scholarly journals Comparison home care service versus hospital-based care in patients with diabetic foot ulcer: an economic evaluation study

2020 ◽  
Vol 19 (1) ◽  
pp. 445-452
Author(s):  
MR Jafary ◽  
MR Amini ◽  
M Sanjari ◽  
M Aalaa ◽  
Z Goudarzi ◽  
...  
2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Q Ain ◽  
P Solanki ◽  
T Georgi ◽  
T Gala ◽  
H Ashraf ◽  
...  

Abstract Introduction Multidisciplinary foot care services contribute to the reduction in amputations from foot ulceration secondary to diabetes. The COVID-19 pandemic pressurised services and required a pause of elective care. This study reports the patient’s experience of foot care provision during the first wave where self-care, virtual appointments and patient directed appointments were utilised. Method Diabetic foot patients were retrospectively identified over a one-month period booked for MDT care (in hospital, OPD, diabetic foot clinic, community podiatry clinic or at home). All patients>16 years of age diagnosed with a new or previous diabetic foot ulcer or post-operative foot wound were included. Data was collated via a patient survey form and descriptive statistics were used to characterize the study population and responses. Results 63 patients were identified (1/10 – 30/10) with data collated from 51 respondents (81%). 78% (40/51) were male. Median age was 69 years (IQR 59–76). 86% were comfortable attending a hospital appointment. 92% reported continuing to receive an appropriate level of care. All of the patients felt well supported and knew how to access the foot care service. 29% utilised virtual care. 82% (42/51) considered face to face appointments were more suitable for follow up rather than virtual/phone appointments. Conclusions It was possible to continue to provide safe diabetic foot care despite the COVID-19 pandemic but careful patient selection and communication is the key.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Navid Faraji ◽  
Rasoul Goli ◽  
Babak Choobianzali ◽  
Soheyla Bahrami ◽  
Ali Sadeghian ◽  
...  

Abstract Background Diabetic foot ulcer (DFU) is one of the most important complications of diabetes that can lead to amputation. Treatment of DFUs is a major challenge and places a heavy economic and social burden on patients and their families. Case presentation The present case report is of a 52-year-old kurdish male patient with a 7-year history of type 2 diabetes. While on a bike ride, he sustained a traumatic injury to his right leg, which caused a deep gash measuring 14 × 5 cm on the tibia. During the hospital stay, no improvement was observed after routine wound care including suturing, antibiotic therapy, and dressing change. The patient was referred to our wound-care team. In the first step, the necrotic tissues of his foot ulcer were irrigated and then debrided using mechanical debridement and saline. Next, the patient underwent a 70 μg/dL dose of ozone therapy over a 30-day period in 10 sessions (one 20-minute session every 3 days). Between each session, the patient's wound was wrapped in silver-containing gauze bandages. After 1 month of wound-care using ozone therapy, the patient's foot ulcer had healed and he was discharged from our wound-care service with a stable and good general condition. Conclusion Considering the effectiveness of ozone therapy along with silver-containing dressing in the treatment of DFUs, wound-care teams can utilize it as an adjunct to the standard methods of DFU treatment.


Author(s):  
Dr. Devi Das Verma ◽  
Dr. Anil Kumar Saxena

Introduction:  Diabetes is one of the most prevalent metabolic chronic diseases due to the imbalance production of insulin. One of the studies reported that in 2010 worldwide 285 million adults had diabetes and this figure may be increase to 439 million by the year 2030. Globally Diabetic foot ulcers (DFUs) constitute major health problem in people that significantly contribute to morbidity and mortality in diabetes patients. Approximate 1.0% to 4.1% of the annual population-based incidences of a diabetic foot ulcer (DFU) were reported. Due to this the lifetime may be as high as 25%. In Asian countries diabetic foot ulcer are major problems which are different from European countries or developing countries.  From many studies reported diabetic foot problems in India are infectious and neuropathic in nature as compared to developed countries. According to World Health Organization (WHO) diabetic foot is defined as lower limb of a diabetic patient characterized by infection, potential risk of pathologic consequences ulceration or destruction of deep tissues associated with neurological abnormalities, various changes in peripheral neuropathy vasculopathy and superimposed infection that are mainly responsible foot ulceration. Ulcers are one kind of abscess which is difficult to treat because of poor wound healing that result from a combination of neuropathy, ischemia and hyperglycemia.  Aim: The main objective was to study the outcome of treatment modalities and it’s relating factors to complication in diabetic foot ulcer.  Material and method:  Total 60 diabetic foot ulcer patients with the age range from 20 to 70 years were included.  From all the patients’ detailed past and present history were recorded.  For all the patients, general, physical and local and systemic examinations were also done. Detail   laboratory examination like Fasting and Post Prandial Blood sugar levels, blood count, ECG, ESR, complete urine examination for the presence of ketone bodies and sugar, x-ray as well as culture and sensitivity of the discharge from ulcer were also done. Patients were treated with various treatment methods like conservative treatment, split skin grafting and amputation. Result: In this study male patients were more in proportion as compared to female. This study showed that maximum with the age group 14 -50 (43.3%) years old followed by 18.3% in 31-40 years old, 16.7% in 61-70 years old.  6.7% showed the least age group as 20 -30 years old.  Out of total 60 patients, 38.3% of the patients showed diabetic ulcer foot which was more whereas 15% showed diabetic gangrene foot which was least. 25% showed diabetic cellulites foot and 21.7% showed as diabetic abscess foot.  Conclusion: Globally as diabetes mellitus cases are increasing and it became rapidly the public health problem. This may be due to burden on economy, health system and on society to manage the diabetic foot problems. Diabetic foot management guidelines must be made into our practice protocols which may preventing limb loss, and decrease mortality and increase the quality of life of the patient. Hence for this it is only possible with the help of foot care education and health care workers.  Hence, foot infection is to put first and care for it like hands. Keywords: Diabetes, foot ulcers, infections, amputations.


2015 ◽  
Author(s):  
Fakhraddeen Muhammad ◽  
Lateefah Pedro ◽  
Hassan Suleiman ◽  
Enikuomehin Adenike ◽  
Rahila Mukhtar ◽  
...  

2019 ◽  
Author(s):  
Maksym Prystupiuk ◽  
Iuliia Onofriichuk ◽  
Lev Prystupiuk ◽  
Ludmila Naumova ◽  
Marianna Naumova

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