Organization of wound healing services: The impact on lowering the diabetes foot amputation rate in a ten-year review and the importance of early debridement

Hsu, Cherng-Ru; Chang, Chang‐Cheng; Chen, Yu‐Tsung; Lin, Wei-Nung; Chen, Mei‐Yen

doi:10.1016/j.diabres.2015.04.026

Cited by 43 publications

(39 citation statements)

References 31 publications

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“…Uncomplicated DFU would likely be treated and the healing rate was estimated from clinical trials . The probability of complicated DFU arising from uncomplicated DFU was estimated from a Taiwanese study . The risk ratio (RR) of optimal care versus usual care was 0.75 in developing DFU and amputation …”

Section: Methodsmentioning

confidence: 99%

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Cost‐effectiveness of prevention and management of diabetic foot ulcer and amputation in a health resource‐limited setting

Wu¹,

Wang²,

Ma³

2017

Journal of Diabetes

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Section: Methodsmentioning

confidence: 99%

“…17 The probability of complicated DFU arising from uncomplicated DFU was estimated from a Taiwanese study. 16 The risk ratio (RR) of optimal care versus usual care was 0.75 in developing DFU and amputation. 33 Natural mortality could occur at any point during the disease course.…”

Section: Clinical Datamentioning

confidence: 99%

Cost‐effectiveness of prevention and management of diabetic foot ulcer and amputation in a health resource‐limited setting

Wu¹,

Wang²,

Ma³

2017

Journal of Diabetes

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“…(Our wound care center and wound care management are described in detail in our previous publication. [17] ) Exclusion criteria included end-stage renal disease, severe anemia (hemoglobin <9 g/dL), previous lower limb amputation, and heart failure (New York functional class >II). Also, some patients in our wound care center received negative pressure wound therapy or revascularization therapy, but they are not included in this study.…”

Section: Methodsmentioning

confidence: 99%

A quantitative real-time assessment of Buerger exercise on dorsal foot peripheral skin circulation in patients with diabetes foot

et al. 2016

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Buerger exercise can improve the peripheral circulation of lower extremities. However, the evidence and a quantitative assessment of skin perfusion immediately after this exercise in patients with diabetes feet are still rare.We recruited 30 patients with unilateral or bilateral diabetic ulcerated feet in Chang Gung Memorial Hospital, Chia-Yi Branch, from October 2012 to December 2013. Real-time dorsal foot skin perfusion pressures (SPPs) before and after Buerger exercise were measured and analyzed. In addition, the severity of ischemia and the presence of ulcers before exercise were also stratified.A total of 30 patients with a mean age of 63.4 ± 13.7 years old were enrolled in this study. Their mean duration of diabetes was 13.6 ± 8.2 years. Among them, 26 patients had unilateral and 4 patients had bilateral diabetes foot ulcers. Of the 34 wounded feet, 23 (68%) and 9 (27%) feet were classified as Wagner class II and III, respectively. The real-time SPP measurement indicated that Buerger exercise significantly increased the level of SPP by more than 10 mm Hg (n = 46, 58.3 vs 70.0 mm Hg, P < 0.001). In terms of pre-exercise dorsal foot circulation condition, the results showed that Buerger exercise increased the level of SPP in severe ischemia (n = 5, 22.1 vs 37.3 mm Hg, P = 0.043), moderate ischemia (n = 14, 42.2 vs 64.4 mm Hg, P = 0.001), and borderline–normal (n = 7, 52.9 vs 65.4 mm Hg, P = 0.028) groups, respectively. However, the 20 feet with SPP levels more than 60 mm Hg were not improved significantly after exercise (n = 20, 58.3 vs 71.5 mm Hg, P = 0.239). As to the presence of ulcers, Buerger exercise increased the level of SPP in either unwounded feet (n = 12, 58.5 vs 66.0 mm Hg, P = 0.012) or wounded feet (n = 34, 58.3 vs 71.5 mm Hg, P < 0.001). The majority of the ulcers was either completely healed (9/34 = 27%) or still improving (14/34 = 41%).This study quantitatively demonstrates the evidence of dorsal foot peripheral circulation improvement after Buerger exercise in patients with diabetes.

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“…Multiple studies have supported the efficacy of protocolbased treatment for pressure ulcers, venous stasis ulcers, and diabetic foot ulcers. [5][6][7] Edwards et al [8] confirmed that the implementation of evidence-based protocols for wound assessment and treatment was significantly related to improve healing outcomes. The principle of wound care protocol is easy to comprehend, but the execution of the clinical efficient wound management service is complicated and needs a standardized and well-integrated multidisciplinary team with specific capacity.…”

Section: The Efficient Referral System For Wound Care Centermentioning

confidence: 98%

Clinical pathway for an efficient wound care center

Chen¹,

Chang²

2016

PAR

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Organization of wound healing services: The impact on lowering the diabetes foot amputation rate in a ten-year review and the importance of early debridement

Cited by 43 publications

References 31 publications

Cost‐effectiveness of prevention and management of diabetic foot ulcer and amputation in a health resource‐limited setting

Cost‐effectiveness of prevention and management of diabetic foot ulcer and amputation in a health resource‐limited setting

A quantitative real-time assessment of Buerger exercise on dorsal foot peripheral skin circulation in patients with diabetes foot

Clinical pathway for an efficient wound care center

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