Michael B Strauss
Scientific Tracks Abstracts: J Diabetes Metab
Introduction: When one hears of thousands being spent to salvage a diabetic foot problem only to go onto a lower limb amputation, the need for objective criteria for decision making between limb salvage versus amputation (SvA) is apparent. This presentation provides 2 objective scoring tools to justify the SvA decision. Methods: It was apparent that scoring tools were needed to provide guidance for making the crucial decision of SvA. A Wellness Score (WS) and a Goal Score (GS) that I generated solved this problem. Each is based on 5 objective assessments graded from 2 (best) to 0 (worst). This generates a 0 to 10 score for each tool. We utilized these tools in a series of patients where the crucial decision of SvA needed to be made. Findings: The use of the WS & GS provided justification for SvA and was especially useful for the diabetic with a limb threatening Charcot foot ulcer. All patients where a SvA decision needed to be made and an amputation was done scored less than 5 points on either or both of the WS &GS. When the patient (and/or person providing the durable power of attorney) was informed of the scores from these 2 tools decision making became easy. Conclusions: Objectivity can be employed for making decisions whether to SvA a diabetic foot wound using the WS & GS tools. Information from these 2 scoring tools provides cost justification for decisions regarding patient management of diabetic foot ulcers.
