Blanchette Virginie, Hains Sébastien, Cloutier Lyne
Université du Québec à Trois-Rivières, Podiatric Medicine Program, 3351, boul. des Forges, C.P. 500, Trois-Rivières, Québec, G9A 5H7, Canada.
Université du Québec à Trois-Rivières, Nursing Department, 3351, boul. des Forges, C.P. 500, Trois-Rivières, Québec, G9A 5H7, Canada.
Foot (Edinb). 2019 Mar;38:54-60. doi: 10.1016/j.foot.2018.10.001. Epub 2018 Oct 9.
Diabetic foot ulcers (DFUs) are one of the main complications of diabetes affecting many Canadians that need to be effectively managed. There is limited data concerning outcomes of Canadian patients with DFUs treated with a team approach in the public health system. Podiatrists are known to be key members of a multidisciplinary team approach to DFUs management, but in Quebec, Canada, they are only available in private practice. The aim of this study is to evaluate diabetic foot outcomes after integrating podiatric care into in-hospital wound care clinic settings. A 12-month retrospective cohort study was conducted into a new organization named the Pododiabetology University Center (PUC), which is described in this article. Healing rate and healing time were the outcomes measured. The analysis was performed by comparing data collected before and after the integration of the podiatrists. Preliminary results indicate that 73.2% of DFUs (n=52) healed in an average of 19.8 weeks (time to wound closure). Previous data collected on 15 individuals before the integration of podiatric care showed a 27.3% of DFUs resolved in 44.6 weeks. The findings suggest that a patient with DFUs who receives wound care from a multidisciplinary team that includes a podiatrist can improve both their healing rate and time. An integrated multidisciplinary approach including podiatrists for patients affected by acute DFU is highly suggested in the literature in order to reduce the number of hospitalizations, amputations and financial burden, which are variables that could be evaluated in further studies.
糖尿病足溃疡(DFUs)是糖尿病的主要并发症之一,影响着许多需要有效管理的加拿大人。关于加拿大公共卫生系统中采用团队方法治疗DFUs患者的结果的数据有限。已知足病医生是DFUs管理多学科团队方法的关键成员,但在加拿大魁北克,他们仅在私人诊所提供服务。本研究的目的是评估将足病护理纳入医院伤口护理诊所环境后的糖尿病足结局。对一个名为足病糖尿病学大学中心(PUC)的新机构进行了为期12个月的回顾性队列研究,本文对此进行了描述。愈合率和愈合时间是测量的结局。通过比较足病医生纳入前后收集的数据进行分析。初步结果表明,73.2%的DFUs(n = 52)平均在19.8周内愈合(伤口闭合时间)。在纳入足病护理之前收集的15名个体的先前数据显示,27.3%的DFUs在44.6周内愈合。研究结果表明,接受包括足病医生在内的多学科团队伤口护理的DFUs患者可以提高愈合率和缩短愈合时间。文献中强烈建议对急性DFU患者采用包括足病医生在内的综合多学科方法,以减少住院次数、截肢和经济负担,这些变量可在进一步研究中进行评估。