The Impact and Importance of Public Engagement in Wound Care

“We Are Failing Our Patients With Diabetes” was the title of my article in Today’s Wound Clinic in November 2021. Non-traumatic amputation rates have been rising since 2009, despite technological advancements and ever-increasing levels of evidence.

After having been part of the wound care community for a quarter of a century, I—like many of you—have been looking for solutions and answers not only to improve quality of care, but to reverse this worrisome trend.

My takeaway from this is that while technological advancements are critical and helpful, the way to solve this problem is through proactive measures. 

Look no further than the impact that breast cancer awareness campaigns have made, both in prevention and treatment. The combination of increased public awareness, teaching of how to perform self-examination and when to seek professional care have been instrumental in reducing mortality rates, in addition to the funding of life-saving research that has been driven by the public. The same holds true for other forms of cancer, such as prostate, skin, testicular, and ovarian, to name several. 

We know that preventing disease is easier than treating, but unfortunately, the impact of efforts that promote prevention is not immediately apparent or measurable.

With such a precedent already existing in addressing a variety of forms cancer, then doesn’t it make sense to apply such a model to the problem of lower extremity wounds and often unnecessary amputations?

Although our data is limited to date, the Save a Leg, Save a Life Foundation has begun the process of driving public awareness of chronic wounds and peripheral arterial disease through a strategy that includes community outreach and screening events. Over the past year, we have begun conducting community events that include screening for peripheral vascular disease (PAD) and diabetic foot risk assessments, coupled with educational information that targets populations that are at high risk.

Despite our small sample size from screening events in 3 cities to date, the incidence of finding previously unrecognized conditions and making referrals to appropriate specialists has had an immediate impact on a significant number of individuals. Referrals have been made to vascular surgeons, cardiologists, neurologists, orthopedics, podiatrists, and ophthalmologists. 

Why do amputation rates continue to increase? We have done a poor job of conveying the importance of diabetes related complications, such as chronic wounds and PAD, to the public. 

We, the wound care community, understand the critically important nature of our work. This is part of the reason we attend conferences such as the Symposium on Advanced Wound Care (SAWC) and return year after year. Despite our knowledge and skill set, a big part of the problems lies with the people who will never attend SAWC. This is not seeking to affix blame, but the reality is that most people do not understand what is at stake, coupled with the fact that wounds are not something associated with pleasure.

If we are to reverse the disturbing trends associated with diabetes, wounds, and amputation, we must engage the public more effectively. People don’t know what they don’t know. We must teach others how to know their risk factors, perform self-inspections (foot checks), eliminate fear of screening, and assist in access to care. Until there is a shift in the public’s perception and an associated outcry that demands better, things will likely worsen, as our population ages and becomes increasingly diabetic.

Education, advocacy, and community outreach are the principles that the Save a Leg, Save a Life Foundation is built on. We are attempting to serve through actions, not just words. The solutions we are recommending are not high tech, but unless the messages outlined in this blog are delivered repeatedly, complacency will prevail, and the best efforts of the wound care community of the past 30 years, may prove to be in vain.

Dr. Bell is an Executive Physician Coach for MD Coaches LLC and is a Certified Wound Specialist. He is Chief Medical Officer for Omeza, Founder and President of the Save A Leg, Save A Life Foundation, and a Fellow of the Royal College of Physicians and Surgeons of Glasgow.