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ORAL PRESENTATIONS
156
Free Paper Session: Diabetic Foot II
SETTING THE STANDARDS FOR DIABETIC FOOT CARE – DEVELOPMENT
OF A DIABETIC FOOT COMPETENCY FRAMEWORK
Joanne Mccardle 1 , Matthew Young 1
1 TRIEPOdD-UK (Edinburgh, United Kingdom).
Introduction: Worldwide, a lower limb is amputated every 20 seconds due to diabetes.
The majority are preceded by ulceration and the survival rate is low. However, 80% of
amputations are avoidable with appropriate care. Currently, clinicians managing this high
risk group obtain clinical skills in varying ways without structure or standards to their
attainment.
Aim: To benchmark and set clinical standards in diabetic foot care. Provide a
standardised route to obtain theoretical and clinical skills in managing the diabetic foot
and support the delivery of the right care by the right person at the right time.
Methods: A multi-professional, collaborative, working group of clinical experts,
managers and educational providers developed a comprehensive suite of clinical
competencies with theoretical and practical components.
Results: The competency framework for integrated diabetic foot care (*). A suite of 13
dimensions across 6 skill levels up to advanced practice, the largest one being woundcare.
Conclusions: This is the first competency framework that provides clinical
competencies that are underpinned by educational components.
It spans the whole spectrum of diabetic foot care from screening through to advanced
wound management. Although developed in the UK, it is transferrable across
professions and countries. It not only supports the development of existing and future
clinicians but it also the standardisation of diabetic foot care services and patient care.
This will ultimately ensure that patient outcomes are improved with equitable and timely
access to an appropriately trained clinician regardless of where in the world they live.
*TRIEPOdD-UK, 2012
FREE PAPER SESSION: DIABETIC FOOT II
157
Free Paper Session: Diabetic Foot II
TRANSCUTANEOUS OXYGEN TENSION (TcPO2) MEASUREMENTS –
REPRODUCIBILITY PLUS PREDICTABILITY OF AMPUTATION ON DIABETIC
PATIENTS WITH FOOT ULCERS
Anna Marie Nielsen 1
1 Wound Healing Centre, Odense University Hospital (Odense, Denmark).
Background and Aim: To evaluate repetitive measurements of transcutaneous oxygen
tension (TcPO2) – together with Toe Blood Pressure (TBP) and TcPO2 in diabetic
patients with foot ulcers in order to assess quality of predictors for amputation.
Method: Transcutaneous measurements of patients with diabetes and foot ulcers were
carried out. 3 areas were targeted: below the knee (#1), on the dorsum of the foot
between fourth and fifth toe (#2), and between first and second toe (#3). Two
measurements were performed. Simultaneously measurements of TBP took place.
Results: 24 consecutive patients with foot ulcers Wagner grade 1-3 and diabetes.
Median age 65.7 years. Mean values between the 2 TcPO2 measurements:
1.82/2.04/2.85. t-values: 1.29/1.43/1.60. The test shows reproducibility of TcPO2
measurements. Within a follow-up period of 42 (+/- 8) months mortality was 25% and 15
patients had undergone amputation. Mean values: amputation/no amputation: S-albumin:
35/39.4 g/l. t-test 1.89. p< 0.08. Mean –values for HbA1c, diabetes duration and years of
tobacco use were measured. TcPO2 Nr.1: 50.9/51.2 mmHg. TcPO2 Nr.2: 28.3/48.1
mmHg. t-test 1.95. p < 0.07. TcPO2 Nr.3: 31.4/44.2mmHg. TBP: 72.0/84.8 mmHg.
Conclusion: TcPO2 measurements are reproducible and TcPO2 measurements on the
dorsum of the foot (#2) are good predictors for risk of amputation as well as s-albumin in
diabetic patients with foot ulcers.
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