Year 2021
October 2021


Abstract Title
Listening to voices, addressing concerns and healing the wounds: a case series of three patients’ experiences of undergoing “auto-amputation” in primary care

L.WAN1, A. K. YONG1, L. WEI1, J. ZHU1 


NHG Polyclinics1

Background & Hypothesis

Auto-amputation is commonly adopted to manage gangrenous digits for patients with diabetic foot requiring toe amputation but are medically contraindicated for surgery. The process of auto-amputation is lengthy requiring substantial self-care and treatment adherence from patients and personalized patient education by healthcare providers. Failure in any of the mentioned-requirements may create both humanistic and economic burden on patients, healthcare industrials and society. The aim of study is to reveal how wound care nurses (WCN) apply a personalized counselling to improve self-care adherence and achieve optimal healing outcomes.


Three patients (two males and one female) aged 50 to 75 years visited the polyclinic between 2017 and 2020 for treatment of gangrene toes by WCNs. The patients’ medical records were reviewed using descriptive content analysis.


Three patients presented 1-2 gangrene toes for daily to weekly wound care in the polyclinic. During their clinic visits, WCNs treated every patient as a unique individual by listening, communicating, motivating, teaching and learning, then healing. Patients and their caregivers were invited to participate in their care. Patients’ concerns are put at the core of the decision-making in wound care plan. Throughout of the entire auto-amputation process of 3-7 months, all patients were engaged, empowered, motivated and taught to perform self-care and close monitoring of healing process at home, as well as visit clinic for wound advice regularly. Their wounds healed through auto-amputation without detrimental complications and hospital admissions.

Discussion & Conclusion

Personalized care plan and individualized patient education improved self-care and treatment adherence, achieved wound healing.