PRIMARY EVALUATION

The Evaluation Of A Diabetic Foot Care Education Program On Lower Limb Amputation Rate - Primary evaluation

The Evaluation Of A Diabetic Foot Care Education Program On Lower Limb Amputation Rate

Primary Evaluation



Introduction

In this study, diabetic foot is the matter of concern, which is one of the main reasons for amputation and its subsequent physical and emotional problems. The peripheral vessels and nerve disorders may lead to foot ulcers, and super-added infection can cause foot gangrene. Annually, this problem has been one of the main reasons for patients' admission to hospitals and leads to billions of dollars of expense all around the world. In Saudi Arabia and the Arab world the incidence is even more. According to the Tehran University of Medical Sciences, 34.7% of diabetic foot ulcers led to amputation, and the average hospitalization duration was 3.8 weeks.

The diabetes-related lower extremity conditions that increase the risk for amputation among persons with diabetes include peripheral neuropathy, peripheral vascular disease, and infection. Peripheral neuropathy may cause loss of sensation in feet, resulting in a patient's failure to perceive foot problems and may cause development of foot deformities that increase pressure points susceptible to ulceration. Osteomyelitis and gangrene may develop from inadequate blood supply and infection. Risk factors for amputation include being older, male, a member of certain racial/ethnic groups, having poor glycemic control, having diabetes for a longer period, and practicing or receiving poor preventive health care(Dargis Pantelejeva Jonushaite Vileikyte Boulton 2009 pp.1428-1431).

Diabetic foot is a major complication in patients with Diabetes Mellitus world wide. In Saudi Arabia and the Arab world the incidence is even higher. Lower extremity amputation (LEA) remains an all very common outcome of this complication. LEA is a devastating consequence of diabetes, and people with diabetes are 10-15 times more likely to have LEA than non diabetic individuals. The causes of the LEA involves contributions from peripheral arterial vascular disease (PAD), peripheral neuropathy, minor trauma, infection, impaired wound healing, and limited joint mobility. These factors can lead to foot ulceration, gangrene, and finally, amputation if appropriate intervention is not applied. In a recent national study on the prevalence of Diabetes in Saudi Arabia 25% of the population more than forty years old have DM. Given these statistics, the economic and social implications are apparent and significant. The ultimate goal of the program is to reduce the lower limb amputation rate, thereby dramatically reducing the cost to patients, society and the health care system. This can be achieved by educating patients and healthcare workers in the hospital setting and the community, timely detection of patients at risk, interventions for reducing the risks associated with the diabetic foot and prompt and effective treatment of active problems: i.e. ulcers, ischemia. The purpose of this retrospective study is to evaluate the changes in the incidences and the outcome of the diabetic foot complications after implementing the diabetic foot program proposed to the hospital by the author and started implementation in the year 2000(Holstein Sorensen 2009 ...