Use of the Semmes-Weinstein Monofilament
Directions for use of Semmes – Weinstein Monofilament
- Assess integrity of monofilament (no bends/breaks).
- Show the monofilament to the client. Place the end of the monofilament on his/her hand or arm to show that the testing procedure will not hurt.
- Ask the client to turn his/her head and close his/her eyes or look at the ceiling.
- Hold the monofilament perpendicular to the skin.
- Place the end of the monofilament on the sole of the foot. Ask the patient to say ‘yes’ when he/she feels you touching his/her foot with the monofilament. DO NOT ASK THE PATIENT, “did you feel that?” If the patient does not say ‘yes’ when you touch a given testing site, continue on to another site. When you have completed the sequence RETEST the area(s) where the patient did not feel monofilament.
- Push the monofilament until it bends, then hold for 1-3 seconds.
- Lift the monofilament from the skin. Do not brush or slide along the skin.
- Repeat the sequence randomly at each testing site on the foot (see pictures below).
Sites on the sole of the foot for monofilament testing
Loss of protective sensation = absent sensation at one or more sites.
- Apply only to intact skin. Avoid calluses, ulcerated or scarred areas. DO NOT use a rapid or tapping movement.
- If the monofilament accidentally slides along the skin, retest that area later in the testing sequence.
- Store the monofilament according to the manufacturer’s instructions.
- Clean the monofilament according to agency infection control protocols.