Preventing Diabetic Foot Ulcer Recurrence in High-Risk Patients: Use of temperature monitoring as a self-assessment tool

IntroductionWe assessed the impact of a diabetic foot ulcer prevention program incorporating once-daily foot temperature monitoring on hospitalizations, emergency department and outpatient visits, and rates of diabetic foot ulcer recurrence and lower extremity amputations for patients with recently healed foot ulcers.Research design and methodsIn this retrospective analysis of real-world data, we enrolled 80 participants with a healed diabetic foot ulcer in a year-long foot ulcer recurrence prevention program. Four outpatient centers within a large integrated healthcare system in the USA contributed to enrollment. We evaluated diabetic foot-related outcomes and associated resource utilization for participants during three periods: the 2 years before the program, the year during the program, and after the program ended. We reported unadjusted resource utilization rates during the program and the periods before and after it. We then adjusted rates of outcomes in each phase using an interrupted time series approach, explicitly controlling for overall trends in resource utilization and recurrence during the three periods.ResultsOur unadjusted data showed high initial rates of resource utilization and recurrence before enrollment in the program, followed by lower rates during the program, and higher rates of resource utilization and similar rates of recurrence in the period following the end of the program. The adjusted data showed lower rates of hospitalizations (relative risk reduction (RRR)=0.52; number needed to treat (NNT)=3.4), lower extremity amputations (RRR=0.71; NNT=6.4), and outpatient visits (RRR=0.26; absolute risk reduction (ARR)=3.5) during the program. We also found lower rates of foot ulcer recurrence during the program in the adjusted data, particularly for wounds with infection or greater than superficial depth (RRR=0.91; NNT=4.4).ConclusionsWe observed lower rates of healthcare resource utilization for high-risk participants during enrollment in a diabetic foot prevention program incorporating once-daily foot temperature monitoring.Trial registration numberNCT04345016.

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A randomized, open-label, comparative study of lysine cream 15% with standard therapy in the management of non-diabetic foot ulcer assessing by Bates-Jensen wound assessment tool

National Journal of Physiology Pharmacy and Pharmacology ◽

10.5455/njppp.2019.9.0622802072019 ◽

2019 ◽

Vol 9 (8) ◽

pp. 1

Author(s):

Vani J ◽

Shashi Kumara ◽

Prathima C

Keyword(s):

Comparative Study ◽

Diabetic Foot ◽

Standard Therapy ◽

Assessment Tool ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Open Label ◽

Wound Assessment

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NEITHER A COX-2 INHIBITOR NOR NSAID PLUS PPI ADEQUATELY PROTECTED HIGH RISK PATIENTS FROM PEPTIC ULCER RECURRENCE

Evidence-Based Gastroenterology ◽

10.1097/01.ebg.0000154126.32229.48 ◽

2005 ◽

Vol 6 (1) ◽

pp. 11-12

Author(s):

Richard J Saad ◽

James M Scheiman

Keyword(s):

Peptic Ulcer ◽

High Risk ◽

Ulcer Recurrence ◽

High Risk Patients ◽

Risk Patients ◽

Cox 2

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Diabetic foot and its serial treatment in high-risk patients: focusing on the individual

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.11.1542 ◽

2020 ◽

Vol 66 (11) ◽

pp. 1542-1547

Author(s):

Eli Ávila Souza Júnior ◽

Raul Silva Simões de Camargo ◽

Tiago Soares Baumfeld ◽

Daniel Soares Baumfeld ◽

Benjamin Dutra Macedo

Keyword(s):

High Risk ◽

Diabetic Foot ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

High Risk Group ◽

Foot Care ◽

Cross Sectional ◽

High Risk Patients ◽

Risk Patients ◽

The Individual

SUMMARY Objectives: To assess knowledge about diabetic foot, care measures, and the importance attached to serial treatment in a group of high-risk diabetic foot patients. METHODS: This is a cross-sectional study, carried out in a tertiary hospital, with 25 patients undergoing serial treatment for diabetic foot. The tabulation of the data occurred through the use of three methodological figures: core idea, key expressions, and the collective subject discourse. RESULTS: It became evident that even among high-risk patients with diabetic foot, there is no complete knowledge about the definition of the disease. Despite this, all participants reported practicing daily care measures, including frequent inspection of the feet, food care, and attention to footwear. Regarding the importance of serial treatment, there was unanimous recognition of the relevance of this practice, which improves self-care discipline, optimizes the understanding of the disease, and helps to prevent progression. CONCLUSIONS: Authentic speeches in the context of a pathology of considerable prevalence manifested, in an unprecedented way, with conceptions about its definition, care measures, and importance of serial treatment in a high-risk group.

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Relation between knowledge, foot self-care and health status for diabetic foot high risk patients

Mansoura Nursing Journal ◽

10.21608/mnj.2021.63979.1021 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

nora shaker ◽

Marwa Abd-Elgabaar ◽

Taghreed Shakweer

Keyword(s):

Health Status ◽

High Risk ◽

Diabetic Foot ◽

Self Care ◽

High Risk Patients ◽

Risk Patients

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O20 Quick, simple and just as effective—comparing pm: L3 ratio to NELA, P-POSSUM and NSQIP scores in assessing mortality risk for emergency laparotomy

British Journal of Surgery ◽

10.1093/bjs/znab282.025 ◽

2021 ◽

Vol 108 (Supplement_5) ◽

Author(s):

J Y Ming ◽

M Holmes ◽

P Pockney ◽

J Gani

Keyword(s):

Risk Assessment ◽

High Risk ◽

Assessment Tool ◽

Risk Assessment Tool ◽

Emergency Laparotomy ◽

Routine Practice ◽

High Risk Patients ◽

Acs Nsqip ◽

Psoas Muscles ◽

Risk Patients

Abstract Introduction Multiple tools (NELA, P-POSSUM, ACS-NSQIP) are available to assess mortality risks in patients requiring emergency laparotomy(1–3), but they are time-consuming to perform and have had limited uptake in routine clinical practice in many countries(4). Simpler measures, including psoas muscle: L3 vertebrae (PM: L3) ratio(5,6), may be useful alternates. This measure is quick to perform, requiring no special skills or equipment apart from basic CT viewing software. Method We performed an analysis on all patients in the Hunter Emergency Laparotomy Audit (HELA) database, from January 2016 to December 2017. HELA is a retrospective review of all emergency laparotomy undertaken in a discrete area in NSW, Australia. Patients with an available CT abdomen were included (N = 500/562). A single slice axial CT image at the L3 endplate level was analysed using ImageJ® software to measure the area of L3 and bilateral psoas muscles. This can be done using normal PACS software in routine practice. Result PM: L3 ratios in this cohort have a mean of 1.082 (95%CI 1.042–1.122; range 0.141–3.934). PM: L3 ratio is significantly lower (P < 0.00001) in those patients who did not survive beyond 30 days (mean 0.865 [95% CI 0.746–0.984]) and 90 days (mean 0.888 [95%CI 0.768–1.008]) compared to patients that survived these periods (30 day mean 1.106 [95% vs. 1.033–1.179], 90 day mean 1.112 [95% CI 1.070–1.154]). These associations are similar to those calculated by established risk assessment models. Conclusion PM: L3 ratio is a reliable, quick and easy risk assessment tool to identify high risk patients undergoing emergency laparotomy. Take-home Message PM: L3 ratio is a reliable, quick and easy risk assessment tool to identify high risk patients undergoing emergency laparotomy. It is comparable to NELA, P-POSSUM and ACS-NSQIP.

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