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The Development and Application of Diabetic Foot Protocol in Chiang Mai University Hospital With an Aim to Reduce Lower Extremity Amputation in Thai Population: A Preliminary Communication

Department of Surgery, Chiang Mai University, Thailand

N. Kosachunhanun

Department of Internal Medicine, Chiang Mai University, Thailand

S. Tongprasert

Department of Rehabilitation Medicine, Chiang Mai University, Thailand

K. Khwanngern

Department of Surgery, Chiang Mai University, Thailand

A. Matanasarawoot

Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Thailand

C. Thongchai

Faculty of Nursing, Chiang Mai University, Thailand

K. Chimplee

S. Buranapin

Department of Internal Medicine, Chiang Mai University, Thailand

S. Chaisrisawadisuk

Department of Surgery, Chiang Mai University, Thailand

A. Manklabruks

Department of Internal Medicine, Chiang Mai University, Thailand

Lower extremity amputation is a frequent complication of diabetes, and the authors' region did not have effective strategies to minimize it. From August 2005 to July 2006, a diabetic foot protocol (DFP) for out-patient management based on a multidisciplinary team approach was tried at the local teaching hospital. There are devices to reduce pressure and educate. After healing, there are custom fabricated orthoses and footwear, and monitoring of progressive ambulation. This report compares the amputation rate in patients receiving DFP care from August 2005 to July 2006 with those who had standard care from August 2003 to July 2005. Sixty-one and 110 diabetic foot ulcer patients received DFP and standard foot care, respectively. Their sex distribution and mean age were similar. The incidence of major amputations in the DFP and standard care groups was 3.3% and 13.6%, respectively (P = .03). The incidence of minor amputations in the DFP and standard care groups was 3.4% and 15.8%, respectively (P = .02). DFP was associated with improved diabetic foot care outcomes. It may be used by clinical teams with a view to improve outcomes for patients with diabetes.

Key Words: diabetic foot • clinical management protocol • amputation

The International Journal of Lower Extremity Wounds, Vol. 6, No. 1, 18-21 (2007)
DOI: 10.1177/1534734606298285


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