title: Reducing lower extremity amputations due to diabetes: the application of diabetic-foot protocol in Chiang Mai University Hospital.
abstract: The aim of this study was to determine whether intensive treatment and education strategies for diabetic patients with ulcers help in preventing leg amputation. From August 2005 to March 2007, a diabetic-foot protocol using a multidisciplinary approach was applied at our hospital. All the subjects were educated regarding diabetic-foot disease and its complications and prevention. This report compares the amputation rate in patients receiving the protocol care from August 2005 to March 2007 with those who had standard care from August 2003 to July 2005. Seventy-three and 110 diabetic-foot ulcer patients received protocol and standard foot care, respectively. The incidence of major amputations in the protocol and standard care groups was 4.1% and 13.6%, respectively (P= .03). Our protocol was associated with improved diabetic-foot care outcomes. It can be used by any hospital to improve outcomes for patients with diabetes.
authors.affiliation: Department of Surgery, Chiang Mai University, Chiang Mai, Thailand. krerkase@mail.med.cmu.ac.th
authors.forename: Kittipan
authors.initials: K
authors.lastname: Rerkasem
authors.forename: Natapong
authors.initials: N
authors.lastname: Kosachunhanun
authors.forename: Siam
authors.initials: S
authors.lastname: Tongprasert
authors.forename: Krit
authors.initials: K
authors.lastname: Khwanngern
authors.forename: Anuchart
authors.initials: A
authors.lastname: Matanasarawoot
authors.forename: Chaweewan
authors.initials: C
authors.lastname: Thongchai
authors.forename: Kaset
authors.initials: K
authors.lastname: Chimplee
authors.forename: Supawan
authors.initials: S
authors.lastname: Buranapin
authors.forename: Somboon
authors.initials: S
authors.lastname: Chaisrisawadisuk
authors.forename: Ampika
authors.initials: A
authors.lastname: Mangklabruks
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data; D002985:Clinical Protocols; D017719:Diabetic Foot / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D012648:Self Care; D017592:Skin Care; D013785:Thailand; D016896:Treatment Outcome