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and foot rehabilitation are also effective to prevent progression of foot deformities.4-2-3 Edema careCompression therapy is effective for localized lower extremity edema; however, the degree, method (elastic stockings vs. bandages), and extent of compression should be considered on a patient-by-patient basis. Appropriate use of compression therapy depends on the patient’s motor and cogni-tive function; therefore, it is important to select a feasible method. Inappropriate compression therapy can worsen edema or cause pressure ulcers27）; therefore, it is important to perform compression therapy with the patient or family’s consent having confirmed that it can be performed appropriately. An edematous foot is prone to cellulitis; therefore, patients should be instructed regarding skin care, including cleansing and moisturizing. Lifestyle guidance including exercise therapy and weight loss may be necessary in patients with disuse- or obesity-induced edema. Manual lymphatic drainage massage is effective for lymphedema and venous stasis edema; a nurse trained in the appropriate technique performs the massage and the patient is accordingly instructed regarding the technique.4-2-4 Care of diabetic foot lesionsFootcare for patients with diabetes commences with evaluation of diabetic peripheral neuropathy. Owing to the progressive nature of this condition, it is difficult for patients to monitor changes in their feet in a timely manner. Therefore, patients with diabetes should have basic knowledge of preven-tive footcare from the early stage of diagnosis. Diabetic footcare does not include only manage-ment of peripheral neuropathy but also involves the treatment of several overlapping concerns such as impaired blood flow due to arteriosclerosis oblit-erans and reduced self-care ability due to retinop-athy. It is important to establish a rapport between medical professionals and patients for timely advice regarding protection of their feet28）.Progression of diabetic foot lesions is associated with glycemic control; persistent hyperglycemia is known to cause infection. Therefore, diabetic foot-care must necessarily include close monitoring of blood glucose control and progression of complica-tions other than foot lesions and the overall treat-ment of diabetes in addition to that of foot lesions.4-2-5 Care of footwearIt is well known that in addition to shoes with high heels and pointed toes, those with many seams and designs can cause foot lesions. Knowledge regarding selection of appropriate shoes and the correct methods of wearing them is limited among the Japanese; therefore, it is necessary to discuss these shoe-related footcare issues with patients. Footwear is a means of self-expression and individ-uality. Moreover, specific types of shoes may be designated by school or an individual’s occupation; therefore, it may not be possible to change shoes from the viewpoint of “appropriate shoes for feet.” Therefore, it is necessary to provide shoes suitable for an individual and also offer education regarding the appropriate method of wearing shoes until the patient is convinced.Correction of foot alignment is the fundamental principle of treatment of foot lesions. Creation of shoe insoles effectively relieves pain, treats calluses and clavus, and prevents progression of deformities. The Japanese medical insurance system provides coverage for orthotics once every 18 months.The footcare team includes orthopedics, plastic surgery, vascular surgery, cardiology, dermatology, diabetology, nephrology, rehabilitation, and anes-thesiology (pain clinic), although these depart-ments vary depending on the size of the medical institution. Nurses, clinical laboratory technicians, medical staff including physical therapists, exercise therapists, dietitians, pharmacists, and other pros-thetists are also members of the footcare team. Therefore, establishment of a medical system comparable with podiatry services available in Europe and the United States warrants a multidis-ciplinary approach to improve the quality and effi-ciency of medical care. Compared with other professionals, footcare nurses have greater interac-tion with patients and are therefore better suited to understand patients’ viewpoints and background. Footcare nurses provide footcare to patients across all stages and are capable of understanding a patient’s condition closely, as the treatment phase shifts from the acute to the rehabilitation and subsequently the home treatment phase. There-2195. Management of the foot care team