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Archived Comments for: Primary care referral to multidisciplinary high risk foot services – too few, too late

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  1. Limited impact of a tertiary level high risk foot service on amputation rates

    Algenes Aranha, The Gold Coast University Hospital, Australia

    19 January 2016

    We read with interest Plusch and colleagues' recommendation for primary health carers to refer patients to implement multi-disciplinary high risk foot disease clinics. At the Gold Coast University Hospital, we reviewed whether our established Multidisciplinary high risk foot service assists patients with high risk foot disease in avoiding amputations. Data from 50 consecutive case notes, of diabetes patients who required admission for management of lower limb ulcers or ischemia from April 2011 to Dec 2011 was reviewed. 56% (28/50) of patients were known to our service. 30% (15/50) of the patients were unknown to our service and 14% (7/50) patients had failed to attend follow up appointments after previous presentations. 47% (7/15) of new presentations, 50% (14/28) of the known presentations and 43% (3/7) of the previously known presentations underwent surgical amputations of their toes/lower limb during their admission.
    Our findings highlight the fact that despite receiving evidence based care within a tertiary level multidisciplinary service many patients still undergo amputations. The large proportion of patients unknown to our service is of obvious concern. Non compliance of patients and lack of adequate resources in the primary sector are plausible explanations

    Competing interests

    Not applicable