Source: Diabetes  |  Posted 9 years ago

A unified, multidiscipline team approach to wound care may reduce the lower limb amputation rate among diabetics.

Lower-extremity amputation rates among diabetics is high and the wound failure rate at the time of amputation is as high as 28 percent. Even with successful healing of the primary amputation site, amputation of part of the contralateral limb occurs in 50 percent of patients within two to five years.

Dessie D. Meltzer, BS, RN, at the Department of Veterans Affairs, in Bay Pines, Florida, United States, and colleagues analyzed patient outcome data before and 18 months after the implementation of a multidisciplinary team approach, which employed verified methods for improving the institutional care of wounds.

The researchers retrospectively reviewed the medical charts of 118 patients before the new approach was implemented and 116 patients after its implementation.

They found the amputation rate was significantly lower after the unified care approach was implemented compared with the previous rate. In addition, amputations that were required were at a significantly more distal level. No above-the-knee amputations were required in 45 patients who received the more unified care, compared with 14 of 76 patients treated before the new approach, they reported.

"These outcome data suggest that unified care is an effective approach for the patient with diabetic foot problems," the researchers concluded.