Establishing guidelines-based multidisciplinary diabetic limb salvage programme: A 100-day review of clinical...

A newly established hospital in Singapore has introduced a pioneering multidisciplinary diabetic foot programme to provide comprehensive care for patients with diabetic foot ulcers. This study evaluates the early outcomes of a multidisciplinary diabetic limb salvage programme. Over the first 100 days of operation, the diabetic foot programme managed 106 patients.

A descriptive statistical analysis was conducted to evaluate clinical characteristics and outcomes at 100 days of follow-up.

The majority of patients were Malay (46.2%) and male (61.3%), with a median age of 63.5 years. Most patients had long-standing diabetes and poor glycaemic control (77.8%), leading to high rates of diabetes-related complications. A total of 18.3% of patients had osteomyelitis, and 11.7% had gangrene. Of the 106 patients, 61.3% required inpatient management, 25.5% underwent revascularisation, and 34.9% had diabetic foot ulcer-related surgeries. According to Wound, Ischaemia and Foot Infection 12-month risk stratification, nearly 30% of patients were at medium to high risk of major lower extremity amputation. Minor lower extremity amputation occurred in 15.1% of patients and 4.7% required major lower extremity amputation. The 30-day mortality rate was 3.8%, and the average length of stay was 15.7 days. The time from admission to revascularisation was 4.4 days, and the time to diabetic foot ulcer-related surgery was 4.2 days. Wound healing was documented in 34.8% of patients at 100 days of follow-up, with a healing time of 63.2 days.

Our guidelines based, multidisciplinary diabetic limb salvage programme demonstrated favourable limb salvage outcomes despite high predicted amputation risks. The early outcomes of this programme highlight the effectiveness of early medical optimisation, infection control, revascularisation and active wound care.