Interventions in Patient Education to Prevent Lower Limb Amputation

Abstract

 Our hospital is one of the few hospitals in the Izu area that has a Department of Plastic and Reconstructive Surgery. Since 2011, we have operated a foot care outpatient clinic. We have treated many cases of chronic limb-threatening ischemia and have experienced many cases requiring major lower limb amputation（LLA）. Low adherence has led to a noticeable incidence of LLA due to infection. To address this, we implemented interventions in patient education methods aimed at improving adherence.
 We included a total of 109 LLAs performed at our hospital. Those conducted after the start of the intervention in August 2022 were designated as the intervention group, whereas those performed between January 2018 and July 2022 were categorized as the non-intervention group.
 We created a flow chart to identify patients who received LLA and performed treatment at home.
 We issued a “Foot Treatment Prescription” to share multidisciplinary treatment plans in a paper format.
 We found that cases where infection was involved in amputation decreased from approximately 10 cases/year in the non-intervention group to 3 cases/year in the intervention group.
 Our findings suggest that standardizing the quality of patient education and improving adherence contribute to reducing LLA caused by infection.