<p>Prognosis of the outcome of severe diabetic foot ulcers with multidisciplinary care</p>

Abstract

Background: Approximately 2–4% of individuals worldwide with diabetes mellitus have foot ulcers. This study aims to assess the factors affecting the outcomes of severe foot ulcers in diabetic individuals. Methods: An analytical prospective cohort study was conducted from March 1st, 2015, to March 1st, 2017. A total of 34 individuals was selected. The study included patients with foot ulcers below the ankle who were at risk of amputation. All tests used a <5% level of significance and confidence interval of 95%. A Pearson’s chi-squared test and binary multiple regression were performed to assess the factors related to healing. Results: Only 11.7% of the individuals required amputation; ulcers classified as 2/B according to the University of Texas Diabetic Foot Ulcer Classification System healed before the 1/B ulcers. Neuropathic ulcers were the most prevalent (58.8%); 61.8% healed after 1 year. Most of the individuals were overweight, 47.1% had reduced glomerular filtration rates, and 78.8% had glycated hemoglobin >7%. Body mass index and osteomyelitis were the two significant variables in logistic regression. Conclusions: In this study, osteomyelitis was the main complication related to the risk of amputation, and elevated body mass index and osteomyelitis were the significant factors that induced a slower healing time.

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Predict Mortality in Patients with Diabetic Foot Ulcers Undergoing Amputations

“… 2 Moreover, DFUs are associated with higher rates of lower extremity amputation (LEA) with the rate being 15-to 40-fold higher than in patients with DFUs compared to the general population. 3 The mortality rate of patients following amputation is also very high and at 5 years can reach 80% which is worse than that observed in several types of cancers. 4 , 5 Improving the management of patients with DFUs remains critical towards reducing the mortality rate of patients and improved biomarkers to predict mortality rates following amputation due to DFUs are urgently required.…”

The Clinical Profile of Patients with Chronic Wounds at Dr. Soetomo General Hospital 2015-2020

“…Based on some research about chronic wounds, whether or not the patient's chronic wounds have healed is based on their age, gender, past medical history, the presence or absence of problems with the wound such as infection and dead tissue (necrosis), presence or absence of peripheral arterial disease, the immune system, and lifestyle. 24 Based on the research objectives and the research results that have been obtained, the conclusion regarding the profile of patients with chronic wound treated at Dr. Soetomo General Hospital Surabaya are as follows: 1) Patients are dominated by elderly ages more than 46 years and mostly are male, 2) Three most common medical histories of patients before patient suffers from chronic wound are type 2 diabetes, hypertension, and trauma, 3) The majority of the diagnosis are patients with pressure ulcer (decubitus ulcer) and diabetic ulcer, 4) The clinical picture found is a problem with the presence of exudate, 5) All patients receive wound bed preparation but not all receive wound closure (flap and skin graft), 6) Most of the patient that has been discharge from the hospital are in a healed stage.…”

The Influence of 6-Month Interdisciplinary Accompaniment on Family Caregivers’ Knowledge and Self-Efficacy Regarding Diabetic Wound Care

“…Interdisciplinary care is an effort to provide effective and efficient care to patients with chronic health conditions by including various groups of health care professionals (e.g., doctors, nurses, pharmacists, dietitians, and health educators) in the treatment approach, with the patient and family composing the core team ( Codispoti et al, 2004 ). The interdisciplinary care model provides comprehensive treatment that improves glucose and diabetic ulcer control management ( Dutra et al, 2019 ; Sagha Zadeh et al, 2018 ; Tan et al, 2019; Tremblay et al, 2017 ), thereby preventing the need for amputation ( Ugwu et al, 2019 ).…”