CME OnDemand: 2022 AOFAS Annual Meeting-5-year follow-up of Neuropathic Minimally Invasive Surgery for the Management of Diabetic Forefoot Ulcers

Pdf Summary

This document summarizes a 5-year follow-up study on the management of diabetic foot ulcers using neuropathic minimally invasive surgeries (MIS). The study was conducted by Professor Ros Miller from NHS Lanarkshire Universities Hospitals and Glasgow Caledonian University in Scotland.<br /><br />The document starts by mentioning that the number of people with diabetes is projected to reach 700 million by 2040, highlighting the importance of effective management of diabetic foot ulcers. It also mentions that death rates at 5 years for amputations due to diabetic foot ulcers are high.<br /><br />The document then discusses the screening and multidisciplinary team approach for diabetic foot care, using the Scottish Diabetes Foot Action Group's foot risk stratification tool. The tool categorizes patients based on their risk factors and provides guidelines for assessment and management.<br /><br />The document also discusses the use of mechanical off-loading techniques, such as total contact casting, to relieve pressure on heel wounds and reduce re-ulceration. It mentions the use of specialized instruments and percutaneous techniques for MIS surgical debridement, which has shown positive outcomes in healing diabetic foot ulcers.<br /><br />The document highlights the post-operative care and follow-up appointments for patients who undergo MIS debridement. It also mentions the use of antibiotic-loaded "Cerament" void filler to enhance healing and reduce systemic antibiotic load.<br /><br />The 5-year outcomes of the study show that patients treated with MIS surgery experience faster healing times, especially when antibiotic Cerament is used. However, late presentation, limited access to theaters during the pandemic, and lack of awareness among clinicians continue to result in repeated ulcer episodes and poor mobility for some patients. The document points out that the potential benefits of maintaining mobility and overall health for these patients need further research and that mortality rates remain high.<br /><br />The document concludes with contact information for Professor Ros Miller for further inquiries.

Asset Subtitle

Roslyn Miller, MB, ChB, FRCS(Ed), FRCS(Tr&Oth)

Keywords

diabetic foot ulcers

neuropathic minimally invasive surgeries

5-year follow-up study

management

foot risk stratification tool

MIS surgical debridement

Cerament void filler

healing

pandemic

mortality rates