Prevention of Amputation Caroline Leith Team Leader 1

Prevention of Amputation Caroline Leith Team Leader

• 1 -4% of people with diabetes will develop an ulcer per year (Leese at al, 2011; TRIEPod. D-UK, 2012). • Approximately 58% of DFU patients will become clinically infected. (Eurodiale study group 3) • The number of diabetes-related amputations in England has now reached an all-time high of 20 a day (Diabetes UK 2016)

• Individuals with diabetic foot ulcers have a 50% chance of mortality in 5 years (Young 2012) • Early diagnosis and early intervention by an MDT approach can achieve good outcomes (Edmonds 2009)

Case Study One Red Hot swollen Foot

Case Study One

Learning Points • Any red hot swollen foot to consider Charcot until proven otherwise. • Urgent referral to MDT. • Early diagnosis helps prevent deformity. • A diagnosis of Charcot is a life changing event for the patient

Case Study 2 Complex Foot Ulceration

• Early referral to podiatry and the MDT is essential. • Good MDT working prevents major amputation. • Patients with a history of a foot ulcer have a 50% risk of reulceration.

• MDT Foot clinics • Diabetic Foot Community clinics • Clinics

The Multidisciplinary Diabetes Team Diabetologist Practice Nurse Diabetes Specialist Nurse District Nurse The Patient G. P. Tissue Viability Nurses Podiatrists Orthopaedic Surgeon Radiologist Paediatric Consultant Microbiologist Dieticians Orthotist Pharmacist Vascular Surgeon

Increased Diabetic Feet Your feet have been assessed as being at increased risk of developing diabetic foot complications. Podiatry Head Office: 01582 711544 (Mon – Fri 08. 30 – 16. 30) Diabetic Foot Emergencies: New pain or throbbing Foot hotter than usual New redness or swelling New / increased discharge or smell Unexplained increase in blood glucose Flu like symptoms (hot / shivery) If you notice any of the above, contact your GP straight away. Explain that you have a diabetic emergency. Outside of normal hours, call the Out of Hours GP or go to A&E.

Urgent referrals to NHS Podiatry • Ulceration +/- infection Have we answered your burning questions • Red Hot Foot Evaluation • Fax to HCT Podiatry Tel 01582 711544 Fax 01582 765537 www. hct. nhs. uk/our-services/podiatry-service/

Non urgent referrals to NHS Podiatry • On going specialist foot care • Callus and corns in people at risk • Nail care for those at risk Tel 01582 711544 Fax 01582 765537 www. hct. nhs. uk/our-services/podiatry-service/ Complete application form from HCT website and send to podiatry