Effectiveness of a Collaborative Nursing Care Model for the Treatment of Patients with Diabetic Foot Disease by Transverse Tibial Bone Transport Technique: A Pilot Study

Abstract

Medical staff shortages remain a serious challenge, particularly to medical administrators. We aimed to analyze the effectiveness of a collaborative nursing care model in treatment of diabetic foot. Design: A quasi-experimental pilot study. Methods: Twenty-eight patients with diabetic foot treated by transverse tibial bone transport between January 2017 and March 2018 were randomized. The observational group received collaborative nursing care, while the control group received usual nursing care. Postoperative dorsal foot skin temperature, visual analog scale, self-rating anxiety scale (SAS) score, and other endpoints were assessed. Findings: Postoperative dorsal foot skin temperature was significantly higher in the observation group than in the control group. Visual analog scale and SAS scores were significantly lower in the observational group than in the control group. Conclusions: The collaborative nursing care model enhanced collaboration between patient and health care providers, shortened hospital stay, and relieved postoperative pain and anxiety.

Application and Clinical Effectiveness of Antibiotic-Loaded Bone Cement to Promote Soft Tissue Granulation in the Treatment of Neuropathic Diabetic Foot Ulcers Complicated by Osteomyelitis: A Randomized Controlled Trial

“…Analysis of data suggested that patients from control group did spend an overall mean of 1.2 days longer than those from the study group. Even though there was no statistical difference between the two group, it is worth noting that the need for hospitalization is a parameter which might affect the mood of diabetic patients [14]. Hospital LOS has also significantly been associated with number of variables such as the time and type of admission, place of residence,…”

“…The conception of our study was designed to assess if individually adding these two different therapies to the standard care (which mainly includes systemic antibiotherapy combined with standard diabetic wound management) showcases the clinical benefits of ALBC in diabetic foot ulcers suggestive to osteomyelitis. As one of the leading causes of chronic diseases and limb loss worldwide, diabetes mellitus (DM) affects developing countries disproportionately as more than 80% of diabetes deaths occur in low-and middle-income countries [14,17]. Diabetic foot (DF) is described by a decrease in pain and temperature sensation first and later by a decrease in vibratory sensitivity and superficial touch, resulting to the patient being unable to feel painful mechanical, chemical, or thermal stimuli in normal situations [18,19].…”

“…Although its management has evolved throughout the years, an overall analysis of current clinical practices guidelines found its evidence to be controversial [1]. Nevertheless, within the diabetic foot population, pain still remains an essential pathological condition through which physician assesses preoperative medical severity and postoperative outcomes [14]. In the current study, data related to pain intensity showed that with an average reported pain score (NRS) of 3.3 (control group) and 1.4 (study group), the control group's average scores were 2.35 times higher than the average study group score.…”

“…There are several helpful indicators of clinical severity and resources, and hospital length of stay (LOS) is one of them especially in the area of diabetic foot diseases [14]. Assessing patient's rational LOS gives us the possibility to evaluate the degree and quality of hospital care that the patient cannot receive elsewhere [42].…”

“…While patient from control group received a traditional treatment, those from study group were treated with an antibiotic-loaded bone cement. [14]. According to the shape of the wound surface, antibiotic bone cement was used to cover the entire surface.…”