The article highlights the major challenge of limb amputation in the Caribbean and its effects on the patient’s quality of life, stressors on the family and the burden on the healthcare system. Four clinical cases are presented with various wound aetiologies and comorbidities; these patients were candidates for limb amputation. A reassessment of the traditional wound management approach paradigmatically shifted to a new strategy. This strategy includes clinically effective, easy-to-apply, and affordable products that help to reduce limb amputation, resulting in limb salvage.

Authors:

Larry G. Baratta and Yvonne Braithwaite Superville

Larry G. Baratta is International Medical Director, Chief Medical Officer - World Wide Wound Care, LLC;

Yvonne Braithwaite is Chief Executive Officer - Rovon Foot and Wound Care Clinic

      The Foot in Diabetes UK Zero All Preventable (ZAP) Amputations group is dedicated to minimising the occurrence of preventable lower limb amputations. This position statement aims to address the existing gap in delivering foot care services for individuals with diabetes and emphasises the critical necessity of prompt access to specialised foot care services to prevent delays and missed appointments. Moreover, it highlights the individual factors that can hinder or impede people with diabetes from seeking appropriate and timely foot care, encompassing psychological challenges and limitations of health literacy. Additionally, this paper explores recent advances in psychological strategies to mitigate the impact of distress on diabetes foot care.

Author:

Jayne Robbie, Catherine Bewsey, Duncan Stang, Andrew Sharpe, Louise Morris, Krishna Gohil, Christian Pankhurst and Michael Edmonds

Jayne Robbie is Senior Podiatrist, University Hospitals NHS Trust and Senior Lecturer, Birmingham City University, Birmingham, UK;

Catherine Bewsey is Chartered Counselling Psychologist, SWL ICS Foot Network Project, St George’s University Hospitals NHS Foundation Trust;

Duncan Stang is National Diabetes Foot Co-ordinator, Scotland;

Andrew Sharpe is Advanced Podiatrist, Salford Royal NHS Foundation Trust, UK;

Louise Morris is Principal Podiatrist, Trafford Local Care Organisation Podiatry Department, Trafford General Hospital, Manchester, UK;

Krishna Gohil is National Clinical Lead: Lower Limb Wounds National Woundcare Strategy Programme, UK;

Christian Pankhurst is Clinical Specialist Orthotist, Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital. London, UK;

Michael Edmonds is Consultant Diabetologist, Diabetic Foot Clinic, King’s College Hospital, London, UK

This article first appeared in our sister publication, The Diabetic Foot Journal. Citation: Robbie J, Bewsey C, Stang D et al (2023) Zero All Preventable (ZAP) amputations: FDUK position statement on “missingness” and reduc-ing major amputations in the acute diabetes foot pathway. The Diabetic Foot Journal 26(1): 30–6

Andrea Mangion and Neil Piller

Key words

      Lymphoedema, eHealth, mHealth, telehealth Andrea Mangion is a Cancer and Lymphoedema Physiotherapist, Educator and PhD Candidate in the Lymphoedema Clinical Research Unit, Flinders University, Adelaide, Australia. Professor Neil Piller is the Director of the Lymphoedema Clinical Research Unit, Flinders University, Adelaide, Australia.

Declaration of interest: None

Abstract

      While electronic health (eHealth) has been gaining in popularity in recent years, its adoption was accelerated by the COVID-19 pandemic, when restrictions on in-person consultations compelled healthcare practitioners to turn to modalities such as telehealth for patient management. There are numerous potential benefits of using eHealth in lymphoedema management, including improved access to care, better tracking of symptoms and enhanced options for patient engagement and empowerment. As healthcare practitioners continue to prioritise patient-centred care, with an emphasis on putting the patient’s needs first and making treatment as accessible as possible, eHealth offers a promising opportunity to improve lymphoedema care. This article provides an overview of eHealth, explores a classification system for the various forms of eHealth, discusses the rationale for using eHealth, and proposes future research directions in lymphoedema care.

Patricia B Hotaling is a Clinical Assistant Professor of Nursing at the University of Nebraska Medical Center, in Nebraska, USA. She is an Adult-Gerontology Clinical Nurse Specialist;

Joyce Black is a Professor of Nursing at the University of Nebraska Medical Center, in Nebraska, USA; Fellow of the American Academy of Nursing and clinical editor of Wounds International