COVID‑19’s Impact on Diabetic Foot Ulcer Surgeries at a Safety‑Net Hospital
A newly published case series examines how the COVID‑19 pandemic disrupted diabetic foot ulcer (DFU) surgical care at a major safety‑net hospital. The retrospective study evaluated ulcer-related surgeries over a five-year period (March 2018–February 2023), spanning pre-pandemic, pandemic onset, and recovery phases.
Key Findings:
- Surgical Volume Trends: Of the 1,858 total DFU-related surgeries reviewed, 723 occurred pre-pandemic, 368 during the initial pandemic year (March 2020–February 2021), and 767 during the two years that followed.
- Sharp Decline in Outpatient Access: The onset of COVID‑19 brought immediate restrictions on in-person visits and elective procedures, causing a steep drop in clinic access and early-stage DFU care.
- Shift Toward Major Amputations: While minor surgical procedures (e.g., debridement, exostectomy) initially fell, major amputations either remained steady or increased—reflecting more advanced disease upon presentation.
- Lasting Disruption: Even two years after reopening, clinic visit volumes remained below pre-COVID levels, underscoring persistent barriers in care continuity for vulnerable patients.
- Clinical Implications: Delayed care during the pandemic likely contributed to higher rates of severe complications and limb loss. The authors emphasize the importance of preserving access to wound care services during future healthcare system disruptions.
This study illustrates the critical relationship between timely DFU care and surgical outcomes. The ripple effects of the pandemic continue to inform how healthcare systems should prioritize access and care delivery during public health emergencies.
Keywords:
COVID‑19 and DFU,
safety‑net hospital,
limb salvage,
amputation rates,
healthcare access