Cultura

Coordinated Infection Control Across Acute And Non-Acute Care Settings: A Review Of Multidepartmental Clinical And Operational Interventions

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Hamad Hadi Mahdi Al Hattab, Mohammed Mutarid Ojem Alyami, Ali Mana Mohmmed Al jarah, Ojaym Abduirhman Ojaym Almutarid, Abdullah Hadi Mahdi Al Hattab
Saeed Salem Hamad Al Mutyif, Saleh Hamad Mana Al Murdif, Abdullah Obyan Saleh Almansour, Salem Mohammad Salem Alyami

Abstract

Infection prevention and control remains a persistent challenge across healthcare systems, particularly when patients transition between acute and non-acute care settings. While substantial efforts have focused on department-specific infection control measures, less attention has been given to failures arising from poor coordination across clinical, operational, and administrative domains. This review examines infection control as a care-continuum challenge that extends beyond individual units or disciplines, emphasizing the interconnected roles of medical, support, and governance departments in mitigating infection risks. Drawing on recent multidisciplinary evidence, the review synthesizes findings on infection risk touchpoints along the patient care pathway, including admission, diagnosis, treatment, environmental exposure, and discharge or transfer. It highlights the often-overlooked contributions of non-clinical departments, the influence of human and organizational factors, and the impact of fragmented surveillance and information systems. The review further identifies coordination mechanisms and governance structures associated with improved infection control outcomes. Overall, the findings underscore that effective infection prevention depends on system-wide integration, shared accountability, and coordinated interventions across acute and non-acute care environments.

Keywords : Infection control; healthcare-associated infections; multidisciplinary coordination; acute and non-acute care; patient safety; healthcare systems integration; care continuity.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty