Tratamiento multidisciplinar del pie diabéticoevaluación y resultados

Abstract

ABSTRACT Diabetic foot is an important socio-sanitary problem with important clinical repercussions that end up deteriorating the quality of life of patients if adequate prevention measures are not established. In this study the evaluation of the care process of the diabetic foot will be carried out after the implementation of an intra-hospital clinical pathway, and a multidisciplinary consultation specialized in the care of this pathology in the JM Morales Meseguer Hospital of Murcia, covering a period of time from 1998 to 2015. Our objective is to evaluate the influence of the implementation of the multidisciplinary unit in aspects related to complicated diabetic foot: Amputations, mortality, hospital resources and rehabilitative assistance. Objectives: 1.To evaluate the influence of the implementation of the diabetic foot unit on factors related to the number of amputations. 2.To evaluate the mortality rate related to diabetic foot and its evolution in regards to the establishment of this unit. 3.To analyze the influence of the unit on the use of hospital resources. 4.To establish the aspects related to the rehabilitation and prosthetic fitting of the amputated patient under the clinical pathway of diabetic foot in the Morales Meseguer Hospital. Methodology: Retrospective study to evaluate the quality of care of the unit created for the attention ofdiabetic foot, employing data from the clinical histories of patients who have required hospitalization in the General Surgery and Digestive System service due to diabetic foot complications. The comparison of three distinct periods has been made: First period: Before the implantation of the clinical pathway (1998-2000). Second period: After the implementation of the pathway (2001-2005). Third period: After the implementation of the diabetic foot consultation (2006-2015). Conclusions: "A specialized and interdisciplinary surgery-rehabilitation assistance offered through diabetic foot consultation contributes to a reduction of major and minor amputations and adecrease in mortality related to this pathology. "There has been an increase in the performance of procedures related to the revascularization of the neuroischemic diabetic foot, and a decrease in the hospital stay. "Under the protection of the Clinical Pathway, rehabilitation services' assessment and treatment of patients who have undergone major amputation have been optimized.