Impact of multidisciplinary foot care team on outcome of diabetic foot ulcer in term of lower extremity amputation at a tertiary care unit in Karachi, Pakistan

Int Wound J. 2019 Jun;16(3):768-772. doi: 10.1111/iwj.13095. Epub 2019 Feb 15.

Abstract

To compare the outcomes of diabetic foot ulcers (DFU) in terms of healing and lower extremity amputation (LEA) rate before and after training of multidisciplinary foot care team (MDFCT). Subjects were categorised into two groups; Group-A cases seen between 1997 and 2006 (before upgrading of training and services of MDFCT) and Group-B cases seen between 2007 and 2016 (after upgrading of training and services of MDFCT). Baseline demographic characteristics, biochemical results, and outcomes of DFU in terms of healing or amputation were analysed by using statistical package social science (SPSS) version 20. Total 7994 DFU cases seen, 888 in group A and 7106 in group B. Mean age of patients was 53.80 ± 10.40 years and mean haemoglobin (HbA1c) was 10.12 ± 2.44. Overall, decreasing trends of amputations were observed from baseline 27.5% to 3.92% during the period of 20 years. In group A, 479 (78.8%) subjects healed completely compared with 3806 (89.1%) in group B. Significant reduction in toe amputations ([13.81%] vs [8.11%]) and below knee amputations [(5.26%) vs (1.82%)] were seen. Similarly, rates of above knee amputation ([1.80%] vs [0.35%] P-value 0.008) in two groups was also significant. Significant improvement was observed in outcomes of DFU in terms of amputation through multidisciplinary team approach.

Keywords: amputation rate; diabetic foot ulcer; foot care; multidisciplinary team.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Amputation, Surgical / statistics & numerical data*
  • Clinical Competence*
  • Cross-Sectional Studies
  • Diabetic Foot / therapy*
  • Female
  • Humans
  • Interprofessional Relations
  • Lower Extremity / surgery*
  • Male
  • Middle Aged
  • Pakistan
  • Patient Care Team*
  • Retrospective Studies
  • Tertiary Healthcare / statistics & numerical data*
  • Treatment Outcome*