Reduction of major amputations after starting a multidisciplinary diabetic foot care team: single centre experience from Turkey.
BACKGROUND
It is widely recognized that a multidisciplinary team is effective in the management of diabetic foot ulcers. Contrary to developed countries, multidisciplinary diabetic foot care teams and/or clinics have not been constructed in most centres in developing countries. The aim of this study was to present our data regarding amputation rates and profiles before and after starting the Dokuz Eylul University multidisciplinary diabetic foot care team.


METHODS
This study includes data from diabetic foot ulcer episodes which were managed in Dokuz Eylul University Hospital between January 1999 and January 2008. The data was collected prospectively during a minimum follow-up of 6 months in all ulcers. After January 2002, management of ulcers was coordinated by the diabetic foot care team (n=437). Amputation rates were compared to those who were admitted before January 2002 (n=137).


RESULTS
Overall amputation and minor amputation rates were similar for both periods. However, major amputations were observed to be decreased after starting the Dokuz Eylul University multidisciplinary diabetic foot care team (20.4% vs. 12.6%, p=0.026).


CONCLUSIONS
Our results demonstrated that major amputation rates can be reduced by team work. Formation of multidisciplinary diabetic foot care teams and clinics should be encouraged in Turkey.
Yesil
S
S
Division of Endocrinology and Metabolism, Department of Internal Medicine, Dokuz Eylul University Medical School, Inciralti, Izmir, Turkey.
Akinci
B
B
Bayraktar
F
F
Havitcioglu
H
H
Karabay
O
O
Yapar
N
N
Demirdover
C
C
Yener
S
S
Yalcin
M
M
Comlekci
A
A
Eraslan
S
S
D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D017719:Diabetic Foot / Q000453:epidemiology / Q000628:therapy*; D004526:Efficiency; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D014421:Turkey / Q000453:epidemiology