Building Effective Partnerships Between Vascular Surgeons and Podiatric Physicians in the Effective Management of Diabetic Foot Ulcers

2016 ◽  
Vol 106 (4) ◽  
pp. 308-311 ◽  
Author(s):  
Timothy Wu ◽  
Rabih A. Chaer ◽  
Nichol L. Salvo ◽  
◽  
Keyword(s):  
Health Care ◽  
Diabetic Foot ◽  
Multidisciplinary Approach ◽  
The United States ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Effective Management ◽  
Delivery Of Care ◽  
Vulnerable Patient ◽  
Vulnerable Patient Population

Both vascular surgeons and podiatric physicians care for patients with diabetic foot ulcerations (DFUs), one of today's most challenging health-care populations in the United States. The prevalence of DFUs has steadily increased, along with the rising costs associated with care. Because of the numerous comorbidities affecting these patients, it is necessary to take a multidisciplinary approach in the management of these patients. Such efforts, primarily led by podiatric physicians and vascular surgeons, have been shown to effectively decrease major limb loss. Establishing an interprofessional partnership between vascular surgery and podiatric medicine can lead to an improvement in the delivery of care and outcomes of this vulnerable patient population.

scholarly journals The COVID-19 Outbreak Negatively Affects the Delivery of Care for Patients With Diabetic Foot Ulcers

Diabetes Care ◽  
2020 ◽  
Vol 43 (10) ◽  
pp. e125-e126 ◽  
Author(s):  
Chao Liu ◽  
Jiaxing You ◽  
Weifen Zhu ◽  
Yixin Chen ◽  
Shengyun Li ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Delivery Of Care

Pharmacotherapy of Diabetic Foot Ulcers

2004 ◽  
Vol 17 (1) ◽  
pp. 66-74 ◽  
Author(s):  
Curtis L. Smith
Keyword(s):  
Broad Spectrum ◽  
Diabetic Foot ◽  
The United States ◽  
Empiric Antibiotic Therapy ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Skin Substitutes ◽  
Broad Spectrum Antibiotics ◽  
Vascular Insufficiency ◽  
Life Threatening

The incidence of diabetes and diabetic foot ulcers is increasing significantly in the United States. These ulcers and infections are the result of long-term complications of diabetes including neuropathy and vascular insufficiency. These infections can be classified into mild, limb threatening, and life threatening. This classification helps clarify the expected organisms involved and consequently appropriate, empiric antibiotic therapy. Mild infections are generally caused by Gram-positive organisms and can usually be treated as an outpatient with oral antibiotics. Antibiotics used for mild infections-include cephalexin, clindamycin, and amoxicillin/ clavulanate. Moderate to severe or limb-threatening infections are usually polymicrobial and frequently require hospitalization. These infections are typically treated with more broad-spectrum antibiotics including ampicillin/sulbactam, imipenem, or the combination of clindamycin and a fluoroquinolone. Severe or life-threatening infections also require broad-spectrum antibiotics. Other therapeutic options besides antibiotics include growth factors, such as becaplermin, and various skin substitutes.

Barriers to Prevention and Timely Presentation of Diabetic Foot Ulcers: Perspectives of Patients from a High-risk Urban Population in the United States

2021 ◽  
Vol 32 (3) ◽  
pp. 1554-1565
Author(s):  
Anna Flattau ◽  
Molly L. Tanenbaum ◽  
Jeffrey S. Gonzalez ◽  
Cary Andrews ◽  
Stephanie Twomey ◽  
...  
Keyword(s):  
United States ◽  
High Risk ◽  
Diabetic Foot ◽  
Urban Population ◽  
The United States ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Methicillin-Resistant Staphylococcus aureus Endocarditis from a Diabetic Foot Ulcer

2018 ◽  
Vol 108 (6) ◽  
pp. 528-531 ◽  
Author(s):  
Andrew J. Hale ◽  
Emily Vicks ◽  
Mary T. LaSalvia ◽  
John M. Giurini ◽  
Adolf W. Karchmer
Keyword(s):  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
The United States ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Methicillin Resistant ◽  
Diabetic Foot Infections

Diabetic foot infections are a common cause of morbidity and mortality in the United States, and successful treatment often requires an aggressive and prolonged approach. Recent work has elucidated the importance of appropriate therapy for a given severity of diabetic foot infection, and highlighted the ongoing risk such patients have for subsequent invasive life-threatening infection should diabetic foot ulcers fail to heal. The authors describe the case of a man with diabetes who had prolonged, delayed healing of a diabetic foot ulcer. The ulcer subsequently became infected by methicillin-resistant Staphylococcus aureus (MRSA). The infection was treated conservatively with oral therapy and minimal debridement. Several months later, he experienced MRSA bloodstream infection and complicating endocarditis. The case highlights the ongoing risk faced by patients when diabetic foot ulcers do not heal promptly, and emphasizes the need for aggressive therapy to promote rapid healing and eradication of MRSA.

Mortality Rates and Diabetic Foot Ulcers

2008 ◽  
Vol 98 (6) ◽  
pp. 489-493 ◽  
Author(s):  
Jeffrey M. Robbins ◽  
Gerald Strauss ◽  
David Aron ◽  
Jodi Long ◽  
Jennifer Kuba ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Mortality Rates ◽  
Lower Extremity Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Preventive Interventions ◽  
Improve Life Expectancy ◽  
Vulnerable Patient ◽  
Extremity Amputation ◽  
New Onset

Five-year mortality rates after new-onset diabetic ulceration have been reported between 43% and 55% and up to 74% for patients with lower-extremity amputation. These rates are higher than those for several types of cancer including prostate, breast, colon, and Hodgkin’s disease. These alarmingly high 5-year mortality rates should be addressed more aggressively by patients and providers alike. Cardiovascular diseases represent the major causal factor, and early preventive interventions to improve life expectancy in this most vulnerable patient cohort are essential. New-onset diabetic foot ulcers should be considered a marker for significantly increased mortality and should be aggressively managed locally, systemically, and psychologically. (J Am Podiatr Med Assoc 98(6): 489–493, 2008)

scholarly journals Laboratory and Pharmaceutical Data Associated With Hospital Readmission in Persons With Diabetic Foot Ulcers

2021 ◽  
Vol 58 ◽  
pp. 004695802110607
Author(s):  
Alyson K. Myers ◽  
Makeda Dawkins ◽  
Inthuja Baskaran ◽  
Stephanie Izard ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Diabetic Foot ◽  
Hospital Readmission ◽  
Retrospective Chart Review ◽  
Healthcare Services ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Day Hospital ◽  
Insulin Use

Purpose: Diabetic foot ulcers (DFUs) are a leading cause of lower extremity amputations among persons with diabetes (PWD) and a common cause of hospitalizations. This study identified demographic characteristics, lab values, and comorbidities associated with 30-day and 90-day hospital readmission in persons with DFU. Methods: A retrospective chart review at our institution examined 397 patients with type 2 diabetes admitted with DFU between January 2014 and December 2018. Variables were analyzed using descriptive statistics, t-tests, and logistic regressions. Results: None of the studied demographic, laboratory (including Hemoglobin A1c) or comorbid diseases were associated with 30-day readmission in persons with DFU. Risk factors for 90-day readmission included discharge location to home with health care (OR: 2.62, 95% CI: 1.39, 4.95), anticoagulant use (OR: 2.36, 95% CI: 1.27, 4.39), and SQ insulin use (OR: 2.08, 95% CI: 1.20, 3.61). Conclusions: None of the variables examined were associated with 30-day readmission; however, potential predictors for 90-day readmission included anticoagulation or insulin use and discharge home with healthcare services. Future studies should devise interventions to improve transition of care in patients with DFU to further assess the role of medications and home health care as a potential predictor of 90-day hospital readmission.

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