Clinical assessment of the risk of amputation in diabetic foot: A clinical case
DOI:
https://doi.org/10.63341/bmbr/3.2025.54Keywords:
podiatrist, stratification, offloading, affected area, inflammation, antiseptic treatment, sanitationAbstract
The aim of the study was to develop a clinical algorithm for assessing the risk of amputation in patients with diabetic foot syndrome and to test it on a clinical case, with an emphasis on determining the leading role of a podiatrist within a multidisciplinary team. The study was conducted as a description of a clinical case using the author’s 15-point risk stratification card, gentle local podiatric interventions, individual offloading, behavioural modification and multidisciplinary routing, followed by assessment of the dynamics according to a 7- and 14-day observation protocol. During 14 days of observation, the implementation of a structured clinical algorithm ensured a progressive improvement in the local condition of the foot: on the 7th day, there was a reduction in hyperemia, pastosity, and pain, and by the 14thday, a pronounced epithelialisation ridge had formed along the edge of the defect, indicating the activation of reparative processes. The total score on the assessment card increased from 7 to 11, reflecting the patient’s transition from high risk of amputation to moderate risk. The section scores for local examination increased from 1 to 3, for behavioural section – from 1 to 2, and for load correction – from 1 to 2, confirming the effectiveness of gentle sanitation, antiseptics, offloading pads and interdigital orthosis. The positive dynamics were accompanied by an increase in patient compliance and the refusal of traumatic home manipulations. At the same time, the level of glycaemia remained elevated (9-11 mmol/L), which necessitates long-term endocrinological control and prevention of relapses. The implementation of a podiatric algorithm with early stratification, gentle local interventions, individual offloading and behavioural correction allowed a clinically significant reduction in the risk of amputation to be achieved within 14 days of treatment. The results obtained can be used by podiatrists, family doctors and endocrinologists in outpatient care for early risk stratification, optimisation of the scope of interventions and timely referral of patients with diabetic foot syndrome for the purpose of preventing amputations
Received: 31.03.2025 | Revised: 01.08.2025 | Accepted: 02.09.2025
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