Proven Strategies To Prevent Lower Extremity Amputation

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Emphasizing The Value Of Multidisciplinary Care

It is extremely beneficial to have close interaction with the patient’s primary care physician for help with diabetic control or management of other co-morbidities such as renal disease or congestive heart failure that could affect healing. It is also effective to have a dietitian both for diabetes management and increased protein intake to aid wound healing. If the patient has significant infection, infectious disease consultation may be appropriate. We work with all of these providers at our facility for comprehensive care of each patient. A multidisciplinary approach has been associated with better outcomes in treating diabetic ulceration since many health-related factors may affect wound healing.17-19

Monica H. Schweinberger, DPM

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14. Schweinberger M, Roukis T. Surgical correction of soft-tissue ankle equinus contracture. Clin Podiatr Med Surg. 2008;25(4):571-585.
15. Waaijman R, Keukenkamp R, de Haart M, Polomski WP, Nollet F, Bus SA. Adherence to wearing prescription custom-made footwear in patients with diabetes at high risk for plantar foot ulceration. Diabetes Care. 2013 Feb 19. [Epub ahead of print].
16. Apelqvist J, Larsson J, Agardh CD. Long-term prognosis for diabetic patients with foot ulcers. J Intern Med. 1993;233(6):485-491.
17. Weck M, Slesaczeck T, Paetzold H, Muench D, Nanning T, Gagem G, Brechow A, Dietrich U, Holfert M, Bornstein S, Barthel A, Thomas A, Hanefeld M, Koehler C. Structured health care for subjects with diabetic foot ulcers results in a major reduction of amputation rates. Cardiovasc Diabetol. 2013;13;12(1):45 [Epub ahead of print].
18. Vuorisalo S, Venermo M, Lepaentalo M. Treatment of diabetic foot ulcers. J Cardiovasc Surg (Torino). 2009;50(3):275-91.
19. Wrobel J, Charns M, Diehr P, Robbins J, Reiber G, Bonacker K, Haas L, Pogach L. The relationship between provider coordination and diabetes-related foot outcomes. Diabetes Care. 2003;26(11):3042-3047.

   For further reading, see “Preventing Amputation In Patients With Diabetes” in the March 2008 issue of Podiatry Today.

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