{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T07:42:03Z","timestamp":1777794123495,"version":"3.51.4"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In 2017, The Ottawa Hospital initiated a unique\u2010in\u2010Canada quality improvement initiative by opening a novel, multi\u2010specialist limb\u2010preservation clinic. We sought to describe the structure, processes, and initial outcomes of the clinic and evaluate whether it is achieving its mandate of providing high\u2010quality wound clinical care, education, and research. We conducted a descriptive prospective cohort study alongside a nested study of 162 clinic patients requiring serial assessments. There have been 1623 visits, mostly (72.2%) from outpatients. During 17.8% of visits, patients were evaluated by &gt;1 specialist. Therapies provided most often included negative\u2010pressure wound therapy (32.7%), biological wound dressings (21.6%), and total contact casting (18.5%). Furthermore, 1.2% underwent toe\/ray amputations or skin grafting in clinic and 22.8% were initiated on antimicrobials. Mixed\u2010effects models suggested that mean wound volumes for those requiring serial assessments decreased by 1.6 (95% confidence interval\u00a0=\u00a0\u22120.86 to \u22122.27) cm<jats:sup>3<\/jats:sup> between visits. The clinic provided seven rotations to vascular surgery, infectious diseases, dermatology, and palliative care physicians; three nursing preceptorships; and two educational workshops. It also initiated provincial and national vascular health and wound care research initiatives. This study may be used to guide development of other limb\u2010preservation clinics and programmes. Findings support that our programme is achieving its mandate.<\/jats:p>","DOI":"10.1111\/iwj.13633","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T13:08:37Z","timestamp":1622812117000},"page":"326-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Structure, processes, and initial outcomes of <scp>The Ottawa Hospital Multi\u2010Specialist Limb\u2010Preservation Clinic and Programme<\/scp>: A <scp>unique\u2010in\u2010Canada<\/scp> quality improvement initiative"],"prefix":"10.1111","volume":"19","author":[{"given":"Derek J.","family":"Roberts","sequence":"first","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"},{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Murphy","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shira A.","family":"Strauss","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Brandys","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente","family":"Corrales\u2010Medina","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl\u2010Andr\u00e9","family":"Lalonde","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Meulenkamp","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Jennings","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan J.","family":"Forster","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"IC\/ES  Toronto Ontario Canada"},{"name":"Department of Medicine University of Ottawa and The Ottawa Hospital  Ottawa Ontario Canada"},{"name":"School of Epidemiology &amp; Public Health, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel I.","family":"McIsaac","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"IC\/ES  Toronto Ontario Canada"},{"name":"School of Epidemiology &amp; Public Health, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Departments of Anesthesiology and Pain Medicine University of Ottawa and The Ottawa Hospital  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudhir K.","family":"Nagpal","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.03.290"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009724"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31824c39ba"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2254"},{"key":"e_1_2_9_6_1","first-page":"e432","article-title":"Ninety\u2010day readmission risks, rates, and costs after common vascular surgeries","volume":"20","author":"Xenos ES","year":"2014","journal-title":"Am J Manag Care"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.09.054"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X14568677"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615243"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12683"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2014.882843"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.05.087"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2003.142"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2018.11.042"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2013.01.010"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.05.101"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2014.10.030"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1112149"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2008.11.025"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734614521234"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-821310"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452746"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofx015"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.04.010"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000248116.28131.94"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2012.11.112"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/2000625X.2018.1452513"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002648"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2005.00397.x"},{"key":"e_1_2_9_30_1","volume-title":"A Dictionary of Epidemiology","year":"2008"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1687"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000431329.50869.6f"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.08.244"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003319714523113"},{"key":"e_1_2_9_37_1","volume-title":"Vascular Volumes and Outcomes Report: The Ottawa Hospital","author":"Ontario CorHealth","year":"2021"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13633","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.13633","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13633","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T03:23:05Z","timestamp":1744082585000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.13633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,3]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1111\/iwj.13633"],"URL":"https:\/\/doi.org\/10.1111\/iwj.13633","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,3]]},"assertion":[{"value":"2021-04-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}