Team-based diabetic foot care could substantially reduce major amputations, according to physicians at Myongji Hospital. The medical staff presented their findings at the first Diabetic Foot Clinic Multidisciplinary Symposium, emphasizing that combining infection control, blood flow restoration, reconstructive surgery and rehabilitation is essential for patient outcomes.
The high cost of delayed treatment
Diabetic foot disease develops when nerve and vascular damage leads to wounds, infections and tissue necrosis. Jeong Sang-jin, a professor of orthopedic surgery, noted that diabetic foot and lower-extremity infections affect up to one in three people with diabetes. Delayed care can ultimately result in amputation, which carries a severe prognosis. Among patients who undergo a major amputation above the ankle, the five-year mortality rate can reach 70 percent.
By implementing a multidisciplinary care process where specialists jointly assess patients, the major amputation rate can be reduced to around 10 percent, according to Jeong. This contrast highlights the danger of treating the wound in isolation rather than addressing the systemic vascular and neurological issues present in diabetic patients. The hospital operates a multidisciplinary program involving its Reconstructive Plastic Surgery Center, departments of orthopedic surgery, endocrinology, cardiology and surgery, and Hyperbaric Oxygen Therapy Center.
Treating the root causes of tissue damage
Yoon Jung-soo, a professor of plastic surgery, focused on the role of reconstructive surgery in advanced disease. Microsurgical reconstruction involves transferring tissue and connecting small blood vessels to cover damaged areas. This technique helps restore blood flow and promote wound healing while reducing the risk of amputation. Yoon stated that diagnosis, infection control, restoration of blood flow, microsurgical reconstruction, rehabilitation and follow-up care should be integrated from the early stages of treatment.
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Kim In-byeong, a professor of emergency medicine, discussed the use of hyperbaric oxygen therapy. This treatment may aid diabetic foot management by promoting new blood vessel formation, reducing inflammation and swelling, suppressing infection and supporting tissue repair. Park Yong-man, a professor of surgery, highlighted the importance of early vascular assessment and revascularization. Around half of patients with diabetic foot ulcers also have peripheral artery disease, which can be missed based on pain or routine examinations alone.
Park cited an analysis in which 31 of 33 studies evaluating multidisciplinary diabetic foot teams reported reductions in major amputations. Studies have also reported limb salvage rates of around 80 to 85 percent at 12 months among patients who underwent revascularization. This statistical evidence suggests that when vascular pathways are restored early, the body has a much higher chance of preserving the limb.
A unified treatment pathway
“Diabetic foot is difficult to manage through any single specialty, making it important to comprehensively assess each patient’s condition and provide the necessary treatment at the right time,” said Cho Yun-hyeong, vice president for medical affairs and professor of cardiology at Myongji Hospital. “Our diabetic foot clinic will connect expertise across specialties to reduce the risk of amputation and help patients return to their daily lives on their own feet,” Cho said.
Myongji Hospital also operates a specialized service for patients undergoing cesarean sections or cataract surgery, utilizing advanced medical techniques to ensure optimal recovery and health outcomes. The institution continues to refine these multidisciplinary approaches to further improve patient safety and treatment efficacy.
