Abstract

Objective: To assess changes in diabetic lower extremity amputation rates in a defined, relatively static population over an eleven year period following the introduction of a multidisciplinary foot team.

Research Design and Methods: All diabetic patients with foot problems admitted to Ipswich Hospital a large district general, were identified by twice weekly surveillance of all relevant in-patient areas and outcomes including amputations recorded.

Results: The incidence of major amputations fell 62% from 7.4 to 2.8 per 100,000 of the general population. Total amputation rates also decreased (40.3%) but to a lesser extent due to a small increase in minor amputations. Expressed as incidence per 10,000 people with diabetes, total amputations fell 70%, from 53.2 to 16.0, and major amputations 82%, from 36.4 to 6.7.

Conclusion: Significant reductions in total and major amputation rates occurred over the eleven year period following improvements in foot care services including multidisciplinary team working.