title: Use of a surgical preparation and sterile dressing change during office visit treatment of chronic foot and ankle wounds decreases the incidence of infection and treatment costs.
abstract: Foot and ankle surgeons work with a patient population burdened by multiple factors that adversely affect wound healing and the ability to combat infection. As a result, many of these patients are seen for treatment of chronic ulcerations on their lower extremities that are highly susceptible to colonization and possible progression to a limb- and/or life-threatening infection. The Limb Preservation Service at the Madigan Army Medical Center hypothesized that implementation of a standardized protocol involving a formal physician-directed surgical preparation of the affected lower extremity and a physician-applied sterile dressing at each outpatient clinic appointment would reduce the incidence of infection, use of systemic antibiosis, and thus the requirement for frequent follow-up office appointments. Initiation of this protocol resulted in the reduction of infection to the extent that antibiotic need was eliminated. The frequency of office visits required for follow-up was also significantly reduced. This is key in treating a patient population in which the financial burden to treat chronic wounds and associated infections represents a large portion of the health care money spent for their medical care.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, Washington 98431, USA.
authors.forename: Valerie L
authors.initials: VL
authors.lastname: Schade
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Roukis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001458:Bandages / Q000592:standards; D002985:Clinical Protocols; D015331:Cohort Studies; D003646:Debridement; D017719:Diabetic Foot / Q000601:surgery*; D004203:Disinfection / Q000592:standards; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000891:Anti-Infective Agents, Local