Effective management of patients with diabetes foot ulcers: outcomes of an Interprofessional Diabetes Foot Ulcer Team

被引:25
作者
Ogrin, Rajna [1 ,2 ]
Houghton, Pamela E. [3 ]
Thompson, G. William [4 ]
机构
[1] Univ Western Ontario, Sch Phys Therapy, London, ON, Canada
[2] Royal Dist Nursing Serv Inst, Ctr Wound Management, St Kilda, Vic, Australia
[3] Univ Western Ontario, Fac Hlth Sci, London, ON, Canada
[4] Univ Western Ontario, Schulich Sch Med & Dent, Dept Internal Med, London, ON, Canada
关键词
Diabetes-related foot ulcer; Healing; Interprofessional care; Patient-centred care; Quality of life; INTERNATIONAL-WORKING-GROUP; CLASSIFICATION-SYSTEM; SCORE; RISK; CARE; POPULATION; VALIDATION; CONSENSUS;
D O I
10.1111/iwj.12119
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
A longitudinal observational study on a convenience sample was conducted between 4 January and 31 December of 2010 to evaluate clinical outcomes that occur when a new Interprofessional Diabetes Foot Ulcer Team (IPDFUT) helps in the management of diabetes-related foot ulcers (DFUs) in patients living in a small urban community in Ontario, Canada. Eighty-three patients presented to the IPDFUT with 114 DFUs of average duration of 195 +/- 27 weeks. Patients were 584 +/- 14 years of age and 90% had type 2 diabetes, HbA1c of 83 +/- 20%, with an average diabetes duration of 223 +/- 34 years; in 69% of patients, 78 DFUs healed in an average duration of 74 +/- 07 weeks, requiring an average of 38 clinic visits. Amputation of a toe led to healing in three patients (4%) and one patient required a below-knee amputation. Six patients died and three withdrew. Adding a skilled IPDFUT that is trained to work together resulted in improved healing outcomes. The rate of healing, proportion of wounds closed and complication rate were similar if not better than the results published previously in Canada and around the world. The IPDFUT appears to be a successful model of care and could be used as a template to provide effective community care to the patients with DFU in Ontario, Canada.
引用
收藏
页码:377 / 386
页数:10
相关论文
共 42 条
[1]   Improvement of diabetic foot care after the Implementation of the International Consensus on the Diabetic Foot (ICDF): Results of a 5-year prospective study [J].
Anichini, Roberto ;
Zecchini, Franco ;
Cerretini, Ivano ;
Meucci, Giuseppe ;
Fusilli, Daniela ;
Alviggi, Lorenzo ;
Seghieri, Giuseppe ;
De Bellis, Alessandra .
DIABETES RESEARCH AND CLINICAL PRACTICE, 2007, 75 (02) :153-158
[2]  
[Anonymous], 2012, Global Guideline for Type 2 Diabetes
[3]   Practical guidelines on the management and prevention of the diabetic foot - Based upon the International Consensus on the Diabetic Foot (2007) prepared by the International Working Group on the Diabetic Foot [J].
Apelqvist, J. ;
Bakker, K. ;
van Houtum, W. H. ;
Schaper, N. C. .
DIABETES-METABOLISM RESEARCH AND REVIEWS, 2008, 24 :S181-S187
[4]   Validation of a diabetic wound classification system - The contribution of depth, infection, and ischemia to risk of amputation [J].
Armstrong, DG ;
Lavery, LA ;
Harkless, LB .
DIABETES CARE, 1998, 21 (05) :855-859
[5]   A new wound-based severity score for diabetic foot ulcers -: A prospective analysis of 1,000 patients [J].
Beckert, S ;
Witte, M ;
Wicke, C ;
Königsrainer, A ;
Coerper, S .
DIABETES CARE, 2006, 29 (05) :988-992
[6]   A firm trial of interdisciplinary rounds on the inpatient medical wards - An intervention designed using continuous quality improvement [J].
Curley, C ;
McEachern, JE ;
Speroff, T .
MEDICAL CARE, 1998, 36 (08) :AS4-AS12
[7]   Complexity of factors related to outcome of neuropathic and neuroischaemic/ischaemic diabetic foot ulcers: a cohort study [J].
Gershater, M. A. ;
Londahl, M. ;
Nyberg, P. ;
Larsson, J. ;
Thorne, J. ;
Eneroth, M. ;
Apelqvist, J. .
DIABETOLOGIA, 2009, 52 (03) :398-407
[8]   Symptoms of depression prospectively predict poorer self-care in patients with Type 2 diabetes [J].
Gonzalez, J. S. ;
Safren, S. A. ;
Delahanty, L. M. ;
Cagliero, E. ;
Wexler, D. J. ;
Meigs, J. B. ;
Grant, R. W. .
DIABETIC MEDICINE, 2008, 25 (09) :1102-1107
[9]  
Hamonet J., 2010, Annals of Physical and Rehabilitation Medicine, V53, P306, DOI 10.1016/j.rehab.2010.04.001
[10]   Four-fold increase in foot ulcers in type 2 diabetic subjects without an increase in major amputations by a multidisciplinary setting [J].
Hedetoft, Christoffer ;
Rasmussen, Anne ;
Fabrin, Jesper ;
Kolendorf, Klaus .
DIABETES RESEARCH AND CLINICAL PRACTICE, 2009, 83 (03) :353-357