Dr Jason Diab1, Dr Andrea Issler-Fisher1, Mrs Miranda Pye1, Ms Christine Parker1, Prof Peter Kennedy1, Prof Peter Haertsch1, Dr Justine O’Hara1, Professor Peter Maitz1
1Concord Burns Unit, Concord Hospital, Concord, Australia
The International Diabetes Federation estimates 1.1 million people aged between 20 and 79 years with diabetes in Australia . Diabetic foot burns are a common clinical presentation that poses a challenge for teams to manage requiring a multidisciplinary approach. Our aim is to identify and classify epidemiological trends of diabetic foot burns at Concord hospital from 2014 – 2019. The secondary objective will examine the ways a diabetic foot burn protocol can be implemented to provide patient education on diabetic foot burns and reduce costs.
A retrospective audit from 2014 – 2019 at Concord General Repatriation Hospital Burns Unit summarised patient demographics, burn injury, diabetic status, operations and length of stay. All foot burn injuries from 2014 – 2019 of all ages and gender that attended Concord burns hospital were included in this study. A statistical analysis using SPSS was used to analyse the data.
There were 135 patients whom presented with diabetic foot burns representing 15.2% of all foot burns. The average age was 60.25 years with winter being the most affected season. The most common mechanism of injury was contact (38.5%), followed by scald (34.1%). There is a strong statistical relationship with first aid and the extent of burn surface area such that they are dependent and statistically associated from the data [χ2 (5df) = 23.331, p =< 0.001; Cramer’s V = 0.416, p < 0.001]. The average total burn surface area (TBSA) was 1.78% with 26.67% required grafting. Multiple regression analysis was undertaken to predict length of stay from age, gender, TBSA, mechanism of injury, sensory modality, and seasons. From the model, TBSA, sensory modality and gender were statistically significant for increased length of stay F (5,53) = 4.707, P=0.001, R2 = 0.308.
With the increase of diabetes, our multidisciplinary approach to diabetic foot care should include nursing, medical and surgical disciplines to identify patients at risk. The data highlights that a focus on prevention and education for diabetes is central to optimize glycaemic control and burn management, whilst providing a multidisciplinary network on discharge.
Jason is a SRMO at Concord Burns Unit with experience in health research, craniofacial and plastic surgery.