Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers
This study aimed to validate the association between the grades of severity of diabetic foot ulcers (DFUs) identified by the fast-tack model and specific outcomes. Three hundred and sixty-seven patients with new DFUs who were referred to a tertiary level diabetic foot service serving Rome, Italy, we...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/3/761 |
| _version_ | 1797624157218799616 |
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| author | Marco Meloni Benjamin Bouillet Raju Ahluwalia Juan Pedro Sanchez-Rios Elisabetta Iacopi Valentina Izzo Chris Manu Vouillarmet Julien Claas Luedmann José Luis Garcia-Klepzig Jérome Guillaumat Jose Luis Lazaro-Martinez |
| author_facet | Marco Meloni Benjamin Bouillet Raju Ahluwalia Juan Pedro Sanchez-Rios Elisabetta Iacopi Valentina Izzo Chris Manu Vouillarmet Julien Claas Luedmann José Luis Garcia-Klepzig Jérome Guillaumat Jose Luis Lazaro-Martinez |
| author_sort | Marco Meloni |
| collection | DOAJ |
| description | This study aimed to validate the association between the grades of severity of diabetic foot ulcers (DFUs) identified by the fast-tack model and specific outcomes. Three hundred and sixty-seven patients with new DFUs who were referred to a tertiary level diabetic foot service serving Rome, Italy, were included. The fast-track model identifies three levels of DFUs’ severity: uncomplicated DFUs, including superficial wounds, not-infected wounds, and not-ischemic wounds; complicated DFUs, including ischemic wounds, infected wounds, and deep ulcers involving the muscles, tendons, or bones, and any kind of ulcers in patients on dialysis and/or with heart failure; and severely complicated DFUs, including abscesses, wet gangrene, necrotizing fasciitis, fever, or clinical signs of sepsis. Healing, minor and major amputation, hospitalization, and survival after 24 weeks of follow-up were considered. Among the included patients, 35 (9.6%) had uncomplicated DFUs, 210 (57.2%) had complicated DFUs, and 122 (33.2%) had severely complicated DFUs. The outcomes for patients with uncomplicated, complicated, and severely complicated DFUs were as follows, respectively: healing, 97.1%, 86.2%, and 69.8%; minor amputation, 2.9%, 20%, and 66.4%; major amputation, 0%, 2.9%, and 16.4%; hospitalization, 14.3%, 55.7%, and 89.3%; survival, 100%, 96.7%, and 89.3%. DFU severity was an independent predictor of healing, amputation, hospitalization, and survival. The current study shows an association between the grade of severity of DFUs identified by the fast-track model and the considered outcomes. The fast-track model may be a useful tool for assessing the severity and prognosis of DFUs. |
| first_indexed | 2024-03-11T09:39:07Z |
| format | Article |
| id | doaj.art-a0ce62e3d40d4ea0abc130be06ad7825 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:39:07Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-a0ce62e3d40d4ea0abc130be06ad78252023-11-16T17:06:47ZengMDPI AGJournal of Clinical Medicine2077-03832023-01-0112376110.3390/jcm12030761Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot UlcersMarco Meloni0Benjamin Bouillet1Raju Ahluwalia2Juan Pedro Sanchez-Rios3Elisabetta Iacopi4Valentina Izzo5Chris Manu6Vouillarmet Julien7Claas Luedmann8José Luis Garcia-Klepzig9Jérome Guillaumat10Jose Luis Lazaro-Martinez11Diabetic Foot Unit, Department of System Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyEndocrinology Department, University Hospital Center, 21000 Dijon, FranceDepartment of Trauma and Ortophaedic, King’s College Hospital, London SE5 9RS, UKDiabetic Foot Unit, Vascular Surgery Department, Hospital Fundación Alcorcon, 28922 Madrid, SpainDiabetic Foot Section, University of Pisa, Ospedale di Cisanello, 56124 Pisa, ItalyUniCamillus-Saint Camillus International, University of Health Science, 00131 Rome, ItalyDiabetic Foot Clinic, King’s College Hospital, Denmark Hill, London SE5 9RS, UKEndocrinology Department, University Hospital Center, 69007 Lyon, FranceFranziskus Krankenhaus Berlin, 10787 Berlin, GermanyInternal Medicine Department, Hospital Clinico San Carlos De Madrid, 28040 Madrid, SpainDepartment of Vascular Surgery, University Hospital of Caen, 14033 Caen, FranceDiabetic Foot Unit, Universidad Complutense de Madrid, 28040 Madrid, SpainThis study aimed to validate the association between the grades of severity of diabetic foot ulcers (DFUs) identified by the fast-tack model and specific outcomes. Three hundred and sixty-seven patients with new DFUs who were referred to a tertiary level diabetic foot service serving Rome, Italy, were included. The fast-track model identifies three levels of DFUs’ severity: uncomplicated DFUs, including superficial wounds, not-infected wounds, and not-ischemic wounds; complicated DFUs, including ischemic wounds, infected wounds, and deep ulcers involving the muscles, tendons, or bones, and any kind of ulcers in patients on dialysis and/or with heart failure; and severely complicated DFUs, including abscesses, wet gangrene, necrotizing fasciitis, fever, or clinical signs of sepsis. Healing, minor and major amputation, hospitalization, and survival after 24 weeks of follow-up were considered. Among the included patients, 35 (9.6%) had uncomplicated DFUs, 210 (57.2%) had complicated DFUs, and 122 (33.2%) had severely complicated DFUs. The outcomes for patients with uncomplicated, complicated, and severely complicated DFUs were as follows, respectively: healing, 97.1%, 86.2%, and 69.8%; minor amputation, 2.9%, 20%, and 66.4%; major amputation, 0%, 2.9%, and 16.4%; hospitalization, 14.3%, 55.7%, and 89.3%; survival, 100%, 96.7%, and 89.3%. DFU severity was an independent predictor of healing, amputation, hospitalization, and survival. The current study shows an association between the grade of severity of DFUs identified by the fast-track model and the considered outcomes. The fast-track model may be a useful tool for assessing the severity and prognosis of DFUs.https://www.mdpi.com/2077-0383/12/3/761diabetesdiabetic footfast-tracklimb salvagewound healing |
| spellingShingle | Marco Meloni Benjamin Bouillet Raju Ahluwalia Juan Pedro Sanchez-Rios Elisabetta Iacopi Valentina Izzo Chris Manu Vouillarmet Julien Claas Luedmann José Luis Garcia-Klepzig Jérome Guillaumat Jose Luis Lazaro-Martinez Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers Journal of Clinical Medicine diabetes diabetic foot fast-track limb salvage wound healing |
| title | Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers |
| title_full | Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers |
| title_fullStr | Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers |
| title_full_unstemmed | Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers |
| title_short | Validation of the Fast-Track Model: A Simple Tool to Assess the Severity of Diabetic Foot Ulcers |
| title_sort | validation of the fast track model a simple tool to assess the severity of diabetic foot ulcers |
| topic | diabetes diabetic foot fast-track limb salvage wound healing |
| url | https://www.mdpi.com/2077-0383/12/3/761 |
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