Page 175 - Ebook-Book JCMS 2025

The Outcomes of Multidisciplinary Care on Admitted Diabetic
Foot Ulcer in a Tertiary Hospital Compared to Usual Care
Krittapas Kijkool1*, Thipapron Tharavanit2
1 Department of Internal Medicine Thammasat University and Thammasat University Hospital
2 Endocrinology Unit, Department of Medicine, Faculty of Medicine, Thammasat University
*Corresponding Author E-mail: krittapaskijool@gmail.com
Background: Abstract
Background: Diabetic foot ulcer (DFU) is a leading cause of lower limb amputation. Since
2020, a tertiary care hospital in central Thailand has established multidisciplinary team
(MDT) care as the standard approach for admitted DFU patients. This model integrates
standing orders, guideline implementation, and expertise from medical, surgical, orthopedic,
physical medicine, and rehabilitation physicians, orthotists, nurses, and dietitians. This
study aimed to assess the clinical outcomes before (the control group) and after the
introduction of MDT care.
Methods: A retrospective cohort chart review was conducted on the participants admitted due to DFUs
in medical, surgical, and orthopedic wards. The MDT group comprised 58 participants
admitted between 2020 and 2024, while the control group included 71 participants
admitted between 2015 and 2019. The control group received DFU care, with individualized
management based on physician decisions. A chi-square test was used to compare
categorical data, and the student’s t-test was used to compare continuous data.
Results: The MDT group demonstrated a significantly reduced mean duration of wound healing
compared to the control group (mean difference of 45 days, [95% CI] 13-78 days, p=0.007).
There were no significant differences in major amputation rates (OR 1.43 [95% CI] 0.56-
3.64) or minor amputation rates (OR 0.54 [95% CI] 0.24-1.22). However, MDT care was
significantly associated with an increased readmission rate due to unhealed ulcer (OR 3.5
[95% CI] 1.4-8.9).
Conclusion: Multidisciplinary team care significantly accelerates wound healing in hospitalized DFU
participants. However, the significant association between MDT care and an increased
readmission rate due to unhealed ulcers may reflect the closer follow-up, and proactive
approach to wound management.
Harmony in health: Innovation for Sustainable Medicine
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