Mr Jackie Tey

Jackie began his career at Singapore General Hospital and later at Sengkang General Hospital, working alongside orthopaedic surgeons, plastic surgeons, vascular surgeons and endocrinologists on patients with complex diabetic foot complications. These are among the most demanding cases in the field, where the difference between a healed wound and an amputation often comes down to how quickly the right specialists are brought together.

Much of his work at Sengkang went into fixing that timing problem. He was one of the clinicians who established the DREAM clinic, a fast-access multidisciplinary diabetic foot service built around a simple change in sequence. Traditionally, a patient with a diabetic foot ulcer passes through several specialists one after another, with podiatry assessment somewhere down the line. DREAM put podiatry at the front door instead, so the need for surgical, vascular or endocrine input is identified on day one rather than week three. The workflow and its first two years of outcomes were presented in 2021, and the clinic continues to run today.

At the other end of the pathway, Jackie worked in a joint clinic with orthopaedic and plastic surgery colleagues on the most complex limb-threatening cases, providing the podiatric assessment and wound management alongside their surgical input. That collaboration grew to include day surgery procedures such as skin grafting, performed by the surgical team, which meant patients who would previously have been admitted or referred onward could be managed in one coordinated setting. The model went on to form the basis of Sengkang’s Diabetic Limb Salvage service.

The waterfall technique is his own design. It is a modification of negative pressure wound therapy with instillation and dwell time, and it solves a problem that had frustrated the team for some time: diabetic foot wounds often have deep cavities sitting behind very small openings, and conventional application into that geometry tends to leak or block. Jackie reworked how the tubing and foam are positioned so that irrigation fluid reaches the full cavity rather than pooling at the entrance. His colleagues then led the case series that tested whether it held up in practice. It was published in Wounds: A Compendium of Clinical Research and Practice in 2020, was awarded first place in the 2020 WOUNDS NPWTi-d Case Compendium Contest, and has since been cited in the wider surgical literature. He co-authored a second paper in the same journal applying the technique to a deep plantar foot abscess.

Alongside the clinical work, Jackie has drafted clinical protocols in both public hospital and private practice settings, and continues to write them for Straits Podiatry today. It is a large part of why care follows the same assessment standards across every clinic and every clinician, rather than varying with whoever you happen to see.

Jackie’s interest in orthotic design is personal as much as professional. Since that first prescribed pair during National Service, he has trialled more than ten different orthotic designs on his own feet, up to and including the ones he designs for himself today. Wearing your own prescriptions for two decades teaches you something no textbook does: how genuinely difficult it is to build a device that controls a flat foot properly and still feels tolerable at hour nine of a working day. Most designs manage one or the other.

The interest started early. The Charles W Graves Award for Orthotics recognised it during his student years, well before he had a caseload of his own, and it has run through everything since. It is the same instinct behind the waterfall technique. When something in routine practice does not work well enough, his response is to redesign it and then test whether the redesign holds up.

Today that expertise extends beyond his own patients. Jackie guides fellow podiatrists on insole design for flat feet and has presented on flat foot management to doctors and specialists across the Healthway Medical Group, and on the management of children’s flat feet to paediatricians in Singapore. When a patient tells him an orthotic does not feel right, he tends to know what they mean before they finish the sentence.