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. 2025 Sep 27:13:20503121251368698.
doi: 10.1177/20503121251368698. eCollection 2025.

Establishing guidelines-based multidisciplinary diabetic limb salvage programme: A 100-day review of clinical characteristics and outcomes

Jaime Hui Xian Lin  1 , Nicole Yi Xin Lim  2 , Wai Han Hoi  1 , Kwang Wei Tham  1 , Caroline Hoong  1 , Huilin Koh  1 , Melvin Lee  1 , Ye Ni Tham  1 , Shaun Lee  1 , Jo Ann Lim  3 , Faezah Binte Sani  3 , Seri Musfirah Binte Mustafah  3 , Hannah Leong  3 , James Siow  4 , Kaamini Ravindran Pillay  4 , Daniel Seng  4 , Ernest Kwek  4 , Yanli Shao  5 , Sabariah Binte Kaspon  6 , Yuan Teng Cho  6 , Shaun Chan  6 , Pravin Lingam  6 , Sadhana Chandrasekar  6 , Zhiwen Joseph Lo  6
Affiliations

Establishing guidelines-based multidisciplinary diabetic limb salvage programme: A 100-day review of clinical characteristics and outcomes

Jaime Hui Xian Lin et al. SAGE Open Med. .

Abstract

Objectives: A newly established hospital in Singapore has introduced a pioneering multidisciplinary diabetic foot programme to provide comprehensive care for patients with diabetic foot ulcers. This study evaluates the early outcomes of a multidisciplinary diabetic limb salvage programme. Over the first 100 days of operation, the diabetic foot programme managed 106 patients.

Methods: A descriptive statistical analysis was conducted to evaluate clinical characteristics and outcomes at 100 days of follow-up.

Results: The majority of patients were Malay (46.2%) and male (61.3%), with a median age of 63.5 years. Most patients had long-standing diabetes and poor glycaemic control (77.8%), leading to high rates of diabetes-related complications. A total of 18.3% of patients had osteomyelitis, and 11.7% had gangrene. Of the 106 patients, 61.3% required inpatient management, 25.5% underwent revascularisation, and 34.9% had diabetic foot ulcer-related surgeries. According to Wound, Ischaemia and Foot Infection 12-month risk stratification, nearly 30% of patients were at medium to high risk of major lower extremity amputation. Minor lower extremity amputation occurred in 15.1% of patients and 4.7% required major lower extremity amputation. The 30-day mortality rate was 3.8%, and the average length of stay was 15.7 days. The time from admission to revascularisation was 4.4 days, and the time to diabetic foot ulcer-related surgery was 4.2 days. Wound healing was documented in 34.8% of patients at 100 days of follow-up, with a healing time of 63.2 days.

Conclusion: Our guidelines based, multidisciplinary diabetic limb salvage programme demonstrated favourable limb salvage outcomes despite high predicted amputation risks. The early outcomes of this programme highlight the effectiveness of early medical optimisation, infection control, revascularisation and active wound care.

Keywords: diabetic foot ulcers; limb salvage; multidisciplinary care.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Diabetic foot programme workflow.
See this image and copyright information in PMC

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