Modern Practice of Diabetic Foot Sampling, Protocols, Pathways, Treatments and Techniques: an audit of specimen transport time from theatre to laboratory for diabetic foot tissue (MODAMP 2)

Abstract

Introduction: Outcomes for patients undergoing minor or major amputations as a result of diabetic foot infections are poor. It is essential that specimens taken during investigations for osteomyelitis in these patients are processed correctly. A failure to do this may result in delays in time to start targeted antibiotic therapy and discharge from hospital. Methods: Four hospitals in the West Midlands collected retrospective data on diabetic foot amputations between December 2021 and February 2022. Data on the procedure, specimen collection time, transport medium and specimen receipt time were recorded. The data were analysed to see if they met the recommended standards from the United Kingdom Standards for Microbiology Investigations, which recommends that all specimens taken during the investigation for osteomyelitis should be processed within 2 hours. Results: A total of 129 procedures were performed and 94 of these had specimens taken. Twenty-one specimens (22%) reached the laboratory for processing within the 2-hour recommendation; 15 (29%) of the samples were taken ‘in hours’ and six (14%) were taken ‘out of hours’. Fifty-seven samples had the method of transport recorded, of which 54 (95%) were transported in a dry medium. Conclusion: Improvement is needed to minimise the time samples take to get from theatre to the laboratory. Increased awareness within theatres and microbiology laboratories about the importance of transporting and processing specimens quickly is required, with the result being a quicker diagnosis of osteomyelitis, accurate antibiotic treatment and overall better patient outcomes.