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Creation of a multidisciplinary, evidence based, clinical guideline for the assessment, investigation and management of acute diabetes related foot complications
Author(s) -
Wraight P. R.,
Lawrence S. M.,
Campbell D. A.,
Colman P. G.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2004.01363.x
Subject(s) - medicine , guideline , diabetic foot , multidisciplinary approach , diabetes mellitus , foot (prosody) , intensive care medicine , amputation , population , medline , diabetes management , evidence based medicine , physical therapy , surgery , alternative medicine , type 2 diabetes , pathology , social science , philosophy , environmental health , sociology , political science , law , linguistics , endocrinology
Aims To design a multidisciplinary, evidenced‐based, clinical guideline for the assessment, investigation and management of inpatients with acute diabetes related foot complications. Methods A systematic search of both published (identified by searching all major electronic databases and hand searching key journals) and unpublished literature (derived from national and internationally recognized experts) identified 266 articles specific to diabetes related foot complications. Of these, 126 (47%) were assessed to be methodologically sound and clinically relevant. A narrative summary with the articles tabulated according to their level of evidence was prepared. A multidisciplinary expert group of health professionals, with a known interest and recognized expertise in diabetes related foot complications, was established to assess the evidence. Results The multidisciplinary expert group used the identified literature and clinical experience to create a comprehensive, evidence‐based, clinical guideline for the assessment, investigation and management of acute diabetes related foot complications. Included within the guideline is a novel, diabetes specific classification system, which codes for the presence/absence and severity of the four principle causative factors (Neuropathy, Vascular compromise, Ulceration and Infection) in the development of acute diabetes related foot complications. Conclusion Through the creation and implementation of this evidence‐based clinical guideline, specific for acute diabetes related foot complications, it is hoped that health professionals will be better equipped to make informed decisions for this patient population. This may benefit the individual and health system through reductions in amputation rate, length of hospital stay and health expenditure.