J Korean Foot Ankle Soc.  2022 Mar;26(1):30-39. 10.14193/jkfas.2022.26.1.30.

Current Trends in the Treatment of Diabetic Foot: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey

• Won SH
• Min TH
• Chun DI
• Bae SY
• The Academic Committee of Korean Foot and Ankle Society, 2021

• KMID: 2527010
• DOI: http://doi.org/10.14193/jkfas.2022.26.1.30

Abstract

Purpose
This study aimed to report the current trends in the management of diabetic foot over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members.
Materials and Methods
A web-based questionnaire containing 40 questions was sent to all KFAS members in September 2021. The questions were mainly related to the demographics of patients with diabetic foot, diagnostic tools, and multidisciplinary treatment. Answers with a prevalence of ≥50% of respondents were considered a tendency.
Results
Seventy-eight of the 550 members (14.2%) responded to the survey. The most common demographic factors of diabetic foot patients were male dominance with a high percentage in the 60- to 70-year-old. Although the need for multidisciplinary treatment is highly recognized in the treatment of diabetic foot patients, the actual implementation rate is about 39%. The contrast-enhanced magnetic resonance imaging (88.5%) was reported to be the most used tool for the diagnosis of osteomyelitis of the diabetic foot. It was reported that the use of antibiotics was started empirically and then changed based on bacterial culture tests in 82.1% of patients. Simple wound dressing and antibiotic treatment were most frequently reported for mild ulcers.
Conclusion
This study provides updated information on the current trends in the management of a diabetic foot in Korea. Both consensus and variations in the approach to patients with diabetic foot were identified by this survey study. Further efforts are required for better access to a multidisciplinary approach, such as appropriate insurance payment policies and patient education.

Figure

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  Figure. 1 Diagnostic tools of diabetic foot. DITI: digital infrared thermal imaging, WBC SPECT: white blood cell single photon emission computed tomography, TcPO2: transcutaneous oxygen pressure, SPP: skin perfusion pressure, EMG: electromyography, NCV: nerve conduction velocity, CT: computed tomography, ABI: ankle brachial index, TBI: toe brachial index, MRI: magnetic resonance imaging, USG: ultrasonography.

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  Figure. 2 Classification of diabetic foot. WIFI: Wound, Ischemia and Foot Infection, IWGDF: International Working Group on the Diabetic Foot.

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  Figure. 3 Dedicated team for wound care.

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  Figure. 4 Dressing materials for wound care.

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  Figure. 5 Degree of significance of patients specific factors in decision making for admission.

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  Figure. 6 Treatment failure rate of out-patients.

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  Figure. 7 Treatment failure rate of in-patients.

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  Figure. 8 Treatment strategy for superficial diabetic foot.

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  Figure. 9 Postoperative complications of diabetic foot.

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