Arterial spectral waveform analysis in the prediction of diabetic foot ulcer healing

Objective: We assessed the association between (1) severity of vessel wall calcification, (2) number of patent vessels at the ankle and (3) arterial spectral waveform features, as assessed on a focused ankle Duplex ultrasound (DUS), and healing at 12-months in a cohort of patients who had their diabetic foot ulcers conservatively managed. Research design and methods: Scans performed on 50 limbs in 48 patients were included for analysis. Patient health records were prospectively reviewed for 12-months to assess for the outcome of ulcer healing. Results: We identified that the number of waveform components, peak systolic velocity, systolic rise time and long forward flow as well as the number of vessels patent at the ankle on DUS, may be useful independent predictors of healing, as noted by the trend towards statistical significance. Conclusion: Arterial spectral waveform features may be useful in predicting the chance of diabetic foot ulcer healing.

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Clinical Utility of the Ankle-Brachial Index and Toe Brachial Index in Patients with Diabetic Foot Ulcers

Current Diabetes Reviews ◽

10.2174/1573399815666190531093238 ◽

2020 ◽

Vol 16 (3) ◽

pp. 270-277 ◽

Cited By ~ 1

Author(s):

Mutasem Ababneh ◽

Mousab Y. Al Ayed ◽

Asirvatham A. Robert ◽

Mohamed A. Al Dawish

Keyword(s):

Diabetic Foot ◽

Statistical Significance ◽

Ankle Brachial Index ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Arterial Disease ◽

Cross Sectional Study ◽

Screening Tests ◽

Cross Sectional ◽

Toe Brachial Index

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018. Materials and Methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients’ medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the “χ2” test. Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI. Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.

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Intermittent cycles of remote ischemic preconditioning augment diabetic foot ulcer healing

Wound Repair and Regeneration ◽

10.1111/wrr.12269 ◽

2015 ◽

Vol 23 (2) ◽

pp. 191-196 ◽

Cited By ~ 14

Author(s):

Gad Shaked ◽

David Czeiger ◽

Anwar Abu Arar ◽

Tiberiu Katz ◽

Ilana Harman-Boehm ◽

...

Keyword(s):

Ischemic Preconditioning ◽

Ulcer Healing ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Remote Ischemic Preconditioning

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Health literacy and diabetic foot ulcer healing

Wound Repair and Regeneration ◽

10.1111/wrr.12311 ◽

2015 ◽

Vol 23 (3) ◽

pp. 299-301 ◽

Cited By ~ 16

Author(s):

David J. Margolis ◽

Michelle Hampton ◽

Ole Hoffstad ◽

D. Scot Malay ◽

Stephen Thom

Keyword(s):

Health Literacy ◽

Ulcer Healing ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer

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A Pilot Randomized, Controlled Study of Nanocrystalline Silver, Manuka Honey, and Conventional Dressing in Healing Diabetic Foot Ulcer

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2017/5294890 ◽

2017 ◽

Vol 2017 ◽

pp. 1-15 ◽

Cited By ~ 13

Author(s):

Ka-Kit Tsang ◽

Enid Wai-Yung Kwong ◽

Tony Shing-Shun To ◽

Joanne Wai-Yee Chung ◽

Thomas Kwok-Shing Wong

Keyword(s):

Ulcer Healing ◽

Diabetic Foot ◽

Reduction Rate ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Size Reduction ◽

Controlled Study ◽

Manuka Honey ◽

Ulcer Size ◽

Randomized Controlled

Nanocrystalline silver (nAg) and Manuka honey (MH) dressing have increasing popularity for treating diabetic foot ulcer (DFU). This study was an open-label randomized controlled trial with three parallel groups’ design in examining the preliminary effectiveness of nAg against MH and conventional dressing in healing DFU in terms of ulcer healing, ulcer infection, and inflammation. 31 participants (11 in the nAg group, 10 in the MH group, and 10 in the convention group) diagnosed with type 2 diabetes were enrolled. Wound cleaning, debridement, and topical dressing application were performed according to the group allocation in each visit at weeks 1, 2, 3, 4, 6, 8, 10, and 12. The results found that the proportions of complete ulcer healing were 81.8%, 50%, and 40% in the nAg, MH, and conventional groups, respectively. The ulcer size reduction rate was potentially higher in the nAg group (97.45%) than the MH group (86.21%) and the conventional group (75.17%). In bacteriology, nAg showed a greater rate of microorganism reduction although it was not significant. To conclude, nAg alginate was potentially superior to MH and conventional dressing in healing diabetic foot ulcer in terms of ulcer size reduction rate.

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Continuous diffusion of oxygen improves diabetic foot ulcer healing when compared with a placebo control: a randomised, double-blind, multicentre study

Journal of Wound Care ◽

10.12968/jowc.2018.27.sup9.s30 ◽

2018 ◽

Vol 27 (Sup9) ◽

pp. S30-S45 ◽

Cited By ~ 19

Author(s):

Mark Q. Niederauer ◽

Joel E. Michalek ◽

Qianqian Liu ◽

Klearchos K. Papas ◽

Lawrence A. Lavery ◽

...

Keyword(s):

Multicentre Study ◽

Ulcer Healing ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Placebo Control ◽

Double Blind

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Efficacy of Cellular Therapy for Diabetic Foot Ulcer

Cell Transplantation ◽

10.1177/0963689717738013 ◽

2017 ◽

Vol 26 (12) ◽

pp. 1931-1939 ◽

Cited By ~ 8

Author(s):

Ye Zhang ◽

Hong Deng ◽

Zhouping Tang

Keyword(s):

Ulcer Healing ◽

Diabetic Foot ◽

Cellular Therapy ◽

Meta Analysis ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Mean Difference ◽

Cochrane Library ◽

Transcutaneous Oxygen ◽

Randomized Controlled

Diabetes mellitus is a widely spread chronic disease with growing incidence worldwide, and diabetic foot ulcer is one of the most serious complications of diabetes. Cellular therapy has shown promise in the management of diabetic foot ulcer in many preclinical experiments and clinical researches. Here, we performed a meta-analysis to evaluate the efficacy and safety of cellular therapy in the management of diabetic foot ulcer. We systematically searched PubMed, MEDLINE, EMBASE, and Cochrane Library databases from inception to May 2017 for randomized controlled trials assessing the efficacy of cellular therapy in diabetic foot ulcer, and a meta-analysis was conducted. A total of 6 randomized controlled clinical trials involving 241 individuals were included in this meta-analysis. The results suggested that cellular therapy could help accelerating the healing of diabetic foot ulcer, presented as higher ankle-brachial index (mean difference = 0.17, 95% confidence interval [CI] = 0.11 to 0.23), higher transcutaneous oxygen pressure (standardized mean difference [SMD] = 1.43; 95% CI, 1.09– to 1.78), higher ulcer healing rate (relative risk [RR] = 1.78; 95% CI, 1.41 to 2.25), higher amputation-free survival (RR = 1.25; 95% CI, 1.11 to 1.40), and lower scale of pain (SMD = −1.69; 95% CI, −2.05 to −1.33). Furthermore, cellular therapy seemed to be safe, with no serious complications and low risk of short-term slight complications. Cellular therapy could accelerate the rate of diabetic foot ulcer healing and may be more efficient than standard therapy for diabetic foot treatment.

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