Incidence and predictors of recurrent and other new diabetic foot ulcers: a retrospective cohort study

2019 ◽  
Vol 36 (11) ◽  
pp. 1417-1423 ◽  
Author(s):  
S. Engberg ◽  
K. Kirketerp‐Møller ◽  
H. Ullits Andersen ◽  
A. Rasmussen
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Diabetic Foot ◽  
Retrospective Cohort ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Hyperbaric oxygen treatment for University of Texas grade 3 diabetic foot ulcers: a retrospective cohort study

2021 ◽  
Vol 30 (9) ◽  
pp. 722-728
Author(s):  
Rutger C Lalieu ◽  
Willem Mulder ◽  
René D Bol Raap ◽  
Saskia Stolk ◽  
Casper Smit ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Wound Care ◽  
Complete Healing ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
University Of Texas ◽  
Complete Wound Healing ◽  
Grade 3

Aim: Hard-to-heal diabetic foot ulcers (DFUs) may increase the risk of amputation. This study reports the positive influence of hyperbaric oxygen therapy (HBOT) on hard-to-heal DFUs involving underlying bone. Method: A single-centre, retrospective cohort study reporting the results of HBOT and wound care on hard-to-heal University of Texas grade 3 DFUs (i.e., involving underlying bone) between 2013 and 2019. Outcome measures were primarily (near-) complete wound healing (i.e., ≥80% ulcer surface area reduction) and amputation rate (minor or major), and secondarily the number of hyperbaric sessions and improvement in quality of life (QoL) and pain score. Results: The study included 206 patients, of whom 74 (36%) achieved complete wound healing, and 75 (36%) near-complete healing. Amputations were performed in 27 patients (13%): 12 (6%) minor and 15 (7%) major. The median number of HBOT sessions was 42. Participants who achieved complete healing received a median of 43 sessions, compared with 10 for those who required major amputation. Patients with at least 30 sessions were less likely to undergo amputation (odds ratio: 0.08; 95% confidence interval (CI): 0.03–0.21). Mean QoL increased by 7.6 points (95%CI: 3.9–11.3; p<0.01) and median pain score fell from 3 to 1 (0–3) (p<0.01). Conclusions: The addition of HBOT to standard wound care may lead to a decreased amputation risk, improved wound healing and increased QoL for people with a University of Texas grade 3 DFU. An adequate number of HBOT sessions is required to achieve optimal clinical results. Objective selection criteria and shared decision-making are suggested to improve dropout rates.

scholarly journals Severity and duration of diabetic foot ulcer (DFU) before seeking care as predictors of healing time: A retrospective cohort study

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0177176 ◽  
Author(s):  
Hilde Smith-Strøm ◽  
Marjolein M. Iversen ◽  
Jannicke Igland ◽  
Truls Østbye ◽  
Marit Graue ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Diabetic Foot ◽  
Retrospective Cohort ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Healing Time

Broad-Ranging Nutritional Deficiencies Predict Amputation in Diabetic Foot Ulcers

2019 ◽  
Vol 19 (1) ◽  
pp. 27-33 ◽  
Author(s):  
John Deakin Lees Brookes ◽  
Joseph Swaminadan Jaya ◽  
Henley Tran ◽  
Ashish Vaska ◽  
Keagan Werner-Gibbings ◽  
...  
Keyword(s):  
Wound Healing ◽  
Vitamin C ◽  
Diabetic Foot ◽  
Biochemical Markers ◽  
Retrospective Cohort ◽  
Caloric Intake ◽  
Nutritional State ◽  
Nutritional Deficiencies ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Diabetic foot ulcers present across the spectrum of nonhealing wounds, be it acute or many months duration. There is developing literature highlighting that despite this group having high caloric intake, they often lack the micronutrients essential for wound healing. This study reports a retrospective cohort of patients’ micro- and macro-nutritional state and its relationship to amputation. A retrospective cohort was observed over a 2-month period at one of Australia’s largest tertiary referral centers for diabetic foot infection and vascular surgery. Patient information, duration of ulcer, various biochemical markers of nutrition and infection, and whether the patient required amputation were collected from scanned medical records. A cohort of 48 patients with a broad-spectrum of biochemical markers was established. Average hemoglobin A1c (HbA1c) was 8.6%. A total of 58.7% had vitamin C deficiency, including 30.4% with severe deficiency, average 22.6 Ł} 5.8 μmol/L; 61.5% had hypoalbuminemia, average albumin 28.7 Ł} 2.5 g/L. Average vitamin B12 was 294.6 Ł} 69.6 pmol/L; 57.9% had low vitamin D, average 46.3 Ł} 8.3 nmol/L. Basic screening scores for caloric intake failed to suggest this biochemical depletion. There was a 52.1% amputation rate; biochemical depletion was associated with risk of amputation with vitamin C ( P < .01), albumin ( P = .03), and hemoglobin ( P = .01), markedly lower in patients managed with amputation than those managed conservatively. There was no relation between duration of ulceration and nutrient depletion. Patients with diabetic foot ulceration rely on multidisciplinary care to optimize their wound healing. An important but often overlooked aspect of this is nutritional state, with micronutrients being very important for the healing of complex wounds. General nutritional screening often fails to identify patients at risk of micronutrient deficiency. There is a high prevalence of vitamin deficiency in patients with diabetic foot ulcers. This presents an excellent avenue for future research to assess if aggressive nutrient replacement can improve outcomes in this cohort of patients.

scholarly journals Comment on “Ulcer‐free survival days and ulcer healing in patients with diabetic foot ulcers: A prospective cohort study”

2019 ◽  
Vol 17 (1) ◽  
pp. 228-229
Author(s):  
Amélie Simoneau ◽  
Laurence Blanco ◽  
Frédéric Domenge ◽  
Kamel Mohammedi ◽  
Ninon Foussard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Ulcer Healing ◽  
Diabetic Foot ◽  
Prospective Cohort ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Free Survival
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