Research Week Abstract Book - Northern Health

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Chronic Disease Management SURGICAL INTERVENTION FOR COMPleX AND RECurrenT FOOT ULCeraTION: A liTERATURE REVIEW AND 2 Case STUDies Jilbert E, Harper K, Morphet A, Gazarek J. Background Surgical intervention for complex or recurrent foot ulceration attributed to deformity is developing as an integral part of management for diabetes-related foot ulcers (DRFUs). A multidisciplinary approach to DRFU management has long been established as best practice for achieving optimal patient outcomes and promoting limb salvage. Surgical intervention is increasingly being utilized, with aims to reduce or correct foot deformity, thereby promoting ulcer healing and preventing recurrence. Case Study Case A: 60yo with type 2 diabetes mellitus (DM), rheumatoid arthritis and bilateral Charcot Neuroarthropathy (CN). CN resulted in foot deformity and recurrent DRFU. Multiple offloading modalities were trialed, including total contact cast (TCC), CAM walker, felt padding, Darco surgical shoes and foot orthoses. Various offloading modalities achieved healing of the DRFU, but no modality proved to maintain the healed site. Surgical intervention involved excision of plantar medial cuneiform spur. DRFU healed and remains healed 26 weeks post surgery. Case B: 44yo with type 2 DM and previous toe amputations secondary to osteomyelitis. The amputations resulted in foot deformity and DRFU overlying the fourth metatarsal head. Conservatively, DRFU healed when managed via TCC, but recurred as soon as step down measures were implemented. Surgical intervention included debridement of soft tissue and fourth metatarsal head. DRFU healed and remains healed 25 weeks post surgery. Conclusion These cases highlight the effectiveness of surgical intervention in chronic and recurrent DRFU where non-surgical treatment methods have been exhausted; but may also indicate potential for earlier surgical review when deformity is a causative factor. Positive patient outcomes have been achieved using this multidisciplinary approach to care. 24 Research Week Abstract Book Northern Health 2013
CHROnIC DISEASE Management 25
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Page 5 and 6: Introduction Health Literacy And Cl
Page 7 and 8: Introduction cont’d IntRODUCTION
Page 9 and 10: Event Schedule cont’d event sched
Page 11 and 12: ABSTRACTS Abstracts 9
Page 13 and 14: Aged Care Aged Care Does physiother
Page 15 and 16: Aged Care Aged Care A COMParison OF
Page 17 and 18: Aged Care Aged Care FALLS TRENDS WI
Page 19 and 20: Aged Care 17
Page 21 and 22: Chronic Disease Management A SYSTEM
Page 23 and 24: Chronic Disease Management APProPri
Page 25: Chronic Disease Management INTRODUC
Page 29 and 30: Haematology HaematOLOGY THE IMPleme
Page 31 and 32: Haematology HaematOLOGY HIGH-DOSE M
Page 33 and 34: Haematology HaematOLOGY Intermitten
Page 35 and 36: HaematOLOGY 33
Page 37 and 38: Women’s Health and Paediatrics MU
Page 39 and 40: Women’s Health and Paediatrics TH
Page 41 and 42: Women’s Health and Paediatrics IM
Page 43 and 44: Women’s Health and Paediatrics SA
Page 45 and 46: Health Service Evaluation ESTablish
Page 47 and 48: Health Service Evaluation EValuaTIN
Page 49 and 50: Health Service Evaluation INNOVATIV
Page 51 and 52: Health Service Evaluation EMERGENCY
Page 53 and 54: Health Service Evaluation Northern
Page 55 and 56: Orthopaedics ORTHOPAEDICS DisTAL RA
Page 57 and 58: Orthopaedics ORTHOPAEDICS RETURNING
Page 59 and 60: Orthopaedics ORTHOPAEDICS THEATre S
Page 62: Broadmeadows Health Service 35 John

Research Week Abstract Book - Northern Health

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