Wound healing outcomes in a diabetic foot ulcer outpatient clinic at an acute care hospital: a retrospective study

Lu, Suzanne; Am, McLaren

doi:10.12968/jowc.2017.26.sup10.s4

Cited by 12 publications

(9 citation statements)

References 14 publications

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“…Finally, 18 articles with 5819 random individuals in total included in this study met the inclusion criteria and were enrolled to this meta-analysis. 10,11,[13][14][15][20][21][22][29][30][31][32][33][34][35][36][37][38] The literature review and selection process were minutely demonstrated in a flow diagram (Figure 1).…”

Section: Literature Searchmentioning

confidence: 99%

Association Between Cigarette Smoking and Diabetic Foot Healing: A Systematic Review and Meta-Analysis

Ding

Miao

et al. 2018

The International Journal of Lower Extremity Wounds

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The role of smoking for wound healing in patients with diabetic foot has been unclear. This meta-analysis examined the relationship between cigarette smoking and diabetic foot wound healing. Observational studies for the association between smoking and diabetic foot wound healing of patients were systematically searched through PubMed and Wanfang Data, published up to June 2018. Healing rates of wounds were recognized as outcomes. Meta-analysis models were chosen by heterogeneity. A total of 3388 eligible studies were identified, of which 18 met all our inclusion criteria. In the smoking group, healing rate had an average of 62.1%, ranging from 20.0% to 89.6%; in the nonsmoking group, healing rate had an average of 71.5%, ranging from 40.2% to 93.8%. A significant association was found between smoking and the healing of diabetic foot wounds (z = 3.08; P = .002), with an odds ratio (OR) of 0.70 (95% CI = 0.56-0.88), based on a random-effects model. Meta-regression analyses indicated that the heterogeneity did not come from publication year (t = −0.50, P = .622) or overall healing rate (t = 0.16, P = .872). The leave-one-out sensitivity analysis was robust; sensitivity analysis for pooled estimate of adjusted ORs had an OR of 0.20 (95% CI = 0.07-0.56; z = 3.08; P = .002). Subgroup analysis had an OR of 0.62 (95% CI = 0.41-0.95; z = 2.21; P = .027) in retrospective cohort studies and had an OR of 0.75 (95% CI = 0.57-0.99; z = 2.02; P = .043) in prospective cohort studies. Our meta-analysis indicated that smoking had an overall negative effect on the wound healing of diabetic foot individuals. This study provides evidence for the harm of smoking to diabetic foot and may help reduce the medical and economic burden on poor healing of diabetic foot.

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Section: Literature Searchmentioning

confidence: 99%

Association Between Cigarette Smoking and Diabetic Foot Healing: A Systematic Review and Meta-Analysis

Ding

Miao

et al. 2018

The International Journal of Lower Extremity Wounds

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“…However, only few studies have evaluated the role of such an interdisciplinary team approach in the management of DFUs. In Canada, only four recent studies [25][26][27][28] evaluated that approach, and all of them found positive outcomes in terms of wound healing and reduction of complications.…”

Section: Introductionmentioning

confidence: 99%

Outcomes and prognosis of diabetic foot ulcers treated by an interdisciplinary team in Canada

Patry

Tourigny

Mercier

et al. 2020

International Wound Journal

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The aim of this study was to determine the wound healing outcomes of patients with a plantar diabetic foot ulcer (DFU) treated with an interdisciplinary team approach, and to identify associated variables. A retrospective observational cohort study of 140 adult patients, with a plantar DFU, treated between 2012 and 2018 at a wound care clinic of a University affiliated hospital was conducted. Predictive and explicative analyses were conducted with logistic multivariate methods and with a Receiver Operating Characteristics curve. The best predictor of wound healing at 3 months was a 41.8% wound size reduction at 4 weeks (AUC: 0.86; sensitivity: 83.1%; specificity: 67.2%, positive predictive value: 72.8%; negative predictive value: 78.9%; positive and negative likelihood ratios: 2.53 and 0.25, respectively). Main baseline variables independently associated with this predictor were: a monophasic Doppler waveform (OR 7.52, 95% CI [2.64-21.39]), cigarette smoking (OR 4.7, 95% CI [1.44-15.29]), and male gender (OR 3.58, 95% CI [1.30-9.87]). The health care provider should be cautious and intensify its management of DFUs particularly with patients of male gender; smoking, having a monophasic waveform with a hand-held Doppler, and not achieving a minimal 41.8% wound area reduction at 4 weeks of treatment.

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“…But this treatment is expensive and requires frequent hospitalizations. 21 Recently, topical drugs have been considered because of their low costs and patient compliance. One mechanism of topical drugs is their enzymatic debridement property.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Kiwifruit Therapeutics in the Treatment of Diabetic Foot Ulcer

Kardoust

Salehi

Taghipour

et al. 2021

The International Journal of Lower Extremity Wounds

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Diabetes mellitus is considered a silent disease with possible late chronic complications such as diabetic foot ulcer. This condition is managed by surgical debridement. To improve surgical outcome, some surgeons use proteolytic agents after surgery. Kiwifruit contains a type of proteolytic enzyme called actinidin that may play a role in the treatment of such complication. In the current study, we evaluate the role of kiwifruit extract in the treatment of diabetic foot ulcer. Eighteen diabetic foot ulcer patients were included in a randomized, double-blind clinical trial. The patients were divided randomly to control and experimental groups. Patients in the control group underwent daily wound dressing using base ointment (Eucerin). In the experimental group, we added kiwifruit extract to the standard wound dressing. Clinical data including general appearance of wound (according to recorded photographs before and after medical intervention) were analyzed using SPSS version 22. The mean wound area of the experimental group was significantly less than in the control group ( P = .005) after 4 weeks of treatment. Comparison of the average of size difference, before and after the treatment in the experimental group and the control group, shows that kiwifruit can have a good impact on wound healing ( P = .0001). In patients with diabetic foot ulcer, wound dressing using kiwifruit extract may help reduce time of treatment and may replace surgical debridement for some selected cases.

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Wound healing outcomes in a diabetic foot ulcer outpatient clinic at an acute care hospital: a retrospective study

Abstract: Our findings are the first to demonstrate the benefits of chiropodists leading an acute care outpatient clinic in the management of DFUs in Canada and delivers wound healing outcomes equivalent to or exceeding those previously published.

Cited by 12 publications

References 14 publications

Association Between Cigarette Smoking and Diabetic Foot Healing: A Systematic Review and Meta-Analysis

Association Between Cigarette Smoking and Diabetic Foot Healing: A Systematic Review and Meta-Analysis

Outcomes and prognosis of diabetic foot ulcers treated by an interdisciplinary team in Canada

The Effect of Kiwifruit Therapeutics in the Treatment of Diabetic Foot Ulcer

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