Reducing Lower Extremity Amputations Due to Diabetes: The Application of Diabetic-Foot Protocol in Chiang Mai University Hospital

2008 ◽  
Vol 7 (2) ◽  
pp. 88-92 ◽  
Author(s):  
Kittipan Rerkasem ◽  
Natapong Kosachunhanun ◽  
Siam Tongprasert ◽  
Krit Khwanngern ◽  
Anuchart Matanasarawoot ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Standard Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
University Hospital ◽  
Diabetic Patients ◽  
Foot Care ◽  
Care Groups ◽  
Patients With Diabetes ◽  
Foot Disease

The aim of this study was to determine whether intensive treatment and education strategies for diabetic patients with ulcers help in preventing leg amputation. From August 2005 to March 2007, a diabetic-foot protocol using a multidisciplinary approach was applied at our hospital. All the subjects were educated regarding diabetic-foot disease and its complications and prevention. This report compares the amputation rate in patients receiving the protocol care from August 2005 to March 2007 with those who had standard care from August 2003 to July 2005. Seventy-three and 110 diabetic-foot ulcer patients received protocol and standard foot care, respectively. The incidence of major amputations in the protocol and standard care groups was 4.1% and 13.6%, respectively ( P = .03). Our protocol was associated with improved diabetic-foot care outcomes. It can be used by any hospital to improve outcomes for patients with diabetes.

scholarly journals Factors associated with wound healing outcome among Diabetic Foot patients- A cross sectional Study

2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Wound Management ◽  
Diabetic Patients ◽  
Foot Care ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
One Year

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.

scholarly journals A Survey of Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer in Bangladesh

2014 ◽  
Vol 4 (1) ◽  
pp. 22-26 ◽  
Author(s):  
S Sharmisthas ◽  
P Wongchan ◽  
S Hathairat
Keyword(s):  
Diabetic Foot ◽  
Callus Formation ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Care Program ◽  
Foot Care ◽  
Multiple Choice Questions ◽  
Patients With Diabetes ◽  
Protective Sensation ◽  
Nurses Knowledge

Diabetic foot ulcer is a preventable complication of diabetes. Nurses must have knowledge related to this condition so that education can be given to patients. This study aims to examine the level of nurses’ knowledge regarding prevention and management of diabetic foot ulcer in Bangladesh. A survey involved 218 nurses working at a national, specialized, and well-established institute of diabetic care of Bangladesh. The Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer Questionnaire (NKPMDFUQ) comprising of 40 questions with 20 true/false questions and 20 multiple choice questions was used. It was content validated and tested for internal consistency and stability yielding acceptable levels of reliability. The findings revealed that nurses had very low level of knowledge (M=52.60%, SD=7.86%). The content areas most nurses did not have knowledge were detecting loss of protective sensation of the feet, caring of callus formation, encouraging patients to have activity of daily living in order to self-manage, setting a goal for prevention of amputation, and giving advice to patients that causes of diabetes is the least important element in diabetic foot care program. The findings are beneficial for establishing training courses. Consequently, quality of care for patients with diabetes will be improved. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18549 Birdem Med J 2014; 4(1): 22-26

scholarly journals Assessment of Prevalence, Associations ,Knowledge, and Practices about Diabetic Foot Disease in a Tertiary Care Hospital in Colombo, Sri Lanka

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
V. T. S. Kaluarachchi ◽  
D. U. S. Bulugahapitiya ◽  
M. H. Arambewela ◽  
M. D. Jayasooriya ◽  
C. H. De Silva ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Sri Lanka ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Foot Care ◽  
Diabetic Foot Disease ◽  
Care Practices ◽  
Foot Disease

Background. One in five adults in Sri Lanka has either diabetes or prediabetes, and one-third of those with diabetes are undiagnosed. Diabetic foot is a debilitating condition affecting up to 50% of patients with both type 1 and type 2 diabetes. The risk of nontraumatic lower limb amputations is 15 times higher in diabetic patients when compared with nondiabetics. Patient education about correct foot care practices is the cornerstone of prevention of diabetic foot disease. Objective. To assess the prevalence of diabetic foot disease, knowledge, and practices about diabetic foot care among diabetic patients. Methods. 334 patients attending the diabetic clinic in Colombo South Teaching Hospital were recruited according to the inclusion and exclusion criteria. Data were collected using 3 questionnaires, and they were filled using the foot examination findings, patients’ medical records, and direct interviewing of the patients. Results. The mean age of the patients included in the study was 58.23 ± 10.65 years while the median duration of diabetes was 10.54 ± 7.32 years. 34.1% patients had peripheral neuropathy, and 29.5% had peripheral vascular disease. Diabetic foot disease according to the WHO definition was present only in 23 (6.9%) patients. There was a significant association between peripheral neuropathy and current or past foot ulcer which took more than 2 weeks to heal ( p < 0.05 ). Knowledge about foot care was less among the studied population, and it was associated with poor foot care practices. Presence of diabetic foot and current or past foot ulcer which took more than 2 weeks to heal were significantly associated with the foot care knowledge and practices ( p < 0.05 ) Conclusion. Improvement of patients’ knowledge about foot care and their practices have a significant impact on the reduction of diabetic foot disease.

scholarly journals Prevention and treatment of diabetic foot ulcers

2017 ◽  
Vol 110 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Jonathan Zhang Ming Lim ◽  
Natasha Su Lynn Ng ◽  
Cecil Thomas
Keyword(s):  
Diabetic Foot ◽  
Healthcare Access ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Healthcare Provision ◽  
Foot Complications

The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

scholarly journals The risk factors of developing diabetic foot ulcers incidence with diabetic patients in Mukalla/Yemen

2020 ◽  
Author(s):  
مريم باراس ◽  
Eidha A. Bin Hameed
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Bacterial Infection ◽  
Diabetic Foot ◽  
Age Groups ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Patients With Diabetes

Background: Diabetes is on the rise worldwide and is already considered as an epidemic by some experts. So, there is a need to raise awareness on the important factors that can help prevent bacterial infection in wounds of patients with diabetes. Objective: To study the risk factors of developing diabetic foot ulcer (DFU) in patients with diabetes. The study is the first in Yemen to investigate the prevalence of bacterial infection in wounds of diabetic patients. Materials and Methods: This is a case-control study carried out from November 2018 to May 2019. Twenty diabetic patients with foot ulcer and twenty without foot ulcer were examined. Risk factors and clinical profile of patients were studied by using a standardized questionnaire that included gender, age groups, past history of diabetes, duration of the disease, type of diabetes, DFU, type of ulcer, smoking, glucose level, and control of blood glucose level. Results: The risk factors that affected significantly the occurrence of DFU were gender (0.038), age groups (0.010), and duration of diabetes mellitus (DM) while hyperglycemic control, smoking, and family history were not. There was no significant difference (0.977) in mean fasting blood glucose (MBG) between the DM and DFU patients. Conclusions: Male diabetic patients aged more than 55 years and suffering from DM for more than 10 years were most likely to have DFU. Key words: diabetic foot ulcer, diabetes mellitus, risk factors, Yemen 

scholarly journals 845 Diabetic Foot Care Services in COVID-19 Era – A University Hospital Multi specialty Team Experience

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Q Ain ◽  
P Solanki ◽  
T Georgi ◽  
T Gala ◽  
H Ashraf ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Care Service ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Patient Survey ◽  
University Hospital ◽  
Foot Care ◽  
Face To Face ◽  
Care Services ◽  
Survey Form

Abstract Introduction Multidisciplinary foot care services contribute to the reduction in amputations from foot ulceration secondary to diabetes. The COVID-19 pandemic pressurised services and required a pause of elective care. This study reports the patient’s experience of foot care provision during the first wave where self-care, virtual appointments and patient directed appointments were utilised. Method Diabetic foot patients were retrospectively identified over a one-month period booked for MDT care (in hospital, OPD, diabetic foot clinic, community podiatry clinic or at home). All patients&gt;16 years of age diagnosed with a new or previous diabetic foot ulcer or post-operative foot wound were included. Data was collated via a patient survey form and descriptive statistics were used to characterize the study population and responses. Results 63 patients were identified (1/10 – 30/10) with data collated from 51 respondents (81%). 78% (40/51) were male. Median age was 69 years (IQR 59–76). 86% were comfortable attending a hospital appointment. 92% reported continuing to receive an appropriate level of care. All of the patients felt well supported and knew how to access the foot care service. 29% utilised virtual care. 82% (42/51) considered face to face appointments were more suitable for follow up rather than virtual/phone appointments. Conclusions It was possible to continue to provide safe diabetic foot care despite the COVID-19 pandemic but careful patient selection and communication is the key.

Use of GBT013, a Collagen-Based Dressing, for the Healing of Diabetic Foot Ulcers

2018 ◽  
Vol 108 (5) ◽  
pp. 419-429
Author(s):  
Isabelle J. Dumont ◽  
Marc Lepeut ◽  
Coralie Segalen ◽  
Yannis Guillemin ◽  
Jean Noel Gouze
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Complete Healing ◽  
Ease Of Use ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Foot Care ◽  
University Of Texas

The number of people with diabetes is expected to reach 592 million in the year 2035. Diabetic foot lesions are responsible for more hospitalizations than any other complication of diabetes. The aims of this study were to examine for the first time a new biocompatible and biodegradable tridimensional collagen-based matrix, GBT013, in humans for diabetic foot ulcer wound healing and to evaluate its ease of use to better define a protocol for a future clinical trial. Seven adult patients with a diabetic foot ulcer of grade 1A to 3D (University of Texas Diabetic Wound Classification) were treated using GBT013, a new collagen-based advance dressing and were monitored in two specialized foot care units for a maximum of 9 weeks. Five of seven wounds achieved complete healing in 4 to 7 weeks. Nonhealed ulcers showed a significant reduction of the wound surface (&gt;44%). GBT013 was well tolerated and displayed positive wound healing outcomes as a new treatment strategy of chronic foot ulcers in diabetic patients.

scholarly journals Karakteristik Diabetic Foot Ulcer (DFU) pada Individu dengan Diabetes Mellitus (DM): Studi Deskripsi – Cross Sectional

2020 ◽  
Vol 7 (2) ◽  
pp. 88-98
Author(s):  
Niken Safitri Dyan Kusumaningrum ◽  
Afriana Dwi Saputri ◽  
Henni Kusuma ◽  
Meira Erawati
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Diabetic Patients ◽  
Fatty Tissue ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Patients With Diabetes

Diabetic Foot Ulcer (DFU) is one of the complications often experienced by patients with diabetes mellitus (DM). This is a serious problem that leads to disability, morbidity, and mortality among diabetic patients. However, in Indonesia, studies about DFU characteristics are very limited. This study aimed to describe DFU characteristics among patients with DM. A consecutive sampling involved patients who met inclusion criteria was performed in Tugurejo Hospital; Islamic Sultan Agung Hospital, and Dr. Moewardi Hospital. Their demographic characteristics, clinical condition, and wound appearances were noted and documented. Diabetic Foot Ulcer Assessment Scale (DFUAS) that consists of 11 characteristics was used to observe the wound features. The data were quantitatively analyzed to elucidate the result. A total of 73 patients participated in this study. It was revealed that 50.7% were females and 75.3% have been diagnosed with hyperglycemia. The average age of the respondents was 53.26 years. Observation of DFU characteristics showed that depth of wound was identified more in subcutaneous/ dermis to fatty tissue (40 patients; 54.8%) than in other layers. Moreover, our findings indicated that most of the respondents were identified at a severe level of the wound (55; 75.3%). It is concluded that DFU characteristics vary among patients with DM. Early identification and intensive surveillance are important to improve the management of DFU and to avoid lower limb amputation.

scholarly journals Knowledge of Risk Factors for Foot Ulceration among Patients with Diabetes Mellitus Attending a Tertiary Health Facility in Nigeria

2021 ◽  
Author(s):  
Martins Ehizode Emuze ◽  
Taoreed Adegoke Azeez ◽  
Arinola Esan ◽  
Jokotade Adeleye ◽  
William Balogun ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Health Facility ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Foot Ulceration ◽  
Validated Questionnaire ◽  
Patients With Diabetes

Objective: Diabetic foot ulcer (DFU) is a relatively common complication of diabetes mellitus and constitutes a major cause of mortality. This study aimed to assess the knowledge of risk factors for foot ulceration among patients with diabetes in a tertiary health facility in South Western Nigeria. Materials and Methods: This cross-sectional study was initiated with participation of 100 diabetic patients. Diabetic patients were attending the medical outpatient clinic of the University College Hospital, Ibadan. A structured and validated questionnaire was administered and data was analyzed using SPSS 22. Association between sociodemographic characteristics and knowledge of risk factors for foot ulceration was evaluated by chi-square test. Results: Most of respondents were female (66%). The mean age of the patients was 58.77 (±11.8) years and 51% of patients did not know that it is possible to develop foot ulcer without feeling pain and 30% did not know that features suggestive of neuropathy could be associated with development of foot ulcer. 75% did not know that surgical vascular repair could play any role in the healing of a diabetic foot ulcer. 11% of patients were walking barefooted at home and as much as 63% of respondents did not know that poor longterm glycemic control could be a risk factor for the development of diabetic foot ulcers. Conclusion: The knowledge of the patients attending the diabetes clinic of a tertiary hospital in south-western Nigeria on foot care is generally poor. Education in this direction is very paramount to correct this defect.

scholarly journals Diabetic Foot Ulceration in a Secondary Health Facility

2020 ◽  
pp. 10-15
Author(s):  
Ayuba Affi ◽  
David Mancha ◽  
Pam Stephen ◽  
Amusa Ganiyu ◽  
S. A. Longwap
Keyword(s):  
Risk Factors ◽  
Glycaemic Control ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Serum Glucose ◽  
Diabetic Patients ◽  
Foot Care ◽  
Foot Ulceration ◽  
Poor Glycaemic Control

Aims: To determine the prevalence, pattern and presentation of the diabetic foot ulcer. Background: A diabetic foot ulcer is a major complication in diabetes mellitus and probably the major component of diabetic foot. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations. Poverty, low economic status and ignorance have resulted in this devastating disease. It may worsen in the next decade. There are multiple risk factors that predispose an individual to DM foot ulcer; they include age, gender(male), type of DM, glycaemic (HbA1c) or FBG level, duration of DM (>10yrs) occupational status particular habits of self-foot care and infection. Patients and Methods: This consists of 69 diabetic patients; male and female included done between the months of January 2019 to March 2019. A demographic data questionnaire and social history were obtained. Overnight fasting serum glucose was obtained. Serum glucose was determined by enzymatic glucose oxidase method. Data obtained were subjected to Stata Version 11 Software to determine the graphical representation, mean, standard deviation of the analysis. Results: Thirty-Five 35 were male and 34 were female had type 2 diabetes. Forty-Three 43 patients had foot ulcer, 21 patients had gangrene and 5 had infection. The number of patients with peak glucose values 10 mmol/L and least glucose at 20-25 mmol/L. Those of duration 4-6 years were the most affected the age group most affected is between 40-59 yrs. Discussion and Conclusion: Risk factors for foot ulceration discovered among a host other factors identified in this study, were the infection, low socioeconomic status, improper footwear, poor glycaemic control, structural foot deformity and untreated gangrene. The role of poor glycaemic control in the genesis of diabetic complications cannot be overemphasized as the mean FPG was noted to be considerably higher in patients with foot ulceration As part of a comprehensive foot care programme, education on foot care should be directed at patients, family members and healthcare providers. Not less than 85% of all diabetic foot-related problems are preventable. This can be achieved through a combination of good care of foot, provided by an inter-professional diabetes care team, and appropriate education for people with diabetes.

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