The publication of a Clinical Practice Guideline (CPG) is often not enough for its correct use in the field of health care. There are barriers to the implementation of the CPG recommendations, including those related to the lack of knowledge or skills on the part of health service providers. Strategies have been proposed to improve the implementation of the CPGs through interventions with different levels of effectiveness, such as the use of reminders, informative meetings, sending educational material, audits, among others. Some of these interventions can be carried out through Telehealth strategies, that is, with remote services. The purpose of this study is to evaluate the effectiveness of a Telehealth program to improve the implementation of the Clinical Practice Guideline for diagnosis and preoperative, intraoperative and postoperative treatment of the amputee, the prescription of the prosthesis and comprehensive rehabilitation, through strategies to publicize the recommendations included in the CPG and train doctors, reducing the barriers related to the lack of knowledge of the CPG. For this, two groups of institutions that provide health services in Antioquia will be compared, randomized according to two interventions: the socialization of the recommendations of the CPG for amputees, against a combined strategy of education through a Telehealth platform and the delivery of educational material. Compliance with prioritized recommendations of the CPG will be evaluated, related to surgical techniques, perioperative practices, the prescription of prosthetic components and referral to services that allow the comprehensive rehabilitation of the person with amputation. Additionally, the theoretical knowledge of the doctors of each participating institution before and after the interventions will be evaluated through a written test.
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Rate of patients who received two stages amputation in severe infection
Timeframe: 1 week
Rate of patients who received perioperative analgesia
Timeframe: 72 hours
Rate of patients who received prophylactic antibiotics
Timeframe: 2 hours before the incision until 24 hours after the amputation
Rate of patients who received transfemoral amputation instead of knee disarticulation
Timeframe: 24 hours
Rate of patients who received myodesis
Timeframe: 24 hours
Rate of patients who received immediate postoperative prosthesis
Timeframe: 24 hours
Rate of patients who received a SACH foot
Timeframe: 3 to 6 months
Rate of patients who received an articulated foot
Timeframe: 3 to 6 months
Rate of patients who received a prosthetic knee for above knee amputees
Timeframe: 3 to 6 months
Rate of patients who received a prosthetic knee for knee disarticulated amputees
Timeframe: 3 to 6 months
Rate of patients who received occupational therapy
Timeframe: 3 to 6 months
Rate of patients who received comprehensive Rehabilitation
Timeframe: 2 weeks to 12 weeks