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The Role of Footcare Nurses in Foot Lesions TreatmentCorresponding author: Yuko TachibanaJuntendo University Hospital Podiatry-Center3-1-3, Hongo Bunkyo-ku, Tokyo, 113-8431, JapanTEL: +81-3-3813-3111　E-mail: yutamai@juntendo.ac.jp47th Health Topics for Tokyoites “The Role of the First Podiatry Center in Japan”〔Held on Jun. 19, 2021〕〔Received　Feb. 3, 2022〕〔Accepted　Mar. 8, 2022〕J-STAGE Advance published date: Jun. 2, 2022Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ21-0059-R　Footcare awareness and practice are limited in Japan, which is attributable to unavailability of specialized podiatry services, in contrast to the Western healthcare system. Japan does not have national educational courses in podiatry and footcare, and daily foot care is not routinely practiced owing to the cultural background. Moreover, medical insurance covers only diabetic footcare, which contributes to the limited popularity of footcare in Japan. Footcare in Japan is provided by qualified nurses (foot care nurses) who are certified by various organizations and societies. Footcare nurses render the following services: (a) Provision of professional footcare after evaluation and patient education for foot self-care. (b) Multidisciplinary coordination between the footcare team. Owing to lack of podiatry services in Japan, a multidisciplinary therapeutic approach to foot lesions is necessary. The footcare nurse coordinates communication of patient information across team members and interdepartmental referrals for effective multidisciplinary therapy. (c) Patient education to improve awareness of footcare. Footcare is not currently widely established as a component of medical and nursing care and patient welfare, and greater awareness regarding its role is necessary. The importance of footcare to maintain healthy walking needs to be emphasized among individuals with foot lesions. In view of the high life expectancy and rapid population aging in Japan, maintaining a healthy gait is essential to improve healthy life expectancy, and foot care nurses can play an active role in the future.212Juntendo Medical Journal2022. 68(3), 212-221Health Topics for Tokyoites1. IntroductionThe term “footcare” was introduced in Japan only recently. In 2003, the Ministry of Health, Labor and Welfare added a “project for toe and nail care” to its long-term care prevention and community support program, and efforts were initiated to promote footcare in the domain of long-term care. The project aimed to reduce the risk of falls secondary to nail disorders through promotion of footcare among elderly individuals, their families, and care workers1）. In 2008, a new fee was included in the medical reimbursement system for the management of diabetic foot complications, which led to the implementation of footcare services in many hospitals. This fee included a medical fee for Key words: footcare, footcare nurse, foot lesions, evaluation, footcare teamJuntendo University Hospital Podiatry-Center, Tokyo, Japanfootcare rendered to patients with diabetes at high risk of foot lesions, and many medical centers/hospitals that were unable to provide footcare owing to lack of funds (medical fees for the service) established outpatient footcare clinics. However, the fees for management of diabetic complications can be calculated only for patients who meet the following criteria: (1) a history of foot ulcers and toe or lower limb amputation, (2) diagnosis of arte-riosclerosis obliterans, or (3) diagnosis of diabetic neuropathy. Moreover, foot care services such as edema care, skin care, and nail clipping are not reimbursed and are often unprofitable with regard to revenue generation. In this context, many patients with non diabetic foot conditions including rheumatic deformities, hallux valgus, flat foot, foot Yuko TACHIBANA