The engagement of orthopaedic surgeons in diabetic foot care in England. (1st August 2022)

• Record Type: Journal Article
• Authors: Robinson, A. H. N.; Garg, Parag; Kirmani, Sayyied; Allen, Patricia
• Is Part Of: Bone & joint open. Volume 3:Number 8(2022)
• Page Start: 618
• Page End: 622
• Publication Date: 2022-08-01
• Subjects: Diabetic foot -- Foot and ankle -- Orthopedics -- NHS -- consultant orthopaedic surgeons -- diabetic foot ulcers -- orthopaedic surgery -- vascular surgeons -- Vascular surgery -- foot and ankle surgeons -- foot and ankle surgeons -- foot and ankle surgeons -- Ankle -- Diabetes; Orthopedic surgery -- Periodicals; Musculoskeletal system -- Surgery -- Periodicals; 617.47
• DOI: 10.1302/2633-1462.38.BJO-2022-0025.R1
• Languages: English
• ISSNs: 2633-1462

Abstract

Abstract : Aims: Diabetic foot care is a significant burden on the NHS in England. We have conducted a nationwide survey to determine the current participation of orthopaedic surgeons in diabetic foot care in England. Methods: A questionnaire was sent to all 136 NHS trusts audited in the 2018 National Diabetic Foot Audit (NDFA). The questionnaire asked about the structure of diabetic foot care services. Results: Overall, 123 trusts responded, of which 117 admitted patients with diabetic foot disease and 113 had an orthopaedic foot and ankle surgeon. A total of 90 trusts (77%) stated that the admission involved medicine, with 53 (45%) of these admissions being exclusively under medicine, and 37 (32%) as joint admissions. Of the joint admissions, 16 (14%) were combined with vascular and 12(10%) with orthopaedic surgery. Admission is solely under vascular surgery in 12 trusts (10%) and orthopaedic surgery in 7 (6%). Diabetic foot abscesses were drained by orthopaedic surgeons in 61 trusts (52%) and vascular surgeons in 47 (40%). Conclusion: Orthopaedic surgeons make a significant contribution to both acute and elective diabetic foot care currently in the UK. This contribution is likely to increase with the movement of vascular surgery to a hub and spoke model, and measures should be put in place to increase the team based approach to the diabetic foot, for example with the introduction of a best practice tariff. Cite this article: Bone Jt Open 2022;3(8):618–622.