scholarly journals The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system correlates with cost of care for diabetic foot ulcers treated in a multidisciplinary setting

2018 ◽  
Vol 67 (5) ◽  
pp. 1455-1462 ◽  
Author(s):  
Caitlin W. Hicks ◽  
Joseph K. Canner ◽  
Hikmet Karagozlu ◽  
Nestoras Mathioudakis ◽  
Ronald L. Sherman ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Diabetic Foot ◽  
Classification System ◽  
Cost Of Care ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

scholarly journals The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) Classification Independently Predicts Wound Healing in Neuroischemic Diabetic Foot Ulcers

2017 ◽  
Vol 66 (3) ◽  
pp. e61 ◽  
Author(s):  
Caitlin W. Hicks ◽  
Joseph K. Canner ◽  
Nestoras Mathioudakis ◽  
Ronald Sherman ◽  
Kathryn F. Hines ◽  
...  
Keyword(s):  
Wound Healing ◽  
Vascular Surgery ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Initial Clinical Experience With a Simple, Home System for Early Detection and Monitoring of Diabetic Foot Ulcers: The Foot Selfie

2021 ◽  
pp. 193229682110533
Author(s):  
Mark Swerdlow ◽  
Laura Shin ◽  
Karen D’Huyvetter ◽  
Wendy J. Mack ◽  
David G. Armstrong
Keyword(s):  
Diabetic Foot ◽  
Unmet Need ◽  
Cost Of Care ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diagnostic Quality ◽  
Plantar Surface ◽  
Remote Server ◽  
Ulcerative Lesions ◽  
Serial Images

Background: Diabetic foot ulcers (DFUs) are a leading cause of disability and morbidity. There is an unmet need for a simple, practical, home method to detect DFUs early and remotely monitor their healing. Method: We developed a simple, inexpensive, smartphone-based, “ Foot Selfie” system that enables patients to photograph the plantar surface of their feet without assistance and transmit images to a remote server. In a pilot study, patients from a limb-salvage clinic were asked to image their feet daily for six months and to evaluate the system by questionnaire at five time points. Transmitted results were reviewed weekly. Results: Fifteen patients (10 male) used the system after approximately 5 minutes of instruction. Participants uploaded images on a median of 76% of eligible study days. The system captured and transmitted diagnostic quality images of the entire plantar surface of both feet, permitting clinical-management decisions on a remote basis. We monitored 12 active wounds and 39 pre-ulcerative lesions (five wounds and 13 pre-ulcerative lesions at study outset); we observed healing of seven wounds and reversal of 20 pre-ulcerative lesions. Participants rated the system as useful, empowering, and preferable to their previous methods of foot screening. Conclusions: With minimal training, patients transmitted diagnostic-quality images from home on most days, allowing clinicians to review serial images. This system permits inexpensive home foot screening and monitoring of DFUs. Further studies are needed to determine whether it can reduce morbidity of DFUs and/or the associated cost of care. Artificial intelligence integration could improve scalability.

scholarly journals Use of Cellular and Tissue-based Product in the Treatment of Diabetic Foot Ulcers

2016 ◽  
Vol 3 (2) ◽  
pp. 92-96
Author(s):  
Thomas E Serena ◽  
Raphael A Yaakov ◽  
Eliot N Mostow
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Relevant Literature ◽  
Cost Of Care ◽  
Asia Pacific ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Economic Evaluations ◽  
Diabetic Foot Ulcers

ABSTRACT Introduction The prevalence of diabetes has been rising sharply and the rise in chronic wounds parallels this trend. Lower extremity ulcers present a serious complication for people with diabetes. While debridement of necrotic tissue and off-loading plays an important role in wound healing, many patients with diabetic foot ulcers (DFUs) fail to heal with standard of care (SOC) alone. Unresolved ulcers can lead to complications, such as osteomyelitis and amputation. There continues to be a need for the evaluation of novel wound therapies that can accelerate wound healing and lower the cost of care associated with DFUs. This paper presents recent evidence for the use of cellular and/or tissue-based products (CTPs) and offers an approach for selecting an appropriate CTP. Materials and methods A systematic literature search was conducted using PubMed, Embase, Medline, Cochrane library, and NHS Economic Evaluation Database. Full-length articles in English were assessed for relevance to select studies on effectiveness and economic evaluations. Additionally, Google Scholar was used to gather relevant literature on commonly used CTPs, including Apligraf®, EpiFix®, and Dermagraft®. Findings Results from randomized controlled trials (RCTs) provided evidence for the superior efficacy of CTPs over SOC alone in treatment of chronic DFUs. In recent studies evaluating commonly used CTPs, significantly higher number of DFUs achieved complete closure with EpiFix® when compared to either Apligraf® or Dermagraft®. While cost-effectiveness studies continue to be limited, current literature suggests that CTPs can decrease the long-term costs associated with the care of DFUs by increasing the healing rate, reducing recovery time, and lowering the risk of infection and complications. Cellular and/or tissue-based products (CTPs) may result in higher average number of ulcer-free months and lower average number of amputations or resections compared to SOC alone. How to cite this article Serena TE, Yaakov RA, Mostow EN. Use of Cellular and Tissue-based Product in the Treatment of Diabetic Foot Ulcers. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):92-96.

scholarly journals The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers

2018 ◽  
Vol 68 (4) ◽  
pp. 1096-1103 ◽  
Author(s):  
Caitlin W. Hicks ◽  
Joseph K. Canner ◽  
Nestoras Mathioudakis ◽  
Ronald Sherman ◽  
Mahmoud B. Malas ◽  
...  
Keyword(s):  
Wound Healing ◽  
Vascular Surgery ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

The Costs of Diabetic Foot

2010 ◽  
Vol 100 (5) ◽  
pp. 335-341 ◽  
Author(s):  
Vickie R. Driver ◽  
Matteo Fabbi ◽  
Lawrence A. Lavery ◽  
Gary Gibbons
Keyword(s):  
Limb Salvage ◽  
Diabetic Foot ◽  
The United States ◽  
Cost Of Care ◽  
Emergency Department Visits ◽  
Foot Ulcers ◽  
Team Approach ◽  
Diabetic Foot Ulcers ◽  
Foot Problems

In 2007, the treatment of diabetes and its complications in the United States generated at least $116 billion in direct costs; at least 33% of these costs were linked to the treatment of foot ulcers. Although the team approach to diabetic foot problems is effective in preventing lower-extremity amputations, the costs associated with implementing a diabetic-foot–care team are not well understood. An analysis of these costs provides the basis for this report. Diabetic foot problems impose a major economic burden, and costs increase disproportionately to the severity of the condition. Compared with diabetic patients without foot ulcers, the cost of care for those with foot ulcers is 5.4 times higher in the year after the first ulcer episode and 2.8 times higher in the second year. Costs for treating the highest-grade ulcers are 8 times higher than are those for treating low-grade ulcers. Patients with diabetic foot ulcers require more frequent emergency department visits and are more commonly admitted to the hospital, requiring longer lengths of stay. Implementation of the team approach to manage diabetic foot ulcers in a given region or health-care system has been reported to reduce long-term amputation rates 62% to 82%. Limb salvage efforts may include aggressive therapy such as revascularization procedures and advanced wound-healing modalities. Although these procedures are costly, the team approach gradually leads to improved screening and prevention programs and earlier interventions and, thus, seems to reduce long-term costs. To date, aggressive limb preservation management for patients with diabetic foot ulcers has not usually been paired with adequate reimbursement. It is essential to direct efforts in patient-caregiver education to allow early recognition and management of all diabetic foot problems and to build integrated pathways of care that facilitate timely access to limb salvage procedures. Increasing evidence suggests that the costs of implementing diabetic foot teams can be offset in the long term by improved access to care and reductions in foot complications and amputation rates. (J Am Podiatr Med Assoc 100(5): 335–341, 2010)

Reconstructive vascular surgery and the extent of tissue damage due to diabetic foot ulcers relates to risk of new ulceration in patients with PAD

2015 ◽  
Vol 24 (12) ◽  
pp. 590-597 ◽  
Author(s):  
T. Elgzyri ◽  
J. Larsson ◽  
P. Nyberg ◽  
J. Thörne ◽  
K-F. Eriksson ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Tissue Damage ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers
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