The Diabetic Foot: The Importance of Coordinated Care

Abstract

Because of the severe morbidity and mortality associated with diabetes, diabetic foot care is an essential component of a peripheral vascular service. The goal of this article is to describe the vascular diabetic foot care pathway and how the coordinated foot care service for diabetic patients is delivered at King's College Hospital, London.

Keywords

diabetic foot - multidisciplinary team - coordinated diabetic foot care service - peripheral vascular diseases - wound healing - interventional radiology

• References

• 1 Sanders LJ, Robbins JM, Edmonds ME. History of the team approach to amputation prevention: pioneers and milestones. J Vasc Surg 2010; 52 (3, Suppl): 3S-16S
• 2 Caravaggi C, Ferraresi R, Bassetti M , et al. Management of ischemic diabetic foot. J Cardiovasc Surg (Torino) 2013; 54 (6) 737-754
• 3 Faglia E. Characteristics of peripheral arterial disease and its relevance to the diabetic population. Int J Low Extrem Wounds 2011; 10 (3) 152-166
• 4 Edmonds M. Facts that every vascular surgeon needs to know about the diabetic foot. J Cardiovasc Surg (Torino) 2014; 55 (2) (Suppl. 01) 255-263
• 5 Turina M, Fry DE, Polk Jr HC. Acute hyperglycemia and the innate immune system: clinical, cellular, and molecular aspects. Crit Care Med 2005; 33 (7) 1624-1633
• 6 Armstrong DG, Lavery LA, Sariaya M, Ashry H. Leukocytosis is a poor indicator of acute osteomyelitis of the foot in diabetes mellitus. J Foot Ankle Surg 1996; 35 (4) 280-283
• 7 Edmonds M. Modern treatment of infection and ischaemia to reduce major amputation in the diabetic foot. Curr Pharm Des 2013; 19 (27) 5008-5015
• 8 El Sakka K, Fassiadis N, Gambhir RP , et al. An integrated care pathway to save the critically ischaemic diabetic foot. Int J Clin Pract 2006; 60 (6) 667-669
• 9 Hofmann WJ, Forstner R, Kofler B, Binder K, Ugurluoglu A, Magometschnigg H. Pedal artery imaging—a comparison of selective digital subtraction angiography, contrast enhanced magnetic resonance angiography and duplex ultrasound. Eur J Vasc Endovasc Surg 2002; 24 (4) 287-292
• 10 Slim H, Tiwari A, Ahmed A, Ritter JC, Zayed H, Rashid H. Distal versus ultradistal bypass grafts: amputation-free survival and patency rates in patients with critical leg ischaemia. Eur J Vasc Endovasc Surg 2011; 42 (1) 83-88
• 11 Zayed HA, Fassiadis N, Jones KG , et al. Day-case angioplasty in diabetic patients with critical ischemia. Int Angiol 2008; 27 (3) 232-238
• 12 Huang DY, Ong CM, Walters HL , et al. Day-case diagnostic and interventional peripheral angiography: 10-year experience in a radiology specialist nurse-led unit. Br J Radiol 2008; 81 (967) 537-544
• 13 Rashid H, Slim H, Zayed H , et al. The impact of arterial pedal arch quality and angiosome revascularization on foot tissue loss healing and infrapopliteal bypass outcome. J Vasc Surg 2013; 57 (5) 1219-1226