Evidence for multidisciplinary foot clinics

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Evidence for multidisciplinary foot clinics:
• specialised foot care clinic (podiatrist, shoe fitter, nurse, physcian, surgeon) resulted in large reduction in amputation rate
• Non-compliant subjects at risk where 54 times more likely to develop an ulcer or 20 time more likely to develop an amputation than those who regularly attended for their scheduled foot care
• Decrease in first LEA following the establishment of a dedicated foot care clinic and national health promotion program in island nation of Nauru
• Major amputation rate was decreased by 75% and proportion of minor amputations increased from 28% to 53%; re-amputation proportion decreased from 36 to 22% following the introduction of a multidisciplinary programme for prevention and treatment of diabetic foot ulcers
• Retrospective analysis of 3945 LEA for peripheral vascular disease; those with an above knee amputation average 1.0 foot care clinic visits in the 2 years prior to the amputation; below knee amputations averaged 2.8 and foot & ankle amputations averaged 5.3
• Subjects with diabetes were randomised to a podiatric care group or a non-intervention control group. At 1 year the podiatric care group had grater foot care knowledge, greater self care and less callus than the control group .
• Amputations and ulcerations appear to have decreased by use of foot care clinic
• A reduction in the bilateral amputation rate in diabetic unilateral amputees could not be demonstrated following the introduction of a foot care clinic at a rehabilitation centre . Another study has shown an improvement in outlook . Variations in these outcomes may be due to the accessibility of vascular surgery.

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