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Who Is The First Line Of Defense For DFUs?

David G. Armstrong DPM MD PhD

Important work from multiple friends and colleagues show that patients were more likely than physicians to identify potentially limb-threatening wounds when presenting for primary care visits. 

In a recently published study, Sanchez-Rio and colleagues distributed a two-part online questionnaire among primary care physicians in France, Germany, Spain and the United Kingdom. The first part surveyed the physician perceptions of referrals for DFU and the second part inquired about recently managed DFU cases. 

Sixty percent of DFU diagnoses were instigated by a patient-initiated complaint. About half of these wounds were ischemic and more than half were infected wounds. The authors also compared the countries on methods of care and follow up. 

The authors concluded that education about DFUs should be reinforced among primary physicians and nurses to establish a global network between primary care and specialist care. 

This study offers podiatrists the opportunity to dramatically reduce the cognitive and clinical load on their primary care counterparts. Data strongly suggest that if a patient sees his or her podiatrist along with a primary care physician at least annually, the multi-year amputation risk can be reduced between 20 to more than 80 percent! 

What is the key message to convey to patients when they are visiting their doctor? Knock your socks off!

Editor's Note: This blog originally appeared at https://diabeticfootonline.com/2019/08/17/6-out-of-10-diabetic-foot-ulcers-leading-to-referral-are-caught-by-patients-not-doctors/ . It is adapted with permission from the author.

Reference

  1. Sanchez-Rios JP, Garcia-Klepzig JL, Manu C, et al. Referral of patients with diabetic foot ulcers in four European countries: patient follow-up after first GP visit. J Wound Care. 2019;28(Sup 8). https://doi.org/10.12968/jowc.2019.28.Sup8.S4 . Accessed August 28, 2019.

 

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