Khan T, Shin L, Woelfel S, Rowe V, Wilson BL, Armstrong DG, et al.
Diabetic foot & ankle. Date of publication 2018 Mar 22;volume 9(1):1452513.
1. Diabet Foot Ankle. 2018 Mar 22;9(1):1452513. doi: 10.1080/2000625X.2018.1452513.
eCollection 2018.
Building a scalable diabetic limb preservation program: four steps to success.
Khan T(1), Shin L(2), Woelfel S(3), Rowe V(1), Wilson BL(1), Armstrong DG(1).
Author information:
(1)The Southwestern Academic Limb Salvage Alliance (SALSA), Department of
Surgery, Keck School of Medicine of University of Southern California (USC), Los
Angeles, CA, USA.
(2)Department of Orthopaedics, University of Pittsburgh Medical Center (UPMC),
Pittsburgh, PA, USA.
(3)Division of Biokinesiology and Physical Therapy, University of Southern
California (USC), Los Angeles, CA, USA.
Over the past generation, limb preservation programs and diabetic foot services
have begun to proliferate within academic health science centers as well as
within health-care systems in general. We describe four key components for a
successful program that, developed sequentially with temporal overlap, can allow
the program to scale. The first component includes establishment of a 'hot foot
line' for urgent emergency department/inpatient referral. The second includes
development of a wound-healing clinic to address outpatient care through to
remission. The third component focuses on the diabetic foot in remission to
maximize ulcer-free days following healing. The fourth and final component
focuses on implementation of local and widespread screening clinics to identify
and triage patients into appropriate therapeutic and surveillance programs for
healing, remission, and primary prevention. Along with developing each of these
components, we describe discrete methods to quantify success.
DOI: 10.1080/2000625X.2018.1452513
PMCID: PMC5912709
PMID: 29696071
