Inpatient management of diabetic foot problems: summary of NICE guidance
Delays in diagnosis and management of diabetic foot problems increase morbidity and mortality, contribute to a higher amputation rate, 1 and seriously affect patients' quality of life-for example, by reducing mobility, leading to loss of employment, depression, and damage to or loss of limbs. M...
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Veröffentlicht in: | BMJ 2011-03, Vol.342 (mar23 2), p.d1280-d1280 |
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creator | Tan, T Shaw, E J Siddiqui, F Kandaswamy, P Barry, P W Baker, M |
description | Delays in diagnosis and management of diabetic foot problems increase morbidity and mortality, contribute to a higher amputation rate, 1 and seriously affect patients' quality of life-for example, by reducing mobility, leading to loss of employment, depression, and damage to or loss of limbs. Multidisciplinary foot care team Each hospital should have a care pathway for patients with diabetic foot problems who need inpatient care. [Based on very low quality observational evidence and the experience and opinion of the Guideline Development Group (GDG)] The role of the multidisciplinary foot care team is to: -Assess and treat the patient's diabetes, including interventions to minimise the patient's risk of cardiovascular events, and any interventions for pre-existing chronic kidney disease or anaemia (refer to the NICE guidance on chronic kidney disease 4 and on managing anaemia in people with chronic kidney disease 5 ) -Assess, review, and evaluate the patient's response to initial medical, surgical, and diabetes management -Assess the foot and determine the need for specialist wound care, debridement, pressure off-loading, and/or other surgical interventions -Assess the patient's pain and determine the need for treatment and access to specialist pain services -Perform a vascular assessment to determine the need for further interventions -Review the treatment of any infection -Determine the need for interventions to prevent the deterioration and development of Achilles tendon contractures and other foot deformities -Perform an orthotic assessment and treat to prevent recurrent disease of the foot -Refer patients for physiotherapy where appropriate -Arrange discharge planning, which should include... |
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[Based on very low quality observational evidence and the experience and opinion of the Guideline Development Group (GDG)] The role of the multidisciplinary foot care team is to: -Assess and treat the patient's diabetes, including interventions to minimise the patient's risk of cardiovascular events, and any interventions for pre-existing chronic kidney disease or anaemia (refer to the NICE guidance on chronic kidney disease 4 and on managing anaemia in people with chronic kidney disease 5 ) -Assess, review, and evaluate the patient's response to initial medical, surgical, and diabetes management -Assess the foot and determine the need for specialist wound care, debridement, pressure off-loading, and/or other surgical interventions -Assess the patient's pain and determine the need for treatment and access to specialist pain services -Perform a vascular assessment to determine the need for further interventions -Review the treatment of any infection -Determine the need for interventions to prevent the deterioration and development of Achilles tendon contractures and other foot deformities -Perform an orthotic assessment and treat to prevent recurrent disease of the foot -Refer patients for physiotherapy where appropriate -Arrange discharge planning, which should include...</description><identifier>ISSN: 0959-8138</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.d1280</identifier><identifier>PMID: 21430002</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Achilles tendon ; Amputation ; Anemia ; Anti-Bacterial Agents - therapeutic use ; Bandages ; Cardiovascular diseases ; Diabetes ; Diabetes mellitus ; Diabetic Foot - therapy ; Feet ; Foot diseases ; Hospitalization ; Hospitals ; Humans ; Infections ; Kidney diseases ; Kidney transplantation ; Leg ulcers ; Limbs ; Morbidity ; Mortality ; Pain ; Patient Care Team ; Patient Education as Topic ; Patients ; Physical Examination - methods ; Physicians ; Practice Guidelines as Topic ; Prevention ; Quality ; Quality of life ; Social Support ; Wounds</subject><ispartof>BMJ, 2011-03, Vol.342 (mar23 2), p.d1280-d1280</ispartof><rights>BMJ Publishing Group Ltd 2011</rights><rights>Copyright: 2011 © BMJ Publishing Group Ltd 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b2522-57a448b950418f8a9a6f19d015b3d907bc44477ee7a213e86390803dacf9ebaf3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/342/bmj.d1280.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bmj.com/content/342/bmj.d1280.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21430002$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tan, T</creatorcontrib><creatorcontrib>Shaw, E J</creatorcontrib><creatorcontrib>Siddiqui, F</creatorcontrib><creatorcontrib>Kandaswamy, P</creatorcontrib><creatorcontrib>Barry, P W</creatorcontrib><creatorcontrib>Baker, M</creatorcontrib><creatorcontrib>Guideline Development Group</creatorcontrib><creatorcontrib>on behalf of the Guideline Development Group</creatorcontrib><title>Inpatient management of diabetic foot problems: summary of NICE guidance</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Delays in diagnosis and management of diabetic foot problems increase morbidity and mortality, contribute to a higher amputation rate, 1 and seriously affect patients' quality of life-for example, by reducing mobility, leading to loss of employment, depression, and damage to or loss of limbs. Multidisciplinary foot care team Each hospital should have a care pathway for patients with diabetic foot problems who need inpatient care. 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therapeutic use</subject><subject>Bandages</subject><subject>Cardiovascular diseases</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic Foot - therapy</subject><subject>Feet</subject><subject>Foot diseases</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infections</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Leg ulcers</subject><subject>Limbs</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Pain</subject><subject>Patient Care Team</subject><subject>Patient Education as Topic</subject><subject>Patients</subject><subject>Physical Examination - methods</subject><subject>Physicians</subject><subject>Practice Guidelines as Topic</subject><subject>Prevention</subject><subject>Quality</subject><subject>Quality of life</subject><subject>Social Support</subject><subject>Wounds</subject><issn>0959-8138</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp90UtLxDAQAOAgii7rHvwDUlAQD9UkkzaJN11WXZEV8XENSZtK1z7WpgX996Z29SDoKSHzZWaYQWiP4BNCID415fIkJVTgDTQiLBZhJAA20QjLSIaCgNhBE-eWGGMKXMg42kY7lDDoH0boel6tdJvbqg1KXekXW_bXOgvSXBvb5kmQ1XUbrJraFLZ0Z4HrylI3Hz1ZzKez4KXLU10ldhdtZbpwdrI-x-jpcvY4vQ5v767m0_Pb0NCI0jDimjFhZIQZEZnQUscZkSkmkYFUYm4Sxhjn1nJNCVgRg8QCQ6qTTFqjMxijoyGvb-mts65VZe4SWxS6snXnlIgZkdT_8_Lgl1zWXVP55hSRDIQE4Uv8qwjmHKSgXh0PKmlq5xqbqVWT93NQBKt-DcqvQX2twdv9dcbOlDb9kd9D9yAcQO5a-_4T182rijnwSC2ep0rADbt5uAd14f3h4Psaf9f9BMkgmkE</recordid><startdate>20110323</startdate><enddate>20110323</enddate><creator>Tan, T</creator><creator>Shaw, E J</creator><creator>Siddiqui, F</creator><creator>Kandaswamy, P</creator><creator>Barry, P W</creator><creator>Baker, M</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20110323</creationdate><title>Inpatient management of diabetic foot problems: summary of NICE guidance</title><author>Tan, T ; Shaw, E J ; Siddiqui, F ; Kandaswamy, P ; Barry, P W ; Baker, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b2522-57a448b950418f8a9a6f19d015b3d907bc44477ee7a213e86390803dacf9ebaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Achilles tendon</topic><topic>Amputation</topic><topic>Anemia</topic><topic>Anti-Bacterial Agents - 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Multidisciplinary foot care team Each hospital should have a care pathway for patients with diabetic foot problems who need inpatient care. [Based on very low quality observational evidence and the experience and opinion of the Guideline Development Group (GDG)] The role of the multidisciplinary foot care team is to: -Assess and treat the patient's diabetes, including interventions to minimise the patient's risk of cardiovascular events, and any interventions for pre-existing chronic kidney disease or anaemia (refer to the NICE guidance on chronic kidney disease 4 and on managing anaemia in people with chronic kidney disease 5 ) -Assess, review, and evaluate the patient's response to initial medical, surgical, and diabetes management -Assess the foot and determine the need for specialist wound care, debridement, pressure off-loading, and/or other surgical interventions -Assess the patient's pain and determine the need for treatment and access to specialist pain services -Perform a vascular assessment to determine the need for further interventions -Review the treatment of any infection -Determine the need for interventions to prevent the deterioration and development of Achilles tendon contractures and other foot deformities -Perform an orthotic assessment and treat to prevent recurrent disease of the foot -Refer patients for physiotherapy where appropriate -Arrange discharge planning, which should include...</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>21430002</pmid><doi>10.1136/bmj.d1280</doi></addata></record> |
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subjects | Achilles tendon Amputation Anemia Anti-Bacterial Agents - therapeutic use Bandages Cardiovascular diseases Diabetes Diabetes mellitus Diabetic Foot - therapy Feet Foot diseases Hospitalization Hospitals Humans Infections Kidney diseases Kidney transplantation Leg ulcers Limbs Morbidity Mortality Pain Patient Care Team Patient Education as Topic Patients Physical Examination - methods Physicians Practice Guidelines as Topic Prevention Quality Quality of life Social Support Wounds |
title | Inpatient management of diabetic foot problems: summary of NICE guidance |
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