Subject    :    [2018 Aug;42(4)] The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study
Writer KDA
Date 2019-03-06 09:54:14 Hit 225
Diabetes Metab J. 2018 Aug;42(4):308-319. English.
Published online Apr 27, 2018.  https://doi.org/10.4093/dmj.2017.0076 
Copyright © 2018 Korean Diabetes Association
   
The Changes of Trends in the Diagnosis and Treatment of Diabetic Foot Ulcer over a 10-Year Period: Single Center Study
Choong Hee Kim,1,* Jun Sung Moon,1,* Seung Min Chung,1 Eun Jung Kong,2 Chul Hyun Park,3 Woo Sung Yoon,4 Tae Gon Kim,5 Woong Kim,6 Ji Sung Yoon,1 Kyu Chang Won,1 and Hyoung Woo Lee1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
2Department of Nuclear Medicine, Yeungnam University College of Medicine, Daegu, Korea.
3Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.
4Division of Vascular Surgery, Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
5Department of Plastic Surgery, Yeungnam University College of Medicine, Daegu, Korea.
6Division of Cardiology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.

Corresponding author: Hyoung Woo Lee. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. Email: helee@ynu.ac.kr

 

*Choong Hee Kim and Jun Sung Moon contributed equally to this study as first authors.
 
Received November 14, 2017; Accepted March 13, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



Abstract

Background

This study aims to describe the trends in the severity and treatment modality of patients with diabetic foot ulcer (DFU) at a single tertiary referral center in Korea over the last 10 years and compare the outcomes before and after the introduction of a multidisciplinary diabetic foot team.

Methods

In this retrospective observational study, electronic medical records of patients from years 2002 to 2015 at single tertiary referral center were reviewed. Based on the year of first admission, patients were assigned to a group either before or after the year 2012, the year the diabetes team launched.

Results

Of the 338 patients with DFU, 229 were first admitted until the year 2011 (group A), while 109 were first admitted since the year 2012 (group B). Mean age was higher in group B, and ulcer size was larger than those of group A. Whereas duration of diabetes was longer in group B, glycemic control was improved (mean glycosylated hemoglobin, 9.48% vs. 8.50%). The proportion of minor lower extremity amputation (LEA) was increased, but length of hospital stay was decreased (73.7±79.6 days vs. 39.8±36.9 days). As critical ischemic limb increased, the proportion of major LEA was not decreased.

Conclusion

Improved glycemic control, multidisciplinary strategies with prompt surgical treatment resulted in reduced length of hospital stay, but these measures did not reduce major LEAs. The increase in critical ischemic limb may have played a role in the unexpected outcome, and may suggest the need for increased vascular intervention strategies in DFU treatment.

   
Keywords:
AmputationDiabetic footLength of stayPatient care team
 

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