Effectiveness of the fast-track pathway for the management of patients with diabetic foot through the network between second and third level centers

Abstract

Diabetic foot is one of the most serious and expensive complications of diabetes. It requires prompt treatment in
order to avoid the amputation of the foot, lower limb or even death of the patient.
The aim of this study is to evaluate the effectiveness of the Fast Track Pathway (FTP) between level I, II and III
diabetes centers in the Lazio Region for the treatment of diabetic patients with injuries in order to reduce the rate of
amputation and mortality.
A retrospective observational study was performed from January 2020 to December 2020. We enrolled 23 diabetic
patients presenting injuries and Diabetic Foot Ulcers (DFUs) belonging to a level I and II di-abetic foot care center
and were divided according to the type of DFUs into uncomplicated, complicated and severe; and when necessary,
sent to a specialized center for the care of level III diabetic foot. The following outcomes were evaluated: healing,
healing time, minor amputation, major amputation, and survival.
Healing occurred in 15/23 patients (65.2%). Healing time averaged approximately 7 ± 5 weeks. The minor
amputation rate was 17.4%. The major amputation rate was 0. The survival rate was 95.6%.
The preliminary data collected allow us to state that the FTP path guarantees excellent management of the diabetic
patient with DFUs between the territory and a second and third level diabetes center.