Evaluating the impact of an interdisciplinary integrated limb preservation service operating concurrently with a single‐specialty service

Abstract

Abstract Background This study examined the efficacy of an interdisciplinary limb preservation service (LPS) in improving surgical outcomes for diabetic foot ulcer (DFU) patients compared to traditional care. Methods Data from January 1, 2017 to September 30, 2020 were retrospectively reviewed. An interdisciplinary LPS clinic began on August 1, 2018, coexisting with a preexisting single specialty service. Primary outcomes were major/minor amputation rates and ratios and hospital length of stay. Surgical endpoints pre‐ and post‐LPS launch were compared. Results Among 976 procedures for 731 unique DFU patients, most were male (80.4%) and Hispanic (89.3%). Patient demographics were consistent before and after LPS initiation. Major amputation rates decreased by 45.5% (15.4%–8.4%, p = 0.001), with outpatient procedures increasing over 5‐fold (3.3% pre‐LPS to 18.7% post‐LPS, p < 0.001). Hospital stay reduced from 10.1 to 8.5 days post‐LPS (p < 0.001). The major to minor amputation ratio declined from 22.4% to 12.7%. Conclusions The interdisciplinary LPS improved patient outcomes, marked by fewer major amputations and reduced hospital stays, suggesting the model's potential for broader application.

Keywords

• diabetic foot ulcers
• limb preservation
• lower extremity amputation
• podiatry
• vascular surgery