A survey of physicians' involvement in the management of diabetic foot ulcers in secondary health care

Abstract

A survey was conducted to investigate the management of diabetic foot ulcers by physicians in secondary health care. Questionnaires were sent to 160 consultant diabetologists in the UK. Questions covered a number of important issues regarding the management of diabetic foot ulcers. A 50% response rate was recorded. Reportedly, 67.1% of respondents had a designated foot clinic. The majority (61.1%) of physicians used antibiotics for all clinically infected ulcers. Many (67.1%) used antibiotics until clinical signs of infection had resolved, 25.3% used antibiotics until the ulcer healed completely, while 7.6% used antibiotics for a fixed time period. Most (83.5%) physicians used a variety of techniques for off‐loading foot ulcers, and the majority (81.0%) reviewed patients fortnightly or more frequently. Some physicians (30–50%) admitted all patients with complicated foot ulcers: this number was less in centres that had a designated foot clinic (p=0.01). Two‐thirds of physicians used a combination of intravenous antibiotics for inpatients. The availability of vascular surgery, podiatry and orthotist services in each centre was reported by 91.1%, 92.4% and 77.2% of physicians respectively. In conclusion, there is considerable variation and potential deficiencies in certain aspects of diabetic foot care in the UK. National consensus and guidelines are required to streamline the management of diabetic foot ulcers. Copyright © 2003 John Wiley & Sons, Ltd.