Foot and Ankle Surgery
Volume 14, Issue 2 , Pages 74-81 , 2008

Multidisciplinary treatment of diabetic foot ulcers in Canadian Aboriginal and non-Aboriginal people

  • Greg Rose, MD

      Affiliations

    • Department of Medicine, Section of Infectious Diseases, University of Ottawa, Ottawa, Ontario, Canada
    • ,
  • Frank Duerksen, MD, FRCSC

      Affiliations

    • Diabetic Foot and Complicated Wound Clinic, Health Sciences Centre, Winnipeg, Manitoba, Canada
    • Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
    • ,
  • Elly Trepman, MD

      Affiliations

    • Diabetic Foot and Complicated Wound Clinic, Health Sciences Centre, Winnipeg, Manitoba, Canada
    • Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
    • Department of Orthopaedic Surgery, Grand Itasca Clinic & Hospital, Grand Rapids, MN, United States
    • ,
  • Mary Cheang, MMath

      Affiliations

    • Department of Community Health Sciences, Statistical Consulting Unit, University of Manitoba, Winnipeg, Manitoba, Canada
    • ,
  • J. Neil Simonsen, MD, FRCPC

      Affiliations

    • National Microbiology Laboratory, Winnipeg, Manitoba, Canada
    • ,
  • Joshua Koulack, MD, FRCSC

      Affiliations

    • Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
    • ,
  • Hank Fong, MD, FRCSC

      Affiliations

    • Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
    • ,
  • Lindsay E. Nicolle, MD, FRCPC

      Affiliations

    • Diabetic Foot and Complicated Wound Clinic, Health Sciences Centre, Winnipeg, Manitoba, Canada
    • Department of Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
    • ,
  • John M. Embil, MD, FRCPC

      Affiliations

    • Diabetic Foot and Complicated Wound Clinic, Health Sciences Centre, Winnipeg, Manitoba, Canada
    • Department of Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
    • Corresponding Author InformationCorresponding author at: Infection Control Unit, Health Sciences Centre, MS673-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9 Canada. Tel.: +1 204 787 4654; fax: +1 204 787 4699.

Received 20 November 2006 ,Revised 15 October 2007 ,Accepted 29 October 2007.

References 

  1. Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diab Care. 1990;13:513–521
  2. Pecoraro RE, Ahroni JH, Boyko EJ, Stensel VL. Chronology and determinants of tissue repair in diabetic lower-extremity ulcers. Diabetes. 1991;40:1305–1313
  3. Goodridge D, Trepman E, Sloan J, Guse L, Strain LA, McIntyre J, et al. Quality of life of adults with unhealed and healed diabetic foot ulcers. Foot Ankle Int. 2006;27:274–280
  4. Reiber GE. The epidemiology of diabetic foot problems. Diab Med. 1996;13(Suppl. 1):S6–S11
  5. Nelson RG, Gohdes DM, Everhart JE, Hartner JA, Zwemer FL, Pettitt DJ, et al. Lower-extremity amputations in NIDDM. 12-yr follow-up study in Pima Indians. Diab Care. 1988;11:8–16
  6. Most RS, Sinnock P. The epidemiology of lower extremity amputations in diabetic individuals. Diab Care. 1983;6:87–91
  7. Lee JS, Lu M, Lee VS, Russell D, Bahr C, Lee ET. Lower-extremity amputation. Incidence, risk factors, and mortality in the Oklahoma Indian Diabetes Study. Diabetes. 1993;42:876–882
  8. Statistics Canada. Census of Population, May 15, 2001, www12.statcan.ca, accessed May 22, 2004.
  9. Green C, Blanchard JF, Young TK, Griffith J. The epidemiology of diabetes in the Manitoba-registered First Nation population. Diab Care. 2003;26:1993–1998
  10. Blanchard JF. Manitoba Health, unpublished data.
  11. Schraer CD, Weaver D, Naylor JL, Provost E, Mayer AM. Reduction of amputation rates among Alaska Natives with diabetes following the development of a high-risk foot program. Int J Circumpolar Health. 2004;63(Suppl. 2):114–119
  12. Foster AVM, Snowden S, Grenfell A, Watkins PJ, Edmonds ME. Reduction of gangrene and amputations in diabetic renal transplant patients: the role of a special foot clinic. Diab Med. 1995;12:632–635
  13. Apelqvist J, Ragnarson-Tennvall G, Persson U, Larsson J. Diabetic foot ulcers in a multidisciplinary setting. An economic analysis of primary healing and healing with amputation. J Intern Med. 1994;235:463–471
  14. Frykberg RG. The team approach in diabetic foot management. Adv Wound Care. 1998;11:71–77
  15. Steed DL, Edington H, Moosa HH, Webster MW. Organization and development of a university multidisciplinary wound care clinic. Surgery. 1993;114:775–779
  16. Margolis DJ, Kantor J, Berlin JA. Healing of diabetic neuropathic foot ulcers receiving standard treatment. Diab Care. 1999;22:692–695
  17. Steed DL, Donohoe D, Webster MW, Lindsley L. Effect of extensive debridement and treatment on the healing of diabetic foot ulcers. J Am Coll Surg. 1996;183:61–64
  18. Steed DL. Foundations of good ulcer care. Am J Surg. 1998;176(Suppl. 2A):20S–25S
  19. Dussault R, Erasmus G, Chartrand PLAH, Meekison JP, Robinson V, Sillett M, et al. Report of the Royal Commission on Aboriginal Peoples. Ottawa: Indian and Northern Affairs Canada; 1996;
  20. Wagner FW. The dysvascular foot: a system for diagnosis and treatment. Foot Ankle. 1981;2:64–122
  21. Wagner FW. The diabetic foot. Orthopedics. 1987;10:163–172
  22. Schon LC, Easley ME, Weinfeld SB. Charcot neuroarthropathy of the foot and ankle. Clin Orthop. 1998;349:116–131
  23. Edmonds ME, Blundell MP, Morris ME, Thomas EM, Cotton LT, Watkins PJ. Improved survival of the diabetic foot: the role of a specialised foot clinic. Q J Med. 1986;60:763–771
  24. Holstein P, Ellitsgaard N, Olsen BB, Ellitsgaard V. Decreasing incidence of major amputations in people with diabetes. Diabetologia. 2000;43:844–847
  25. Myerson M, Papa J, Eaton K, Wilson K. The total-contact cast for management of neuropathic plantar ulceration of the foot. J Bone Joint Surg. 1992;74-A:261–269
  26. Runyan JW. The Memphis chronic disease program: comparisons in outcome and the nurse's extended role. JAMA. 1975;231:264–267
  27. Northern Medical Unit . A look back at 2003. Northern Medical Unit News. 2004;2(1):1
  28. Katz SJ, Zemencuk JK, Hofer TP. Breast cancer screening in the United States and Canada, 1994: socioeconomic gradients persist. Am J Public Health. 2000;90:799–803
  29. Badgley RF. Social and economic disparities under Canadian health care. Int J Health Serv. 1991;21:659–671
  30. Newbold KB. Problems in search of solutions: health and Canadian aboriginals. J Community Health. 1998;23:59–73
  31. Veugelers PJ, Yip AM. Socioeconomic disparities in health care use: Does universal coverage reduce inequalities in health?. J Epidemiol Community Health. 2003;57:424–428
  32. Kapral MK, Wang H, Mamdani M, Tu JV. Effect of socioeconomic status on treatment and mortality after stroke. Stroke. 2002;33:268–273
  33. Edelson GW, Armstrong DG, Lavery LA, Caicco G. The acutely infected diabetic foot is not adequately evaluated in an inpatient setting. Arch Intern Med. 1996;156:2373–2378

PII: S1268-7731(07)00099-9

doi: 10.1016/j.fas.2007.10.006

Foot and Ankle Surgery
Volume 14, Issue 2 , Pages 74-81 , 2008

Article Tools