(CS-070) Endocrinology and Wound Care: A Multidisciplinary Team Approach to Optimizing Diabetes and Wound Healing

Co-Author(s):

Brandon Lew, MD – Resident, Internal Medicine, Prisma Health; Maximilien Rappaport, DO, ECNU – Endocrinologist, Internal Medicine, Prisma Health; Caleb Payne, RN – Wound Care Nurse, Wound Care, Prisma Health

Introduction:

Collaboration between Endocrinology and Wound Care can greatly impact the rate of healing in diabetic foot wounds. Here we highlight the improvement of wound healing through multidisciplinary care with improved diabetic control in combination with frequent wound care. 

Methods: A retrospective chart review was conducted for five patients with diabetic foot wounds who had seen Endocrinology and Wound Care. All five patients were type 2 diabetics who had established care with endocrinology within the last six years. Wounds in this retrospective review included diabetic foot ulcerations and/or surgical wounds (Refer to Wound Photos). Their diabetic and wound care course, diabetic complications, and interventions that improved diabetic control were reviewed.

Results:

Patient one had significant improvement of HgbA1c (10.0 to 7.1) following the initiation of Dulaglutide and titration of insulin regimen. Patient two had significant improvement of HgbA1c (15.0 to 9.9) after reinitiating insulin and the use of Continuous Glucose Monitoring. Patient three had the most significant improvement of HgbA1c from 13.5 to 7.2 following reestablishment of care. The two remaining patients who did not have improved control of their diabetes had questionable compliance. Four of the five patients foot wounds were significantly improved and/or went on to closure. Wound care modalities included debridement, antibiotics, NPWT, collagen, and total contact casting.

Discussion:

Regular follow up with endocrinology and wound care are essential for rapid improvement of diabetic foot wounds. Compliance, close titration of insulin with endocrinology combined with aggressive wound care were all significant contributors for improvement or closure of these wounds.

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