RT Journal Article
T1 Effectiveness of fast-track pathway for diabetic foot ulcerations
A1 Meloni, Marco
A1 Lázaro Martínez, José Luis
A1 Ahluwalia, Raju
A1 Bouillet, Benjamin
A1 Izzo, Valentina
A1 Di Venanzio, Michela
A1 Iacopi, Elisabetta
A1 Manu, Chris
A1 García Klepzig, José Luis
A1 Sánchez Ríos, Juan Pedro
A1 Lüedemann, Claas
A1 De Buruaga, Víctor Rodriguez-Saenz
A1 Vouillarmet, Julien
A1 Guillaumat, Jérôme
A1 Aleandri, Anna Rita
A1 Giurato, Laura
A1 Edmonds, Micheal
A1 Piaggesi, Alberto
A1 Van Acker, Kristien
A1 Uccioli, Luigi
AB Aim. To investigate the effectiveness of fast-track pathway (FTP) in the management of diabetic foot ulceration (DFU) after 2 years of implementation. Methods.  The study group was composed of patients who referred to a specialized DF centre due to DFUs. Those were divided in two groups: early referral (ER) and late referral (LR) patients. According to FTP, ER were considered patients who referred after 2 weeks in the case of uncomplicated non-healing ulcers (superficial, not infected, not ischemic), within 4 days in the case of complicated ulcers (ischemic, deep, mild infection) and within 24 h in the case of severely complicated ulcers (abscess, wet gangrene, fever). Healing, healing time, minor and major amputation, hospitalization, and survival were evaluated. The follow-up was 6 months. Results.  Two hundred patients were recruited. The mean age was 70 ± 13 years, 62.5% were male, 91% were affected by type 2 diabetes with a mean duration of 18 ± 11 years. Within the group, 79.5% had ER while 20.5% had LR. ER patients showed increased rates of healing (89.9 vs. 41.5%, p = 0.001), reduced healing time (10 vs. 16 weeks, p = 0.0002), lower rates of minor (17.6 vs. 75.6%, p < 0.0001) and major amputation (0.6 vs. 36.6%, p < 0.0001), hospitalization (47.1 vs. 82.9%, p = 0.001), and mortality (4.4 vs. 19.5%, p = 0.02) in comparison to LR. At multivariate analysis, ER was an independent predictor of healing, while LR was an independent predictor for minor and major amputation and hospitalization. Conclusion.  After the FTP implementation, less cases of LR were reported in comparison to ER. ER was an independent predictor of positive outcomes such as healing, healing time, limb salvage, hospitalization, and survival.
PB Springer Nature
SN 0940-5429
YR 2021
FD 2021-05-03
LK https://hdl.handle.net/20.500.14352/124866
UL https://hdl.handle.net/20.500.14352/124866
LA eng
NO Meloni, M., Lazaro-Martínez, J.L., Ahluwalia, R. et al. Effectiveness of fast-track pathway for diabetic foot ulcerations. Acta Diabetol 58, 1351–1358 (2021). https://doi.org/10.1007/s00592-021-01721-x
NO Open access funding provided by Università degli Studi di Roma Tor Vergata within the CRUI-CARE Agreement.
DS Docta Complutense
RD 22 dic 2025