Effect of a multidisciplinary team approach in patients with diabetic foot ulcers on major adverse limb events (MALEs): systematic review and meta-analysis for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

Autor: Meloni M; Department of Systems of Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. meloni.marco@libero.it., Giurato L; Department of Endocrinology and Diabetology, CTO Hospital, 00145, Rome, Italy., Monge L; AMD-Italian Association of Clinical Diabetologists, Milan, Italy., Miranda C; Pordenone Hospital, Pordenone, Italy., Scatena A; Ospedale San Donato, Arezzo, Italy., Ragghianti B; Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50141, Florence, Italy., Silverii GA; Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50141, Florence, Italy., Vermigli C; Azienda Ospedaliera Santa Maria Della Misericordia, Ospedale Di Perugia, Perugia, Italy., De Cassai A; University Hospital of Padua, Padua, Italy., Volpe A; Policlinico Abano Terme, Padua, Italy., Tramonta R; Asl Roma 4, Civitavecchia, Italy., Medea G; SIMG- Italian Society of General Medicine, Florence, Italy., Bordieri C; Università Cattolica del Sacro Cuore, Rome, Italy., Falcone M; Cisanello Hospital and University of Pisa, Pisa, Italy., Stefanon L; Azienda Sanitaria Friuli Occidentale, Pordenone, Italy., Bernetti A; Sapienza University, Rome, Italy., Cappella C; Associazione Di Volontariato Piede Diabetico Umbria ODV, Perugia, Italy., Gargiulo M; University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy., Lorenzoni V; Scuola Superiore Sant'Anna, Pisa, Italy., Scevola G; Ospedale Sandro Pertini, Rome, Italy., Stabile E; Azienda Ospedaliera Regionale 'San Carlo', Potenza, Italy., Da Ros R; Azienda Sanitaria Universitaria Giuliana Isontina, Monfalcone, Italy., Murdolo G; Azienda Ospedaliera Santa Maria Della Misericordia, Ospedale Di Perugia, Perugia, Italy., Bianchini E; Azienda Ospedaliera Santa Maria Della Misericordia, Ospedale Di Perugia, Perugia, Italy., Gaggia F; Azienda Ospedaliera Santa Maria Della Misericordia, Ospedale Di Perugia, Perugia, Italy., Gauna C; ASL Città Di Torino, Turin, Italy., Romeo F; ASL TO5, Chieri, Turin, Italy., Apicella M; Ospedale San Donato, Arezzo, Italy., Mantuano M; Ospedale San Donato, Arezzo, Italy., Monami M; Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50141, Florence, Italy., Uccioli L; Department of Systems of Medicine, University of Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.; Department of Endocrinology and Diabetology, CTO Hospital, 00145, Rome, Italy.
Jazyk: angličtina
Zdroj: Acta diabetologica [Acta Diabetol] 2024 May; Vol. 61 (5), pp. 543-553. Date of Electronic Publication: 2024 Mar 10.
DOI: 10.1007/s00592-024-02246-9
Abstrakt: The treatment of patients with diabetic foot ulcers (DFUs) is extremely complex, requiring a comprehensive approach that involves a variety of different healthcare professionals. Several studies have shown that a multidisciplinary team (MDT) approach is useful to achieve good clinical outcomes, reducing major and minor amputation and increasing the chance of healing. Despite this, the multidisciplinary approach is not always a recognized treatment strategy. The aim of this meta-analysis was to assess the effects of an MDT approach on major adverse limb events, healing, time-to-heal, all-cause mortality, and other clinical outcomes in patients with active DFUs. The present meta-analysis was performed for the purpose of developing Italian guidelines for the treatment of diabetic foot with the support of the Italian Society of Diabetology (Società Italiana di Diabetologia, SID) and the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD). The study was performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. All randomized clinical trials and observational studies, with a duration of at least 26 weeks, which compared the MDT approach with any other organizational strategy in the management of patients with DFUs were considered. Animal studies were excluded. A search of Medline and Embase databases was performed up until the May 1st, 2023. Patients managed by an MDT were reported to have better outcomes in terms of healing, minor and major amputation, and survival in comparison with those managed using other approaches. No data were found on quality of life, returning-to-walking, and emergency admission. Authors concluded that the MDT may be effective in improving outcomes in patients with DFUs.
(© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.)
Databáze: MEDLINE
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