A survey to explore the provision of treatments for patients with diabetes mellitus following a lesser toe amputation across the United Kingdom

Background:
The number of lesser toe amputations (LTA) being undertaken in the United Kingdom (UK) is increasing (Hughes et al 2020). These procedures can avoid further lower limb amputations especially with advances in vascular surgical techniques. However, little is known about post-operative treatments and rehabilitation practices following LTA, or which health care professionals provide them. This study aimed to establish current treatment provision and professional roles involved in postoperative care following LTA.

Methods:
An electronic questionnaire was created and distributed via social media platforms, specialist podiatry and wound care workshops, postgraduate cohorts within a university in the North of England and personal invitation.

Results:
267 valid responses were received. Twenty-one health care professional roles were represented. Forty-two different treatments were identified with post-surgical dressings and toe dividers being the top two treatments. Otoform was the material most used to create the toe divider.

Conclusion:
This study is the first to demonstrate that a wide range of healthcare professionals provide a variety of treatments to patients with diabetes and an LTA. It identified considerable variation in post operative care, with no consistency in the materials used. These findings highlight the need for further research to ensure patients receive the most appropriate and effective evidence-based care.