

Disinfectants 

As if in cotton 

Just as water leaves traces on ceramics or 

aluminium over long periods, disinfectants 

also act on materials, especially if they are 

aggressive. For gentle disinfection of instruments 

and surfaces, you should therefore 

use products which were tested for their 

material tolerability, such as Microbac forte 

for surfaces or the Korsolex drill bath for 

disinfecting instruments. The surface 

disinfectant cleaner Microbac was tested on 

numerous surface materials, among them: 

Stainless steel, aluminium, copper, brass, 

rubber, latex, Teflon, Vivak and some other 

synthetics. In general, material damage 

does not occur with proper use. 

Gentle use of utilised instruments and 

surfaces in the foot care practice is an 

economic matter, but also influences the 

overall perception. In times of greater 

hygiene awareness, among other things 

due to publicly discussed subjects such as 

MRSAs and antibiotic resistance, the 

hygiene status of a practice also plays an 

increasing role in customer relations, and 

therefore for the image of the foot care 

institution. And good customer relations 

with always satisfied loyal customers is 

part of the prerequisites for commercial 

success. So hygiene is doubly worth it. 

Make it simple 

It‘s natural to integrate hygiene into 

daily work processes. But hectic periods, 

stress and lack of time often make you 

want to say to yourself: “I‘ll do it 

tomorrow.“ But then it ends up not 

being done. These five tips are intended 

to help you master everyday hygiene 

more easily: 

Post the hygiene plan in the practice 

in a central, easily visible location. 

Don‘t postpone disinfection, even 

if the next customer has to wait five 

minutes. 

Our offer 

Instrument disinfection 

Korsolex drill bath Cleaning and disinfectant agent for rotary instruments, 

VAH listed 

2,000 ml 

Surface disinfection 

Microbac forte Wiping disinfection, aldehyde-free, VAH listed 

25 units, 20 ml each 

Skin and hand disinfection 

Sterillium classic pure Refatting, gentle on the skin, 

for rubbing on hands and skin, free of colourants and scents, RKI listed 

100 ml 500 ml 1,000 ml 5,000 ml 

Use the right product for the applicable 

cleaning and disinfection steps. 

Ensure that the disinfectants are gentle 

on the materials. 

Avoid hasty disinfection, and note the 

manufacturer‘s recommendations for 

use. 

If you have employees, ensure that 

everyone complies with all applicable 

hygiene standards. 

Wound disinfection 

Cutasept F Skin disinfectant with defatting cleansing effect, RKI listed 

50 ml 250 ml 1,000 ml 

5 



ELMASONIC S podo basic 

Foto: Philips 

The power of tiny bubbles 

Blub blub 

Hygiene is the alpha and omega in a foot care practice. This also includes 

cleaning and disinfection of instruments after they are used in treatments. 

Machine support simplifies everyday practice work and ensures more 

thorough cleaning results. The power is in tiny bubbles. The magic word of 

the ELMASONIC S podo basic is: Ultrasound. 

Electrical toothbrushes bring water into 

strong motion: tiny bubbles are formed and 

wildly moved about. While it is nonetheless 

the mechanical motion of the brushes 

which leads to the cleaning effect on the 

teeth in the so called “sound“ toothbrushes, 

the new ultrasound toothbrushes use the 

same gentle effect as in ultrasound cleaning 

devices. The ELMASONIC S podo basic 

also utilises this technology, which is gentle 

on materials. 

Magic word “Ultrasound“ 

Ultrasound forms tiny hollows in the liquid 

which are also formed between the dirt 

and the instrument. These so called cavitation 

bubbles are very unstable and rapidly 

collapse - i.e. implode. In the process, they 

simply burst the dirt away from the instrument 

surface. This results in clean small parts, 

grinders and polishers. 

Natural in the practice 

Foot care pros and podologists profit from 

machine support by an ultrasound cleaner 

in everyday work. The ELMASONIC S podo 

basic with its fill volume of 0.8 litres is 

especially suitable for small practices, or 

when only a few instruments need to be 

cleaned every day. It finds space in every 

practice, saves costs for consumables, 

is immediately ready for operation, and 

provides optimal cleaning results. 

Secure the offer for yourself now! 

The basic equipment of the ELMASONIC S 

podo basic includes a cover which also 

reduces operating noise and serves as a 

drip base for the stainless steel basket, 

which is included in the scope of delivery 

during the campaign. The basket makes it 

possible to insert and remove instruments 

without reaching into the liquid. The 

ELMASONIC also comes with tweezers 

and two cups for small parts. The scope of 

delivery is also available at the special 

Our offer 

price of 187.50 Euros in the current offer. 

You secure a six percent discount for 

yourself as compared to the regular price 

of 199.00 Euros, and will soon profit from 

the helpful power unit in your practice. 

ELMASONIC S podo basic 

including 

stainless steel basket, 

tweezers, plastic cover 

and two small parts cups 

Fulfilling claims 

This is also the hope of the general hygiene 

plan which is determining for foot care pros 

and podologists. Therefore, machine cleaning 

and disinfection is always preferable. The 

advantages are also obvious for the practice: 

While the unit performs cleaning and 

disinfection, foot care pros and podologists 

can do their actual work. Machine processing 

also protects personnel from injuries, skin 

damage and sensitisation to sometimes 

high dosed disinfectants. Surrounding 

areas are also better protected, since, for 

instance, no liquids can spray out of the 

unit. 


6


NEW: EUROCLINIC treatment chair MYA 2 with foot care cabinet JUPITER DUOMATIC S 2 or S 2 MINI with 

Practice equipment with 

Have you ever thought about re-equipping your practice more ergonomically? Better back relief, more 

patient comfort, greater efficiency with faster, functionally supported work. If yes, that‘s what the new treatment 

chair MYA 2 offers, also in combination with the highly proven cabinet and device unit JUPITER DUOMATIC 

(with suction and spray technology) - an attractive perspective. 

According to the DAK Health Report 2013, 

muscle and skeletal disorders in 2012 

amounted to a share of 23.2 percent of 

cases of being absent from work due to 

illness, and held first place in the ranking 

of absences. Back pain in particular 

currently dominates the complaints and is 

the second most common reason for early 

pensioning. In everyday work, which often 

involves a lot of sitting, impairments of the 

locomotor and support apparatus are 

usually due to wrongly applied strain. This 

is further underlined by a general lack of 

exercise, which, however, is necessary for 

functional training of joints and ligaments 

as well as muscles. 

Relief for foot care pros 

Avoid wrongly applied strain, increase 

orthopaedically sensible room for movement 

- that‘s the principle of ergonomics, 

which accompanies the development of 

equipment for everyday work since more 

than 45 years as an interdisciplinary scientific 

discipline. Since 1969, GERLACH TECHNIK 

has accompanied your everyday working 

life and followed this principle when 

developing cabinets, patient chairs and 

work chairs. It‘s always about a technological 

vision in which functional designs not only 

increase work efficiency, but also provide 

more and more physical relief to foot care 

pros. 

Pending makes your work 

chair a movement therapist! 

Read more about this on page 12. 

7 



additional cabinet 

back training 

NEVER BEFORE! 

Included FREE! 

Pending work chair at your option! 


8


Variant 1 

Foot care cabinet 

JUPITER DUOMATIC S 2 

In this variant, the proven foot care cabinet which 

is especially comfortable due to its generous space 

division combines high performance spray and suction 

technology in an ergonomically sophisticated cabinet 

and device unit which is further improved by a high 

shine Polygloss surface. Among other things, the 

ergonomic advantage lies in the construction of the 

four spacious drawers, of which one serves as a UV 

compartment to maintain hygiene. The drawers quietly 

open and close on roller guided full pull-outs; noise 

is further reduced by the automatic dampening 

system. A small push is enough to close them. Little 

effort is required to open them. Even when sitting 

upright, you can reach the cabinet compartments 

quickly and easily. This is ensured by continuous grip 

bars. 

Variant 2 


JUPITER DUOMATIC S 2 MINI 

with additional cabinet 

Optimal use of a small amount of available standing 

space - that‘s the strength of the MINI variant. The 

device unit and separate additional cabinet can be 

positioned independently of each other. This saves 

space and offers the option of grouping both elements 

so that they are easily accessible even without 

bending your back. 

Our offer 

EUROCLINIC treatment chair MYA 2 - also with 


JUPITER DUOMATIC S 2 

combined cabinet and device unit 


JUPITER DUOMATIC S 2 MINI 

Device cabinet with additional cabinet 

Rates plus Value Added Tax / Financing: 36 months without down payment, 2.8% 

effective annual interest / offer valid until 31 March 2014. 

9 



EUROCLINIC treatment chair MYA 2 

MYA 2 is the new one, and its origins are 

Italian, which is immediately obvious. The 

EUROCLINIC manufacturer originates 

from the Northern Italian region of Emilia- 

Romagna, just like Ferrari. And similarly to 

the world famous luxury sports car manufacturer, 

the developer of treatment chairs 

is also internationally renowned for his 

claim of offering modern industry designs 

with high quality materials and technical 

finesse for more efficient, pleasant work to 

select partners in the world market. 

GERLACH TECHNIK is the exclusive foot 

care partner in Germany. 

The new one has a lot to offer - at a fair 

price. The ergonomic highlight is the 

enormous range between the minimum 

and maximum foot height, which can be 

adjusted over up to 139 cm with the aid of 

the electronically guided seat incline, seat 

height, and pull-out leg rests. The chair also 

rotates by 175 degrees in each direction. 

The precise position of the foot can therefore 

be adjusted with a lot of flexibility. In 

ergonomic terms, this means that you can 

always operate your instruments while 

sitting upright with a straight back, and 

work in a relaxed manner. 

All advantages at a glance 

Cushion colours 

Also comfortable when lying 

down: The folding arm rests are 

cushioned on both sides. 

Multi-zone cushion foam for the 

greatest patient comfort 

Oval additional cushions to support 

the head and lumbar spine 

Minimum seat height: 54 cm 

Maximum seat height: 89 cm 

Seat incline adjustment: up to 36 

degrees 

Incline adjustment of the back rest: 

95 to 180 degrees 

Chair rotates by: 175 degrees 

(to both sides) 

Leg rests fold and can swing to 

either side (45 degrees each) 

Pull-out leg rests: 41–62 cm 

maximum strain (lift): 200 kg 

Seat height and incline 

electromechanically adjustable 

53 cm (seat width) x 49 cm 

(seat depth), empty weight: 95 kg 

The foot switch remotely controls 

the chair - including two elective 

positions and a home function 


10


Work chairs with the Pending system are a revolution in the field of work 

economics. GERLACH TECHNOLOGY‘s product range includes three high 

quality chair with these “mobile“ mechanics. A Pending chair of your choice 

is now available as a free addition to any ordered practice equipment with the 

MYA treatment chair and the JUPITER treatment unit. 

Pending: the silent movement therapist 

Free-swinging seat surface encourages fatigue-free sitting 

In a work chair with the Pending system, 

the seat surface is freely suspended - that 

is, it can move to all sides within limits. 

The fine micromovements of the seat 

surface are driven by body vibrations 

which are due to respiration and muscle 

reflexes. A total of eight pendulums which 

are concealed in a module box inside the 

chair (see diagram) pick up these impulses 

and transfer them to the seat surface as 

resonance vibrations. The body must 

continuously equalise these vibrations, 

unnoticeably training the support apparatus. 

The worldwide patented Pending system 

can even correct chronic malpositions in a 

short time. The entire support and locomotor 

apparatus is relieved, lessening back pain. 

Aside from the pendulums, the module 

box contains a special weight equalisation 

system in the form of a brace which yields 

in all directions. This frees the pelvis from 

the rigidity in which it is commonly placed 

in static work chairs. If the body‘s centre of 

gravity moves forward or sideways, e.g. by 

stretching out the arms, this imbalance can 

be equalised by a pelvic movement - 

similarly to using an exercise ball. The 

spine remains in its natural S shape. The 

equalisation movements and 

straight sitting position reduce 

one-sided strain and pressure 

on spinal disks and effectively 

relieve the back. 

Other advantages: Circulation 

and oxygen supply to the muscles 

are increased. Exercise also 

encourages nutrition of the spinal 

disks, which lose less volume and 

buffering capacity for the back 

due to sitting. 

The seat surface which is mounted on a 

module box is not fastened on the column 

in the Pending system, but freely suspended 

from eight pendulums. This makes the seat 

surface mobile in all directions. 

11 


Instruments CURRENT 

NEW: Scalpel handle BB063R 


A “lancet“ or “carving knife“ - that is the original meaning of the Latin word scalpellum. Today, it‘s hard to imagine 

medicine and professional foot care without the scalpel. The new scalpel handle BB063R from GERLACH TECHNIK 

simplifies professional work with a blade on the foot, and is also economical. 

While fixed instruments were in primary use 

in earlier times, scalpels are now usually 

constructed so as to allow blades to be 

exchanged. Foot care pros know scalpel 

technology and need high quality scalpel 

blades for their work. The blades are inserted 

into the handle and are ready for work. Here, 

the new scalpel handle BB063R from 

GERLACH TECHNIK sets new standards. The 

indentations offer the foot care pro a perfect 

grip. The round handle of the blade holder 

makes it especially easy and secure to guide, 

and easy to turn with the fingers. Unpleasant 

and straining hand rotation during work is 

consequently avoided. This is easier on the 

wrists and effectively prevents risks such as 

secondary arthrosis. The BB063R not only 

contributes to health, but is also especially 

economical. The higher purchase price is 

amortised in daily work. The instrument has 

a very long service life, simplifies work, saves 

time and can also be used for various hollow 

chisel blades. 

What users say 

Norbert Cohrs, who has worked as a lecturer at the Hanover 

Podology College since many years, makes good experiences 

in practical use: 

“The end of the BB063R scalpel handle is always between 

the little finger and ring finger. The round handle is simply 

much better in this position; for instance, it is more easily and 

safely guided when removing surface callus. My trainees give me a lot of 

positive feedback. The high quality instrument is especially suitable for 

processing as well.“ 

Fotos: Norbert Cohrs 

Due to its position at the back between the little and ring fingers, the BB063R 

can be ideally guided at the front, e.g. for removing excess callus. 

Our price 

Scalpel handle BB063R 

Round handle; stainless steel, 

14.5 cm for blades BB 10-15 

Due to the roundness and 

indentations, the scalpel 

handle BB063R is very easy 

to guide. This simplifies work 

on clients‘ feet. 

Scalpel blades BB 10–15 

10 Units 

100 Units 


12


Nails with a yellowish discolouration 

Innumerable causes 

Finger and toe nails are regarded as the reflection of the physical state of health. If they show a yellowish 

discolouration, this is often embarrassing to affected persons. Cosmetic problems are often the reason. In many 

cases, however, there is also a medical problem, such as a metabolic disorder. 

istockphoto | Photoevent 

Finger and toe nails 

reflect the physical 

state. Discolouration 

may be cosmetic or due 

to illness. 

Patients are quickly suspected of not looking 

after their finger nails when they are 

discoloured. In some cases, this is actually 

due to a cosmetic cause. Smoking often 

embeds toxins in the nails. They attack the 

callus plates and lead to colour changes. 

Wrong care, trauma or constant strain due 

to excessively tight shoes are also regarded 

as causes of yellowish finger and toe 

nails. Physical influences such as 

colour forming bacteria or x-rays 

may also be causes. Yellow nails 

often occur after pedicures. The cause 

is deemed to be the solvents which are 

contained in many - especially coloured 

- nail polishes. 

From yellow to crumbly 

But very often, the affected persons are 

not directly responsible for the discolouration. 

Colour changes and excessively soft or 

brittle nails, crosswise grooves, a detaching 

nail plate or crumbly nails may be signs of 

physical disorders. In yellow nail syndrome, 

a growth disorder thickens the nails and 

gives them a yellowish discolouration. 

Lymphatic oedemas may form; nasal sinus 

inflammation may occur, and the bronchi 

may expand. 

In a metabolic disorder, the supply of 

important building materials to the nails is 

prevented. Fungal nail infections (onychomycosis), 

skin and thyroid disorders, 

various deficiencies or infections can also 

be causes. 

In onychogryposis (bent nails; claw nails) 

the nail plate no longer adheres to the nail 

bed. The nail is then a dirty yellow colour, 

but remains transparent. This is probably 

triggered by hyperkeratosis of the nail bed 

which could be caused by circulatory 

disorders in the end flow zones. 

If the foot specialist finds a yellowish 

discolouration, the medical history of the 

client is taken. When obtaining the medical 

history, questions should be asked about 

lifestyle (smoking, alcohol etc.), the use of 

medications, use of nail polish, existing 

illnesses and dietary behaviour, among 

other things. If there are a number of signs 

that a systemic underlying illness is present, 

the client must see a doctor. 

What to do? 

In cosmetic causes, there are numerous 

tips and home remedies. For instance, 

using lemon juice is at the top of the 

recommendation list. A lemon is squeezed, 

a cotton cloth dipped into the juice until it 

is soaked, and the yellow shimmer wiped 

off the nail with it. 

A bath in vinegar water, rubbing off with 

dissolved baking powder or olive oil, and 

taking Vitamin E which also occurs in some 

nuts and in the oils of wheat germ, maize, 

canola and sunflower germs in higher 

levels are also part of it. A base polish coat 

provides protection against discolouration 

due to nail polishes. Here, foot specialists 

can help with professional work. 

Care for healthy and beautiful nails 

Care and optimal treatment of toenails 

with important nutrients comes in the form 

of effective, high quality nail products. For 

instance, the proven GEHWOL FUSSKRAFT 

Nail and Skin Protection Spray with 

panthenol, bisabolol and Vitamin E ensures 

that moisture is stored deep in the nails 

and their elasticity is improved. 

These active substances also support the 

regeneration process of the surrounding 

skin, giving the nails a secure hold. The 

provided Vitamin E stabilises the skin cells, 

delays the aging process and counteracts 

yellow discolouration. Panthenol and 

bisabolol complement this with antimicrobial 

properties; together with the often used 

antifungal active substance clotrimazole, 

they also provide protection against 

unpleasant nuisance fungal nail infections 

which may persist for a long time. 

13 


Foot fungus prevention is still important 


fotolia | Delphimages 

Collecting 

fungi? 

Fungal infections are among the most common skin disorders in Germany. 

Persons who use pools and saunas as well as athletes are at special risk 

of dermatomycosis on the feet. Some years ago, there were consequently 

preventive systems in the form of fixedly installed spray nozzles in every 

bathing facility. But they disappeared from bathing facilities over time. 

Therefore your own initiative is needed to prevent fungal disorders. 

While the bacterial share of the pathogenic 

flora is well investigated, less was known 

about fungal colonisation of the skin thus 

far. In recent years, the number of fungal 

disorders in Germany has risen strongly, 

particularly as far as nails are concerned. 

The increasing numbers of older persons in 

the population, who are more commonly 

affected by infections, is discussed as a 

cause. Foot mycoses are far more than just 

a cosmetic problem. On the feet, the affected 

skin areas may hurt when walking. Finger 

nail infections may be repulsive to others, 

and represent a handicap depending on 

the profession. Since the disorder particularly 

affects performance athletes and ambitious 

leisure athletes, foot fungus is also often 

called “athlete‘s foot“ in English-speaking 

regions. So that foot mycoses do not occur 

in the first place, there used to be separate 

fungus prevention means, e.g. at pools. 

The spray systems were intended to inhibit 

fungal growth and prevent infections in 

this manner. 

Where is the foot fungus prevention? 

But why did those protective devices 

suddenly disappear from public bath facilities, 

even though they are really most urgently 

needed there? This is less related to a lack 

of effectiveness of these products. Instead, 

they were often used wrongly, impairing or 

nullifying the efficacy of the products. 

Wrongly used, spray nozzles may even 

encourage an infection in the worst case. 

More difficult licensing procedures are 

also responsible for the disappearance of 

the protection systems from swimming 

pools. Until a few years ago, the spray 

agents were still counted among medications 

and were therefore treated equally to 

hygienic hand disinfectants. But the 

products were stopped by the strict 

requirements, such as proving preventive 

efficacy. The problem: Studies would 

have to prove that a test subject group 

who regularly uses the product for longer 

periods develops less foot fungus than the 

control group which does not use the 

product. Due to the high illness rate, it‘s 

already difficult to find test subjects who 

are completely free of foot fungus. 

Another obstacle lies in the long observation 

period which would be required due to 

the slow progression of the illness. 

Confirmation of the disinfectant effect of 

the products was not sufficient on its own 

in the verification process for the medication. 

For this reason, it was not possible to 

license them as a medication, and the 

spray installations disappeared from 

saunas and baths. 

Prevention with bath shoes 

Pool and sauna users are often advised to 

wear bath shoes to prevent foot and nail 

fungus. But the efficacy of this preventive 

measure is not proven by studies. Shoes 

may even increase the risk of infection. 

Since the shoes often have a watertight 

surface, it‘s difficult for water which remains 

on the foot to dry. Moist conditions in the 

shoe are a perfect feeding ground for fungal 

pathogens. Wearing the shoe practically 

massages the pathogens into the soaked 

skin. The raised fingers which are typical 

for bath flip-flops intensify the effect further 

and are especially dangerous. For this 

reason, bath shoes can, at best, complement 

effective prevention of foot fungus, 

but never completely replace it. 

Tips to prevent 

foot fungus 

Intact, resistant skin is the most important 

protection against foot and nail fungus 

due to its barrier properties. 

A special foot care product should 

therefore be part of any sports and pool 

bag. Foot creams with antimycotic 

ingredients offer additional protection. 

Before they are used, you should 

thoroughly dry your feet, including 

the spaces between the toes. 

Foot care products with antifungal 

protection are also available as sprays, 

e.g. GEHWOL FUSSKRAFT Care Spray 

or GEHWOL Foot + Shoe Deodorant. 

Antimycotic ingredients in GEHWOL 

products include e.g. climbazole, 

clotrimazole, undecylenamide and 

essential oils such as rosemary oil, 

lavender oil and peppermint oil. 

After foot care, you should absolutely 

avoid walking barefoot in potentially 

contaminated areas. 


14


Diabetes 

A healthy state 

Consequential disorders on the feet can be prevented with special attention, prevention, early diagnostics and 

required therapies in diabetes mellitus. Attaining this and generally achieving optimal care of patients requires 

interdisciplinary cooperation. 

three to max. five minutes. Home foot exercises 

according to instructions or illustrated 

exercises as well as home foot massages are 

recommended to strengthen the foot muscles 

and encourage the circulation. 

fotolia | DenisNata 

Strong pressure, e.g. in excessively 

tight shoes, acts on the feet. In diabetes, 

this can lead to massive damage. 

The objective of diabetic foot care is always 

to preserve the foot. With an annual amputation 

rate of approx. 30,000 in Germany, 

however, there are still considerable requirements. 

But there are many approaches for 

avoiding amputation before it occurs. 

Knowledge about possible consequential 

disorders is the foundation - for instance: 

Macro/microangiopathy: the disorder of 

large and small blood vessels; 

Polyneuropathy: disorder of the peripheral 

nervous system by reducing or nullifying 

pain, temperature and vibration sensations; 

motor disorders such as muscle 

imbalance, formation of hammer or claw 

toes; also autonomous disorders not 

subject to will, such as the nullification 

or reduction of sweat secretion with dry 

skin, hyperkeratosis, corns, callosities 

(weals) and rhagades (cracks) as well as 

tears, which are common entry ways for 

bacterial infections; 

Fatty tissue atrophy: Atrophy of fatty tissues, 

especially on the foot sole, leading to a 

lack of pressure redistribution and 

vibration buffering; 

Myatrophy: Atrophy of foot muscles with 

functional impairments; 

Neuro-osteo-arthropathy - diabetic Charcot 

foot - with damage to the nerves, joints 

and bones; demineralisation of the bones 

often means spontaneous fractures when 

minor trauma occurs; these lead to flat 

foot (pes planus) and lastly to the foot 

soles developing a plantar convex 

(outward) bend. 

Other consequential disorders are also 

possible, such as gout (hyperuricaemia), 

lipid metabolism disorders (hyperlipidaemia), 

degenerative joint disorders (arthrosis), 

skeletal disorders with reduced bone mass 

and a tendency to develop fractures 

(osteoporosis) and high blood pressure. 

Preventing diabetic foot syndrome requires 

a team of specialists, podologists, diabetes 

specialists, physiotherapists, orthopaedic 

technologists, orthopaedic shoemakers, 

ergotherapists, psychologists and health 

insurance funds. The patient‘s cooperation 

is decisive; however it appears unmotivated 

or insufficient in many cases (figure 1). 

Foot experts 

Affected persons receive important tips for 

home foot care to prevent foot problems 

during the necessary and medically 

prescribed podological treatment. This 

ranges from the use of sandpaper files to 

nail trimming to using a natural pumice 

stone to remove hyperkeratosis or clavi. 

Skin care is provided with fatty creams 

which contain five to ten percent urea. 

When the skin is intact, foot baths should 

not exceed a temperature of 35 degrees 

Celsius (bath thermometer) and be used for 

Professional podological treatment with 

grinders, polishers or trimmers contributes 

significantly to preventing the consequences 

of diabetic foot syndrome. This includes: 

Nail trimming, brace treatment if required 

- especially in nail deformities or threatening 

ingrown nails (unguis incarnatus), 

removal of hyperkeratosis, clavi, callosities 

which may lead to ulcers, infection, 

gangrene, tissue death (necrosis) and 

finally amputation due to increasing 

pressure. Ulcers are treated by a doctor. 

Prevention includes regularly participating 

in trainings for diabetics, and also for 

relatives if applicable. Here, affected 

persons receive important information 

about the principles and associations of 

the glucose metabolism disorder with its 

consequential disorders, dietary recommendations, 

instructions for independent 

mandatory daily foot examinations and 

knowledge about home foot care. 

Well shoed 

Individual care with orthopaedic footwear 

is also required, depending on the severity 

of peripheral nerve damage (neuropathy) 

or peripheral arterial occlusion disease. 

Parallel to specific orthopaedic shoe care, 

existing pressure points on the foot sole are 

identified with a computer supported 

electronic measuring procedure (dynamic 

pedography) to perform required pressure 

redistribution. 

Since most ulcers are due to pressure spots 

due to internal (inner) or external (outer) 

mechanical causes, pressure redistribution 

on the foot sole is required. It is the doctor‘s 

task to prescribe care with orthopaedic 

shoes. A regular check-up of diabetes 

adapted foot beds, confectioned diabetes 

protection footwear, interim footwear such 

as bandage, therapy or frontal foot relief 

shoes, customised confectioned shoes, 

orthopaedic custom shoes or orthotics is 

provided by the doctor and orthopaedic 

shoemaker (figure 4). 

15 



Fotos: Dr. med. Renate Wolansky 

Figure 1: 60 year old diabetic with polyneuropathy (peripheral 

nerve damage) declines podological treatment and consultation 

despite massive hyperkeratosis, dry skin and several small skin 

lesions. 

Figure 2: 65 year old diabetic with pressure ulcer on the apex 

(tip of the last segment) due to excessively short shoes. The 

patient wears the diabetes adapted foot beds and orthopaedic 

measures only sporadically. 

Figure 3: This 80 year old diabetic with polyneuropathy and 

peripheral arterial occlusion disease has a pressure ulcer 

between the toes due to orthopaedic custom shoes which were 

made too short. 

Figure 4: Example of a custom orthopaedic shoe which was 

adjusted to the needs of a diabetes patient. The various layers of 

the insoles are easily recognisable. 

Decisive details 

Serious errors in shoe care must be corrected 

at an early time. Among other things, this 

includes: insoles which are too thin or 

provide too little pressure redistribution, 

missing shoe customisations (on the heel, 

walking sole, tab or shaft), insufficient 

distance from the longest toe to the frontal 

edge of the shoe (which should be about 

seven millimetres while standing), 

insufficient shoe height in the frontal foot 

region, insufficient pad width (distance 

from the first metatarsal protuberance to 

the fifth metatarsal protuberance), inner 

seams which apply pressure, and a lack of 

actively breathing shoe materials (figures 

2 and 3). Diabetic shoes must be felt daily 

for foreign bodies such as pebbles, wood 

splinters and other particles, which must 

be removed. 

Taking required medications, regular 

trainings, treatment by a foot specialist, 

suitable shoes, daily age-appropriate 

exercise and consultations with the doctor 

and orthopaedic shoemaker are also part of 

the catalogue of preventive measures. This 

allows the multidisciplinary team to provide 

optimal care and treatment to the diabetic. 

Minimising risk factors makes it possible to 

reduce the rate of amputations, hospital 

stays and consequential costs, and improve 

the patient‘s quality of life. 

Rare foot disorders 

The new book by Dr. Renate Wolansky 

does not show the classic foot deformities, 

such as hallux valgus, but strongly 

concentrates on the specific foot illnesses: 

Berndorf syndrome, Friedreich ataxia, 

Raynaud‘s syndrome, erysipelas. 

Genetic predisposition or infections 

are regarded as the cause. The illnesses 

are illustrated with 

many clear figures. 

Medical therapies as 

well as possible 

treatment options 

for podologists and 

foot care pros and 

orthopaedic footwear 

treatment options 

are described. 

Dr. med. Renate Wolansky 

The established orthopaedist, sports physician and medical foot care 

provider teaches in the field of podology at several educational 

institutions. The expert has also published numerous books and writes 

for recognized specialised institutions. 

176 pages, bound, 29 Euros. 

C. Maurer Printing and Publishing, Geislingen 

ISBN-13 978-3-87517-049-8 


16


NEW: GEHWOL Diabetes Report 2014 


Positives first: Diabetics trust their foot care pros with 

consultation tips. According to the GEHWOL Diabetes 

Report 2014, this is what 84 percent of patients say. But by 

far not every patient uses podological services for prevention 

or performs their own foot care measures. The report shows 

this as well. Therefore risk awareness has scarcely improved 

since its first edition in the year 2009. 

Foot complications are among the most 

common consequential complications of 

diabetes. The most significant consequences 

of diabetic foot problems include ulcers 

and small (minor) as well as high (major) 

amputations. According to the German 

Health Report on Diabetes 2014, approx. 

250,000 persons with diabetes have a foot 

lesion within the Federal Republic; one 

million diabetics have a higher risk of 

suffering foot injuries. 

Prevention requires information 

Even though major amputations have 

decreased in recent years, especially in 

women, the relative risk of a high amputation 

is still about twenty times higher for diabetics. 

Prevention strategies are needed to avoid 

foot complications and the associated 

physical and emotional suffering of affected 

persons. Among other things, this requires 

greater patient awareness of foot care 

measures. Corresponding information and 

advice herein refers both to the field 

of home foot hygiene and to podological 

services for inspection, early risk detection 

and foot treatments. But to what degree are 

diabetics aware of foot care? To find out, 

Gerlach again surveyed 3459 patients out 

of a treatment pool of 369 doctors‘ practices. 

Consultation tips for foot care at home 

During the daily foot inspection (with a mirror), pay special 

attention to injuries, foreign bodies, blisters and fine cracks. 

Bathe the feet for no longer than three minutes, and not too hot 

(maximum water temperature 37 to 38 degrees Celsius, check 

the temperature with a bath thermometer). 

Dry the feet with a soft towel, and use a cotton swab between 

the toes. Blow dryers, heating pillows or heating bottles are 

taboo. There is a risk of burns. 

For self-care of the feet, do not use sharp instruments which 

may cause injuries. It is best to use a fine sand file to trim the 

nails instead of pointed shears or other instruments which are 

likely to result in injuries. 

Always file the toe nails only so that the nail edge lines up with 

the tip of the toe. Treat the nails with nail protection oil. 

Apply cream to the feet daily. Use a urea-containing cream or 

lotion with a sufficiently high fat and moisture content so that 

the skin barrier does not dry out and remains resistant. Pay 

attention to products with effective antifungal protection. 

Avoid pressure spots and only wear soft, comfortable and 

sufficiently wide shoes with no inner seams. Regularly feel 

the shoes and socks for foreign bodies. 

To protect against infection, always wear shoes with clean, 

freshly washed socks. Regularly have an expert check the 

socks and shoes for pressure sports. 

Special pressure relief cushions made from highly elastic 

polymer gel provide relief and prevent callus weals. 

Never walk barefoot, not even in your own home. See a doctor 

immediately if you have wounds, inflammation or blisters. 

17 



Patients‘ problem awareness 

Patients don‘t think that they have to pay attention to their feet 63 

Patients feel insufficiently informed 63 

Patients do not use regular preventive care 53 

Patients do not use regular foot care 45 

Patients don‘t know what an ulcer is 17 

Frequency in percent 

Jupiterimages | Emmanuel Faure 

You can find the results of the GEHWOL 

Diabetes Report 2014 as a download at 

www.gehwol.de/service/diabetes_und_ 

fusspflege. 

Common foot problems in diabetes 

Dry skin 31 

Excess callus 31 

Foot or nail fungus 28 

Rhagades (cracks) 21 

Inflammation 16 

Foot malpositions 15 

Current ulcer treatment (repeated) 12 

Multiple ulcer treatments in the past 12 

Single ulcer treatment in the past 10 

Gait changes 9 

Current ulcer treatment (first time) 8 

Implementation of care recommendations 



Inspection 47 

Using moisturising cream 29 

Removal of skin with pumice stone 27 

Using suitable shoes 27 

Blunt nail care (shortening the nails with a file) 21 

Paying attention to suitable socks 17 

Wearing orthopaedic insoles or orthotics 16 

Disinfecting foot baths (maximum 3 minutes) 15 

Pressure relief with pressure relief products 15 

Using products with antifungal protection 11 

Wearing custom orthopaedic shoes 10 

Toe and foot exercises 10 

N = 3,459 patients 

The results of the survey are provided by 

the GEHWOL Diabetes Report 2014, 

which provides information about the 

frequency of foot problems, problem 

awareness and patient know-how about 

recommended measures for foot care and 

prevention for the second time since 2009. 

Numerous risk factors 

Foot ulcers develop out of an interplay of 

various factors in which diabetic polyneuropathy 

plays a central role. This was present in 

about one quarter of the usually elderly 

patients. Nerve damage reduces secretions of 

the sebaceous and sweat glands, rendering 

the skin dry, brittle and cracked. One third of 

diabetics actually confirmed that they had 

dry foot skin. The skin also had rhagades in 

21 percent. The nerve damage also often 

results in coordination problems, which 

may lead to foot deformities and wrongly 

applied strain. This was the case in 15 percent. 

The wrongly applied strain then changes 

pressure conditions on the foot. Persistent 

pressure leads to strong callus formation. 

One third of surveyed persons were affected 

by this as well. 

At the same time, a sensory orientation of 

the neuropathy may mean that patients are 

less pain sensitive. Painful skin tears are not 

noticed and may develop into ulcers if 

untreated. Wound healing is also impaired if 

there is macroangiopathy. 18 percent of 

diabetics confirmed this in the survey. 

At the time of the survey, eight percent of 

diabetics were receiving ulcer treatment; 

12 percent of them not for the first time. This 

means that the prevalence is even higher 

than the frequency of two to ten percent of 

the diabetic population which is stated in the 

German Health Report. 

Many patients underestimate the risk 

Despite objectively present risk factors 

including acute ulcers, a large share of 

diabetics is barely informed about the 

problems. Two out of three diabetics did 

not believe that they had to pay special 

attention to their feet. 53 percent stated 

that they did not have regular preventive 

visits with a podologist. Even at home, 

nearly half of those surveyed (45%) care 

for their feet only occasionally (if at all), 

and only rarely with consistency. 


18


Instrument care 

Lasting joy 

Many people believe that “stainless steel“ implies indestructability. But physical, 

thermal and chemical influences may lead to discoloured, rusty or spotty instruments. 

Tweezers, shears, scalpels and rotary instruments, even good quality ones, 

can certainly suffer if they are not treated correctly. Making instrument 

care part of daily work as a natural process reduces the risk of infection 

and ensures instrument preservation. The following tips can support 

you in preserving your instruments. 

Regularly caring for instruments 

lowers the risk of infection and 

saves money in the long term. 

1. Unpack and let‘s go! 

Temperature variations can cause 

condensation (moisture accumulation) in 

plastic packaging of new instruments. 

Therefore, unpack the instruments soon. 

Also make sure that they are not stored 

near chemicals whose harmful vapours 

may attack instrument surfaces. 

4. Use the right 

instruments! 

For instance, using very fine shears for 

strong nails may bend the tips of the 

instrument. Always pay attention to 

using the right instrument for the task. 

This avoids serious, lasting damage and 

premature, unwanted consequential 

expenses. 

7. Next customer, 

please! 

Always allow instruments to cool and 

dry thoroughly after processing before 

using them again. New or repaired 

instruments should be processed again 

before their first or renewed use to 

exclude the possibility of pathogens 

which were acquired during transport. 

2. Not all steels are 

the same! 

Depending on the requirements, there 

are different kinds of instruments. 

Stainless steel can be disinfected 

without problems. This is not quite as 

simple for chrome and nickel surfaces. 

Always note the manufacturer‘s instructions 

so that your instruments are not prematurely 

damaged. 

5. Dirt also has an 

effect! 

To avoid dirt drying on the instrument, 

it should be cleaned and disinfected 

immediately after use. Ultrasound 

cleaning is suitable for removing 

residue from the very fine pores of 

grinders and polishers and avoiding loss 

of grinding performance. 

8. Check your 

inventory! 

All instruments must have a homogeneous 

(smooth) surface. Sort out damaged 

instruments (e.g. if the nickel or chrome 

layer is bursting off), since contact 

corrosion may occur, increasing the risk 

of infection. Use high quality instruments 

if possible. 

3. The right rotation 

quality! 

6. Disinfect and 

sterilise! 

9. Smooth closure 

If the shaft of a rotary instrument 

is made from lower quality steel or 

a too-soft alloy, the shaft can bend 

during use, ruining the hand piece. 

Higher qualities, such as hardened 

stainless steel, are much more solid, 

reducing this risk. 

Note the manufacturer‘s instructions for 

the acting time of utilised disinfectants 

and cleaners so that pathogens are 

killed (not too short) and the instrument 

is not attacked (not too long). Avoid 

exceeding a temperature of 180 degrees 

Celsius during sterilisation to avoid 

de-hardening the steel. 

You should regularly treat instruments 

with a closing mechanism such as 

shears and scissors with instrument oil 

(e.g. from GERLACH TECHNIK). This 

prevents material being removed by 

friction (the so called stick and slip 

effect). It also prevents the nut in the 

closing zone from becoming set in. 

fotolia: mopsgrafik 

19 



Material properties 

Long-lived cushions 

Not all cushions are the same. It is the material properties which make the upholstery of a foot care chair a high 

quality sitting surface. The right care and following some tips for use keep the material at top optical appearance, 

which also makes a good impression on customers. 

A customer comes into the treatment room 

and the foot care pro asks them to sit down. 

The customer looks at the treatment chair 

and stops. The chair has cracks and is worn 

off in many places. “An older model?“ asks 

the customer. The foot care pro explains 

that the chair is not yet all that old. Such a 

situation is embarrassing and creates a 

negative first impression of the foot care 

practice. Using high quality materials with 

a long service life is doubly advisable from 

an economic perspective. They make a 

positive impression on customers, and 

need to be replaced less often. 

Especially robust 

Good material properties in furniture 

upholstery have other advantages. The 

skai ® brand of synthetic leather specialist 

Hornschuch is one example. The “made in 

Germany“ cushion cover materials which 

are used on all Gerlach treatment chairs 

and work chairs offer sustainability, a long 

service life and easy care in numerous 

applications. This keeps cushions at a high 

quality level, hygienically safe, able to 

handle strain, easy to clean, pleasant and 

also visually attractive. 

The first-class synthetic leather is seamlessly 

processed. This simplifies cleaning and 

disinfection. The disinfection which is 

necessary for daily hygiene is easily performed 

with licensed disinfectants. For example, 

Microbac Tissues are especially suited for 

this purpose. Cushion workmanship at 

GERLACH TECHNIK is the foundation of 

great sitting comfort. The solid formed 

wood which is glued in several layers 

receives a contoured mantle of a special 

foam, finishing with the cover. 

Remember care 

Despite good attributes, care makes an 

important contribution to preserving 

upholstery in the long term. If, for instance, 

aggressive and possibly unlicensed cleaners 

and disinfectants are used, even the best 

material may appear damaged in the long 

term, creating a negative impression. 

With regular cleaning and care, cushions 

easily maintain their original shine and 

suppleness. The following tips help to ensure 

correct use of cushions and materialpreserving 

disinfection in everyday 

practice work: 

Note the care information in the instructions 

for use. 

Avoid contact with pointed and rough 

objects. They may tear the surfaces. 

Modern materials are usually relatively 

insensitive to dirt. But spots and other 

residue of consumables should still be 

removed immediately at all times. 

Bright cushions are generally more 

susceptible to dirt than dark ones. 

Discolouration which is due e.g. to a belt 

or suede clothing should be removed 

immediately after it occurs. Therefore 

pay attention to any visible residue with 

every patient and remove it properly if 

applicable. 

Fundamentally disinfect sitting surfaces 

after every treatment. Ensure that the 

surface dries completely after the specified 

acting time before you use it to treat the 

next patient. 

Only use products permitted by the 

manufacturer for required cleaning and 

disinfection. Also pay attention to use 

wiping cloths or wipes which are as 

colour neutral as possible. 

High quality: The foam is sprayed on 

around the solid formed wood which is 

glued in ten layers, and finished with the 

robust cover. 


20


fotolia | diego cervo 

The consultation: “Yes, you can“ 

Shoe pressure 

Tight shoes and toe malpositions such as hallux valgus are among the main causes of corns, which are a special 

form of callus formation. Pain quickly develops when the skin is close to bones. As a foot care pro, you can 

correct the problem for your customers with professional treatment, and also provide valuable tips and products 

for preventive care - so that the shoes are no longer too tight. 

Foot care pro: Hello, Ms. Kern! 

Customer: Hello to you as well! 

Foot care pro: We haven‘t seen each other 

in a long time. 

Customer: Well, my feet already missed 

you and cried for you. 

Foot care pro: So let‘s get started right 

away. Do you have specific problems? 

How can I help you? 

Customer: The elegant shoes which I have 

to wear for the office every day unfortunately 

squeeze my right small toe. 

Foot care pro: I see! You definitely have a 

small corn here. 

Customer: So that‘s what it looks like. Can 

you make it go away as quickly as it came? 

I‘m hoping for that! 

Foot care pro: Yes, of course I can help 

you, and you can take care to prevent it in 

the future. 

Customer: I‘m very glad for that. What 

exactly is a corn? 

Foot care pro: Corns are a special form of 

callus formation which can protrude deep 

into the skin, and then causes pain. As in 

you, for instance, they can be caused by 

too tight shoes. The body forms strong callus 

at the irritated point to defend itself against 

the pressure. If the shoe is continuously too 

tight, the callus cannot subside and collects 

deep below the skin until it forms a thorn... 

Customer: ... which causes the deep 

pressing pain to me. 

Foot care pro: Yes, the skin is very close to 

the bone on the little toe. So it hurts 

quickly. It‘s very good that you didn‘t try to 

treat it yourself at home. 

Customer: Why? 

Foot care pro: In a corn, there is a risk of 

injuring too much of the surrounding healthy 

skin. My instruments allow me to remove 

even deep thorn leftovers safely and 

painlessly. 

Customer: How can I prevent them in the 

future? Do I have to leave my elegant shoes 

at home? 

Foot care pro: Of course, you should 

fundamentally wear comfortable shoes. 

But it‘s especially important that your 

shoes fit properly. Changing them daily 

regularly relieves the pressure spots. 

Customer: I like to wear comfortable shoes 

privately, but the shoes for work do squeeze 

here and there. Then I always think: I have 

to handle it! 

Foot care pro: But that should remain the 

exception. I recommend pressure relief 

bandages to you to relieve pressure when 

needed. Toe rings have a hole for the pressure 

spot which protects against excessive 

pressure spots. If you do get another corn, 

you should immediately make an appointment 

with me. In the meantime, you can 

use the special corn protection ring which 

GEHWOL makes from polymer gel. 

Customer: That sounds good. Can you 

show me the products after the treatment? 

Foot care pro: Of course. I‘ll also put a 

corn protection ring right on your toe when 

I have removed the corn. The ring provides 

three-dimensional cushioning around and 

on the sore spot and relieves it with its soft 

material. 

Customer: This little ring can do all that? 

Foot care pro: It does even more: It‘s made 

from elastic polymer gel which releases 

paraffin oil, caring for the stressed skin under 

the pressure relief cushion. It‘s especially 

important for you right now that no new 

excess callus forms in the fresh wound 

area. This effectively prevents a new corn 

from forming in the same spot. 

Customer: Thank you very much for your 

competent advice! 

21 



Consulting expertise 

Recommendation wanted 

With the introduction of the podology act in 2002, the contents which are part of a podology education were 

specified at the same time. But the changes in the sector and the market made it necessary to readjust the curricula. 

Client consultation will form a future focal point. 

Those who want to use the title of podologist 

or medical foot care professional according 

to the podology act require a state 

recognised professional education or 

recognised diploma. Education for the 

profession of podologist is specified according 

to the podologists‘ act (PodG) and in 

the education and examination regulations 

for podologists (Pod-APrV). Both regulations 

largely specify the content, but leave room 

for design. 

The educational objectives provide that 

students are enabled to work together with 

other professions, practice the profession 

at their own responsibility and with 

independence, and participate in the 

prevention, therapy and rehabilitation of 

foot disorders. Students acquire the generally 

recognised state of medical, social science 

and other scientific knowledge and the 

acting expertise required for their everyday 

work in their education. 

fotolia | contrastwerkstatt 

Forming change 

In view of constant changes in medicine 

and society, they are enabled to react 

appropriately to constantly changing 

requirements. This also increasingly includes 

patient advice. For one objective of the 

podologists‘ act is to support preventive 

work on the patient to lower health care 

costs in the long term. The working 

association of podology schools therefore 

specified in a letter of November 2011 to 

the federal minister of health that a thought 

change would have to take place in 

pedagogical work to allow persons who 

complete the education to continue 

meeting market requirements. 

Aside from stronger health training and 

education, also and particularly including 

children and adolescents, the letter 

specified that podologists should not only 

participate in the therapy and rehabilitation 

of foot disorders as well as their prevention, 

but control it. This exceeds the scope of the 

previous formulation. The health ministry 

postponed a discussion about this issue. 

Nonetheless, this recognition is increasingly 

becoming part of curricula. 

Professional and expert customer advice is increasingly becoming a focus of everyday 

practice work. This is increasingly reflected in education plans. 

Enabling customers 

For instance, the region of Lower Saxony 

has drafted a new version of the general 

guideline for podological education. A focal 

point of the education provides that students 

explain the associations and background 

of foot and leg problems to patients, show 

positive and negative consequences of 

insufficient care and instruct them in age 

appropriate, indication related, preventive 

or rehabilitative measures. About 190 hours 

were specified for this field, while 

comparable blocks in the Pod-APrV are far 

less time intensive. This is doubly important 

in modern foot care practices. On the one 

hand, foot care pros meet the need of 

obtaining comprehensive information 

about treatment measures and options. 

Customers often expect recommendations 

for home foot care as well as offers and 

information about suitable care products 

(e.g. foot care products) from the practice. 

This should be part of the overall calculation 

of a practice. For expert recommendations 

in the sense of meeting needs are usually 

followed by sales, and therefore profits. 


22


Health Report 

fotolia | abcmedia 

2014 

Despite dropping numbers of major amputations, the risk of an amputation 

is still about 20 times higher in persons who have diabetes. This warning was 

issued by the recently published German Health Report on Diabetes 2014. 

FUSSPFLEGE AKTUELL has summarised the most important results. 

Diabetic foot syndrome (DFS) is among the 

most common consequential disorders 

in persons with diabetes. It refers to foot 

injuries - regardless of the type of diabetes 

or the nature of the injury. According to an 

evaluation of international prevalence 

studies, the frequency is at about eight 

percent of all diabetics, while the rate of 

new illnesses is at about three percent, 

wherein the risk of becoming ill increases 

with higher age. Approximately every fourth 

diabetes patient suffers DFS in their life. 

Patients with low social status are primarily 

affected. In a British study, 670 diabetics 

out of 15,983 examined patients developed 

a new foot ulcer, wherein the risk was about 

1.7 times higher with an unfavourable social 

status. The reduction of major amputations 

in Germany by 15.2 percent between 2005 

and 2010 is pleasing. More women than 

men tended to profit from this reduction. 

But this is opposed by a constant rate of 

minor amputations in women and a clear 

increase among men. These and elderly 

patients (65 years and up) therefore still 

have a significantly increased risk of amputations 

in diabetes in Germany. 

Neuropathy and angiopathy 

Significant risk factors for DFS include 

diabetic neuropathy and impaired peripheral 

circulation. Two thirds of all type 2 diabetics 

in the Western industrial nations suffer from 

nerve function disorders. Polyneuropathy 

favours the additional development of 

angiopathy. The risk of skin lesions and 

amputations is also higher. Therefore 

diagnostics of a nerve disorder (using 

monofilament) are an important indicator 

for better predicting the prognosis of 

patients with DFS and initiating suitable 

treatment strategies at an early time. The 

same applies to functional examinations of 

the leg blood vessels using non-invasive procedures 

(ankle or toe pressure measurement, 

duplex sonography, measurement of 

oxygen and nutrient supplies to the tissues). 

Other indicators to determine risk refer to 

the diagnostics of foot deformities as well 

as determining earlier foot lesions and 

amputations. 

Improved circulation 

In patients with peripheral angiopathy 

(atherosclerotic change of the outer blood 

vessels, vascular occlusion) - also when 

combined with nerve damage - rapid arterial 

revascularisation is regarded as being part 

of the most important treatment measures 

to improve circulation. However it is still 

unclear whether the surgical intervention 

(e. g. vascular bridging) or endovascular 

treatment (e. g. expanding the blood 

vessels) is the method of choice. Since the 

intervention is lesser, the endovascular 

procedure is initially preferred, provided that 

it is technically feasible. Special problems 

apply to patients who also have kidney 

problems. Their chances of healing are 

much lower even if 

revascularisation is 

achieved, and amputations 

occur significantly 

more often. The risk of 

mortality is also higher 

in diabetics with kidney 

problems. 

Consistent pressure relief 

When it comes to wound treatment, the 

health report also criticises the sparse data 

situation for assessing evidence and the 

clinical benefits of certain treatment procedures. 

However a current study from 2012 

showed that adapted insoles lead to pressure 

redistribution. This not only favours healing, 

but can also contribute to reducing the risk 

of another foot wound (recurrence) from 

87 to 42 percent. Complete soft foam bedding 

was shown to be superior to shoes without 

a bed or with only a partial bed. 

The healing prognosis is decisively worse 

in the case of an infection, wherein multiresistant 

pathogens (MRSA, MRGN) are an 

additional significant problem. Chronic 

wounds usually have gram positive 

pathogens, primarily Staphylococcus aureus. 

Diagnoses are primarily clinical, with 

temperature measurements and thermography. 

Final treatment is oriented to the 

clinical signs and the pathogen status. Oral 

therapy with antibiotics is recommended 

for mild infections; intravenous treatment 

is initially recommended for severe infections. 

It is possible to change to 

oral treatment as needed 

in the progression. In the 

presence of a moderately 

severe infection, a decision 

as to whether therapy 

will start orally or intravenously 

must be made 

based on the overall 

clinical impression. 

23 



Beauty trends 

From outlandish to calculable 

The desire for beauty and relaxation is rising. It is therefore not surprising that new wellness and spa applications 

are developed all the time. Some foot care pros use this to expand their offers and increase sales potential. But not 

all trends keep their promises. 

fotolia | Heiko Barth 

Nibbling fish from Asia which painlessly and carefully remove dead skin scales from the 

feet have not found common use here. 

There are many options for participating in 

the lucrative wellness market. Foot and leg 

massages are part of the standard today. 

Hot stones, paraffin applications, herbal 

stamps or nibbling fish - most people have 

heard of them. Newer trends include e.g. 

the beauty foot from Japan or foot yoga: 

Foot yoga 

Specific exercises are intended to stretch 

and strengthen the foot muscles. Regular 

use encourages the circulation and 

improves the sense of balance. 

Beauty foot 

The beauty foot is coming to Europe from 

the Asian regions. Users put their feet in 

plastic socks filled with an acidic liquid. 

After a few days, the skin should have 

completely peeled, and young skin should 

appear. However this method is scientifically 

and medically questionable. The use of 

acidic products over large areas can cause 

massive skin damage. 

Building expertise 

The question about required additional 

qualifications is important. For instance, 

foot reflex zone massage requires specific 

knowledge of the nerve end points on the 

sole. Yoga exercises should likewise not be 

offered without in-depth knowledge, since 

they may otherwise lead to problems or 

even injuries. 

Whether such a wellness treatment works 

out depends directly on demand. To 

determine demand, one can ask customers, 

aside from researching among colleagues 

or in the expert press. It‘s also possible to 

do “test balloons“, such as a campaign 

week with “try-out prices“. Advertising is 

needed to ensure success, e.g. in the form 

of flyers, advertisements, word of mouth 

propaganda, or a cooperation with the 

local press. If the offer finds good acceptance, 

it can eventually become a long 

term part of your offered services. 

How can I calculate a 

wellness treatment? 

As in every calculation, you need to 

know your general expenses. What 

does a minute cost, whether you‘re 

working or not? Among other things, 

this includes insurances, rental and 

supplementary expenses, write-offs, 

continued training/education and other 

fees. In combination with direct costs - 

that is, costs incurred for a treatment, 

such as time or materials - this leads to 

the total price per minute. This is clarified 

by the following sample calculation for 

a 45 minute massage: 

1800,00 Euros of monthly 

general costs, divided by 20 working days, 

divided by eight hours, divided by 60 minutes 

Time costs of 35.00 Euros per hour, material 

costs of 6.00 Euros, divided by 60 minutes 

Those who decide to offer a beauty trend 

should closely examine whether it makes 

sense and fits. For not everything will find 

its followers in the market. Sometimes, 

new trends don‘t work here. For instance, 

nibbling fish are much less widespread 

than initially expected. 


24

Marketing CURRENT 

Customer satisfaction 

Emotion sells 

fotolia | Mopic 

Rebates or price drops are only a marginal part of marketing. 

Instead, today‘s discipline sees itself as understanding the 

needs and wishes of its customers, and fulfilling or exceeding 

their expectations. Satisfaction is not via the price, but via the 

world of experiences which are associated with the product. 

A clear profile is the basis for generating superior customer benefits. 

Foot care practices are often engaged in 

local competition. Securing your place in 

the market in the long term requires a 

portfolio of loyal customers and walk-in 

customers. If a foot care practice can not 

only generate customer satisfaction but 

also exceed customer expectations, this 

results in enthusiastic customers who often 

pass on their experiences to potential new 

customers. The same also applies to mobile 

foot care, which, however, does not serve 

walk-in customers. 

But how to reach this? Munich marketing 

professor Dr. Anton Meyer has given the 

matter some thought. He sees marketing as 

a discipline which focuses on customers. 

It‘s not about price reductions, discounts 

or advertising campaigns. Today, marketing 

primarily means “not being replaceable“. 

Relevant attributes 

This, in turn, means that a foot care practice 

with its own profile and positioning has 

good market opportunities. This implies 

that it‘s not necessary for everyone to be 

the best in everything. Even those who offer 

a larger variety have strong and tendentially 

weaker disciplines: “The basic idea of 

positioning is to focus on a few customer 

relevant attributes which can be used to 

obtain superior customer benefits.“ 

These attributes can vary. For instance, one 

foot care pro will specialise in placing nail 

braces. Another has their strengths and 

special expertise in the field of treating 

athletes‘ feet. But if the customer experiences 

work which exceeds their expectations 

here, e.g. by including a guideline for 

self-foot massage and a suitable, effective 

foot care product, they can become an 

enthusiastic customer. 

Repeat the positives 

Clients always tell others about their 

experiences and increasingly internalise its 

story. Professor Meyer sees the actual 

added value in this: “It results in a quasi 

sole position which is based on a clear and 

experienced differentiation.“ At the same 

time, the practice has a high relevance, for 

the customer wants to have the experience 

again. A question from market research 

describes the elementary association: 

What if your foot care practice were no 

longer there tomorrow? 

Those who wish to enthuse customers have 

to think ahead. “Only those who know and 

intuitively guess customer expectations 

can exceed them“, Professor Meyer 

explains. Therefore the core of good 

customer relations is that the foot care pro 

truly understands their customers and 

knows what they need even before they 

do. This makes it possible to fulfil service 

requirements. Customers want trust today, 

and wish to be served in a friendly, familiar 

relationship. Foot pros save them time and 

trouble. 

This and the profiling produces product 

benefits which exceed the actual act of the 

service. Consultation, service and trust 

play just as much of a role in this as 

avoiding problems and uncertainty. 

Conclusion: If the foot care pro can associate 

high product benefits with a clear profile 

in their environment, this results in a 

separate brand which enthusiastic 

customers can then recommend to others. 

State your opinion! 

The 2014 survey pursues two objectives 

this time: On the one hand, Gerlach 

customers can assess for themselves 

how satisfied they are with Eduard 

Gerlach GmbH. On the other hand, 

the results provide possible indicators 

and wishes to which the business can 

respond even better in the future. 

25 


GERLACH Foot care cabinet AT/NT Clean 

Number 1 among 

complete providers 

Sophisticated, stylish, strong and reliable - 

the proven blockbuster AT/NT clean. And 

it‘s clean! For the solidly constructed, 

dust-proof drawer compartments protect 

all small parts, also keeping it neatly out 

of sight. This results in an extremely tidy, 

reduced overall impression. Its quiet 

acoustics when the compartments open 

and close almost soundlessly due to the 

automatic dampening system round out 

the overall impression. Only the high shine 

of the polygloss surfaces and the gentle 

blue of the hygienic UV lighting seem to 

want to call out: Everything has its place 

in this hygiene cabinet. 

Test the AT/NT clean 

at one of our exhibition booths 

25.01.–26.01. COSMETICA 

Hannover 

21.03.–23.03. BEAUTY INTERNATIONAL 

Düsseldorf 

05.04.–06.04. BEAUTY FORUM 

Leipzig 

17.05.–18.05. GOOD on FOOT 

Stuttgart 

28.06.–29.06. COSMETICA 

Frankfurt 

Eduard Gerlach GmbH would like to thank 

all readers of the expert journals BEAUTY 

FORUM and NAILPRO for their trust and 

their choice - first place for the eleventh 

consecutive time, Readers‘ Choice Award for 

the third time; this time, in the category of complete 

foot care providers. 

10.10.–11.10. FUSS – Forum for 

Podology and Foot Care 

Kassel 

25.10.–26.10. BEAUTY FORUM 

Munich 

15.11.–16.11. COSMETICA 

Berlin

SUGAR

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