A Perioperative Approach to Increase Limb Salvage When Treating Foot Ulcers in Patients With Diabetes

ABSTRACT Foot ulceration in patients with diabetes increases the risk of lower extremity amputation. Major amputations produce substantial adverse consequences, increase length of hospital stay, diminish quality of life, and increase mortality. In this article, we describe approaches that decrease a...

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Bibliographic Details
Published in:AORN journal 2018-04, Vol.107 (4), p.431-440
Main Authors: Howell, Raelina S., MD, Criscitelli, Theresa, EdD, RN, CNOR, Woods, Jon S., MD, Gillette, Brian M., PhD, Brem, Harold, MD, FACS, Gorenstein, Scott, MD, FACEP
Format: Article
Language:English
Subjects:
Amputation
Diabetes
diabetic foot ulcer
Feet
Foot diseases
Health surveillance
hyperbaric oxygen therapy
Infections
Injuries
Leg ulcers
limb salvage
lower extremity amputation
Medical/Surgical
Mortality
Nurses
Nursing
Nursing care
Oxygen therapy
Patients
Prevention
Preventive medicine
Quality of life
surgical debridement
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Summary:ABSTRACT Foot ulceration in patients with diabetes increases the risk of lower extremity amputation. Major amputations produce substantial adverse consequences, increase length of hospital stay, diminish quality of life, and increase mortality. In this article, we describe approaches that decrease amputations and improve the quality of life for patients with diabetes and foot ulcers. We highlight the role of the perioperative nurse, who is essential to providing optimal patient care in the perioperative period. Perioperative care of patients with diabetes involves providing optimal surveillance for a break in the skin of the foot, screening for neuropathy, following guidelines for foot ulcer infections, preparing for pathophysiology-based debridement, using adjuvant therapies, and offloading the patient's affected foot. Nurses should understand the disease process and pathophysiology and how to use these approaches in the perioperative setting to assist in curtailing the morbidity and mortality associated with foot ulcers in patients with diabetes.
ISSN:1878-0369
0001-2092
1878-0369
DOI:10.1002/aorn.12099