Self-Introduction
1996
2000
2002
Yuki Izumi

University of Montana（BS）
Temple University（DPM）School of Podiatric Medicine
DPM:Doctor of Podiatric Medicine
University of Texas Health Science Center, San Antonio
Texas License of Podiatric physician (Current)

PhysicalNursesMulti-Professional
Orthotist
Therapist
Podiatrist

Podiatric Physician
Podiatric Surgeon
Plastic
Dermatologist

Orthopedic
Multi-Desciplines
SurgeonSurgeonScope of practice in podiatry varies by country and this is the case in the US

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Published papers
Diabetes Care
Impact Factor in 2006: 8.28

Toe
Diabetes ResearchandAmputationClinical Practice
Impact Factor in 2009: 2.22

RayAmputation

Major

Amputation

Midfoot
Amputation

Contralateral
Amputation

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Risk of Reamputation in Diabetic Patients Stratified
by Limb and Level of Amputation: A 10-year observation~2006

 The definition of re-amputation varied

Some counts the reamputation occurred only on the same side.
Others counts the reamputation occurred on either side The reported reamputation rate contained all-level of amputation

Aims
1. To illustrate the difference between the re-amputation riskfor ipsilateral (same) and contralateral(opposite) limbs
2. To stratify the risk of reamputation by the original level ofamputation

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277

consecutive diabetic patients with a 1st lower-extremity amputation between 1993-1997
observed for reamputation episode on ipsilateral and contralateral limb occurred until 2005

Reamputation rate per Limb

Reamputation rate per Limb per level
Ipsilateral
Toe
Ray
Midfoot
Major

1-year
22.8%
28.7%
18.8%
4.7%

3-year
39.6%
41.2%
33.3%
11.8%

5-year
52.3%
50.0%
42.9%
13.3%

Contralateral
Toe
RayMidfootMajor

1-year
3.5%
9.3%
9.4%
11.6%3-year
18.8%
21.6%
18.5%
44.1%

5-year
29.5%
29.2%
33.3%
53.3%

Cited by257 papers

Google scholar as of 2023/4/17

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International medical collaboration through WHO & the Ministry of HealthEducation to different health care professionals

PhD Research Plan Foot ulcers is difficult to heal as it
continuously receive the force from ground.
 International guideline recommend the useof off-loading device to heal diabetic footulcer.
 In Japan, Prosthesits/orthotist (PO) plays amajor role in providing off-loading devices.
 Japanese experts claim the use of offloading devices is suboptimal and guideline
implementation is urgently needed.
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Podiatrists
In the country with podiatrists

Assessmentof the wound

Prescriptionof the device

Selectionof the device

Fitting &modificationof the device

Educationof the patient

Functional
training

In the country without podiatrists (in Japan)

Plastic Surgeon/
Dermatologist etc…

PO

Prosthesits/Orthotist

NursesPhysicalTherapists

Knowledge & Skills

Interprofessional Education

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Title/TopicThe Effects of an Educational Program
aimed atimproving guideline adherence

incorporating interprofessional educationin the use of off-loading devices.
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Research Questions
RQ

What are the barriers hindering the use of off-loading

1devices for Diabetic Foot Ulcers (DFU) and the level of interprofessional
collaboration practice among members of the wound care clinic?

RQ

What kind of educational program

should beemployed to increase the use of off-loading devices for DFU at the chronic
wound care clinic?

RQ

What are the effects of the educational program aimed at2

3increasing the use of off-loading devices incorporating interprofessional
education?

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Subjects
Members ofthe chronic wound care clinic■physician ■surgeon■nurse■physical therapist■orthotists etc..
at the institution registered forthe chronic wound caremanagement fee.

Methods
Barriers

Cross sectional
surveyEducationalProgram

Curriculum
development

Effects

Pre-/post
testing
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Significance This research will provide a novel perspective

on educational interventions for guideline implementation

by incorporating interprofessional education elements.
 In addition, this study can benefit those seeking to improve

the health of the diabetics and the elderly,
two of the most sharply increasing populations around the world.

My professional Goal
to clinically and academicallycontribute to countries without podiatrists

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