A5040219006- Diabetic Foot Ulcer Assessment and Management
- Pressure Ulcer Prevention and Management
- Wound Healing and Treatments
- Diagnosis and Treatment of Venous Diseases
- Central Venous Catheters and Hemodialysis
- Vascular Procedures and Complications
- Peripheral Artery Disease Management
- Venous Thromboembolism Diagnosis and Management
- Aortic aneurysm repair treatments
- Reconstructive Surgery and Microvascular Techniques
- Cardiac, Anesthesia and Surgical Outcomes
- Vascular anomalies and interventions
- Surgical site infection prevention
- Aortic Disease and Treatment Approaches
- Infectious Aortic and Vascular Conditions
- Frailty in Older Adults
- Migration, Health and Trauma
- Gastrointestinal disorders and treatments
- Vascular Malformations Diagnosis and Treatment
- Gastric Cancer Management and Outcomes
- Foot and Ankle Surgery
- Neuroendocrine regulation and behavior
- Climate Change and Health Impacts
- Gastrointestinal Tumor Research and Treatment
- Long-Term Effects of COVID-19
Tan Tock Seng Hospital
2016-2025
Nanyang Technological University
2023
National University of Singapore
2023
Ministry of Manpower
2023
Health Sciences and Nutrition
1992
Abstract The aim of this study is to evaluate the clinical and economic burden wound care in Tropics via a 5‐year institutional population health review. Within our data analysis, wounds are broadly classified into neuro‐ischaemic ulcers (NIUs), venous leg (VLUs), pressure injuries (PIs), surgical site infections (SSIs). Between 2013 2017, there were total 56 583 wound‐related inpatient admissions for 41 461 patients, with 95.1% increase episodes per 1000 over period (142 277 respectively)....
There is a lifetime risk of 15% to 25% development diabetic foot ulcers (DFUs) in patients with diabetes mellitus. DFUs need be followed up on and assessed for complications and/or resolution, which was traditionally performed using manual measurement. Our study aims compare the intra- inter-rater reliability an artificial intelligence-enabled wound imaging mobile application (CARES4WOUNDS [C4W] system, Tetsuyu, Singapore) traditional This prospective cross-sectional 28 from June 2020...
Background: Diabetic foot ulcers (DFUs) are serious complications of diabetes which can lead to lower extremity amputations (LEAs). Risk prediction models identify high-risk patients who benefit from early intervention. Machine learning (ML) methods have shown promising utility in medical applications. Explainable modeling help its integration and acceptance. This study aims develop a risk model using ML algorithms with explainability for LEA DFU patients. Methods: is retrospective review...
Abstract Diabetic foot wounds (DFW) are notoriously difficult to treat owing poor vascularity, delayed healing and higher rates of infection. Human‐derived acellular dermal matrices (ADM) have been used in DFW treatment, utilizing a matrix scaffold for new tissue generation. We investigate the efficacy micronized injectable human‐derived ADM treatment DFW. retrospectively recruited 13 patients with diabetic wounds. Wounds were adequately debrided, was applied. Wound sizes recorded prior at 2...
Introduction To compare the clinical outcomes and healthcare utilization of patients enrolled in multidisciplinary Diabetic Foot Primary Tertiary (DEFINITE) Care program with a matched historical cohort estimate program’s long-term cost-effectiveness using simulation. Research design methods This study consisted two components: 1-year observational outcome evaluation simulation-based analysis (CEA). We conducted an to analyze 2798 diabetic foot ulcers (DFUs) between June 2020 2021 (DEFINITE...
ABSTRACT Background and Aims Neuro‐ischemic ulcers (NIU) present a substantial clinical economic burden on the healthcare systems. This study aims to evaluate their healing rate, associated resource utilization, prognostic factors influencing healing. Methods Consecutive patients attended specialist clinics or admitted wards in three tertiary hospitals for new existing NIUs from November 2019 2021 were eligible this study. Each participant was followed up times (1‐month, 3‐month 6‐month...
Chronic wounds pose an increasing burden on the healthcare system and data wound outcomes are needed to evaluate address disparities reform policies. In Singapore, chronic fragmented this, we established a Wounds Registry (CWR) collect harmonised their over 6 months. This is multi-centre prospective cohort study from Nov 2019 2021. Patients with were enrolled at multi-speciality acute care hospitals prospectively collected baseline characteristics, including subject demographics, clinical...
Background One of the most common causes arteriovenous fistula (AVF) and/or graft (AVG) failure is thrombosis. Guidelines recommend early AVF salvage within 24–48 hours. Our institution reported poor compliance with these recommendations, a median 3 days prior to vascular access (VA) salvage. We present our initial results following implementation clinical practice improvement programme (CPIP) reduce delay VA Methods The CPIP was conducted in three phases: pre-CPIP (23 January 30 April...
Background Diabetic foot ulcers (DFUs) impose a substantial burden on healthcare systems worldwide, leading to diminished health-related quality of life (HRQoL) characterised by reduced productivity and limited mobility. Objectives The aim this cross-sectional longitudinal study was compare the HRQoL in patients with both healed non-healed over 12 months. Methods We recruited prospective cohort 257 from Foot Primary Tertiary (DEFINITE) Care program. assessed their using EuroQol Five-...
These two case studies describe the use of Octenisept ® in diabetic foot ulcers at a tertiary referral hospital Singapore
Background: With rising immigration rates across Canada, there is increasing demand to tailor integrated primary care the needs of newcomers. The Eastern York Region North Durham (EYRND) Ontario Health Team (OHT) in Ontario, Canada therefore implementing a Newcomer Engagement Initiative with two goals: better understand how newcomers region access care, and improve program development service delivery. In 2022, approximately 8% EYRND OHT’s attributed population consisted who immigrated past...
Abstract This study evaluated the effectiveness of a multi‐disciplinary diabetic limb salvage programme in improving clinical outcomes and optimising healthcare utilisation 406 patients aged ≥80 years with foot ulcers (DFUs), compared to 2392 younger enrolled from June 2020 2021 against 1716 historical controls using one‐to‐one propensity score matching. Results showed that elderly had lower odds amputation‐free survival (odds ratio: 0.64, 95% CI: 0.47, 0.88) shorter cumulative length stay...
Diabetic Foot in Primary and Tertiary (DEFINITE) Care is an inter-institutional multi-disciplinary team (MDT) health systems innovation programme at a healthcare cluster Singapore. We aim to achieve coordinated MDT care across primary tertiary for patients with diabetic foot ulcers (DFU), within our public - integrated network of seven polyclinics two acute hospitals (1700-bed 800-bed) total catchment population 2.2 million residents. Results from prospective DEFINITE referenced against...
Introduction Diabetes foot disease (DFD) contributes to poor quality of life, clinical and economic burden. Multidisciplinary diabetes teams provide prompt access specialist thereby improving limb salvage. We present a 17-year review an inpatient multidisciplinary care path (MCCP) for DFD in Singapore. Methods This was retrospective cohort study patients admitted enrolled our MCCP 1700-bed university hospital from 2005 2021. Results There were 9279 with mean 545 (±119) admissions per year....
To estimate the 'cost of illness' arising from chronic wounds in Singapore. Incidence-based cost illness study using evidence a range sources. Singapore health services. We consider 3.49 million citizens and permanent residents. There are 16 752 new individuals with wound 2017, 598 venous ulcers, 2206 arterial insufficiency 6680 diabetic ulcers 7268 pressure injuries.Primary outcome measures expressed monetary terms value all hospital bed days lost for population; quality-adjusted life years...
Abstract Venous leg ulceration results in significant morbidity. However, the majority of studies conducted are on Western populations. This study aims to evaluate wound healing and quality life for patients with venous ulcers (VLUs) a Southeast Asian population. is multi‐centre prospective cohort from Nov 2019 2021. All were started 2‐ or 4‐layer compression bandage reviewed weekly fortnightly. Our outcomes healing, factors predictive EuroQol 5‐dimensional 5‐level (EQ‐5D‐5L) health states....
Present guidelines recommend a multidisciplinary team (MDT) approach to diabetic foot ulcer (DFU) care, but relevant data from Asia are lacking. We aim evaluate the clinical and economic outcomes of an MDT in lower extremity amputation prevention programme (LEAPP) for DFU care Asian population. performed case-control study 84 patients with between January 2017 October (retrospective control) vs 117 December July 2018 (prospective LEAPP cohort). Comparing retrospective cohort cohort, there...
For patients with "no-option" chronic limb-threatening ischemia, a final attempt can be made for limb salvage in the form of percutaneous deep vein arterialization (pDVA). In present study, we describe five cases pDVA using BeBack crossing catheter (Bentley InnoMed GmbH; previously, GoBack catheter; Upstream Peripheral Technologies). From November 2021 to July 2022, underwent catheter. The demographic data, procedural details, and patient outcomes were recorded. Successful vascular was...