The diabetic foot in Germany – analysis of quality in specialised diabetic wound care centers

Lobmann, Ralf; Müller, E.; Kersken, J.; Bergmann, Klaus von; Brunk-Loch, S.; Groene, C.; Lindloh, C.; Mertes, B.

doi:10.1055/s-2007-972294

Cited by 10 publications

(11 citation statements)

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“…For the evaluation, each center documented 30 consecutively seen individuals with diabetic foot lesions and outcome evaluations of these were performed 6 months after the initial presentation. 96 A similar system of audit, certification, and benchmarking was developed in Belgium under the guidance of Kristien Van Acker. Diabetic foot clinics were required to fulfill special criteria: They had to show experience of 52 new diabetic ulcers with Wagner grade 2 or Charcot foot per year.…”

Section: System Changes Research and Reduction In Amputation Ratesmentioning

confidence: 99%

History of the team approach to amputation prevention: Pioneers and milestones

Sanders

Robbins

Edmonds

2010

Journal of Vascular Surgery

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Section: System Changes Research and Reduction In Amputation Ratesmentioning

confidence: 99%

History of the team approach to amputation prevention: Pioneers and milestones

Sanders

Robbins

Edmonds

2010

Journal of Vascular Surgery

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“…Although the demographics and medical history of the patients in the present study were comparable with those of the Eurodiale study, the ulcers were, due to different inclusion criteria, more severe . Compared to studies including less severe ulcers and/or with a longer follow‐up duration , the achieved healing, amputation and mortality rates were favourable.…”

Section: Discussionmentioning

confidence: 60%

“…Nevertheless, the expert committee included the Belgian participant of the Eurodiale study, so practical issues experienced in Eurodiale were included at an early stage. The German system for accreditation of DFCs started in 2003 , and, in the recent years, there have been frequent exchanges to learn from each other's systems, for example, with regard to benchmarking and the organization of mutual visits between DFCs.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a quality improvement initiative in Belgian diabetic foot clinics: feasibility and initial results

Doggen

Acker²,

Beele

et al. 2014

Diabetes Metabolism Res

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A unique, nationwide quality improvement initiative was established among diabetic foot clinics, covering ulcer healing, lower limb amputation and many other aspects of diabetic foot care. Data completeness increased, thanks in part to questionnaire revision. Benchmarking remains challenging, given the many possible indicators and limited sample size. The optimized questionnaire allows future quality of care monitoring in diabetic foot clinics.

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“…96 A similar system of audit, certification, and benchmarking was developed in Belgium under the guidance of Kristien Van Acker. These requirements established procedures by which specialized centers for the treatment of the diabetic foot syndrome could verify the quality of their management.…”

Section: System Changes Research and Reduction In Amputation Ratesmentioning

confidence: 99%

History of the Team Approach to Amputation Prevention

Sanders

Robbins

Edmonds

2010

JAPMA

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This historical perspective highlights some of the pioneers, milestones, teams, and system changes that have had a major impact on management of the diabetic foot during the past 100 years. In 1934, American diabetologist Elliott P. Joslin noted that mortality from diabetic coma had fallen from 60% to 5% after the introduction of insulin, yet deaths from diabetic gangrene of the lower extremity had risen significantly. He believed that diabetic gangrene was preventable. His remedy was a team approach that included foot care, diet, exercise, prompt treatment of foot infections, and specialized surgical care. The history of the team approach to management of the diabetic foot chronicles the rise of a new health profession-podiatric medicine and surgery-and emergence of the specialty of vascular surgery. The partnership among the diabetologist, vascular surgeon, and podiatric surgeon is a natural one. The complementary skills and knowledge of each can improve limb salvage and functional outcomes. Comprehensive multidisciplinary foot-care programs have been shown to increase quality of care and reduce amputation rates by 36% to 86%. Development of distal revascularization techniques to restore pulsatile blood flow to the foot has also been a major advancement. Patients with diabetic foot complications are among the most complex and vulnerable of all patient populations. Specialized diabetic foot clinics of the 21st century should be multidisciplinary and equipped to coordinate diagnosis, off-loading, and preventive care; to perform revascularization procedures; to aggressively treat infections; and to manage medical comorbidities.

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The diabetic foot in Germany – analysis of quality in specialised diabetic wound care centers

Cited by 10 publications

References 0 publications

History of the team approach to amputation prevention: Pioneers and milestones

History of the team approach to amputation prevention: Pioneers and milestones

Implementation of a quality improvement initiative in Belgian diabetic foot clinics: feasibility and initial results

History of the Team Approach to Amputation Prevention

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