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

2018 ◽  
Vol 17 (4) ◽  
pp. 247-257 ◽  
Author(s):  
Xue-Lei Fu ◽  
Hui Ding ◽  
Wei-Wei Miao ◽  
Hong-Lin Chen
Keyword(s):  
Sensitivity Analysis ◽  
Wound Healing ◽  
Cigarette Smoking ◽  
Cohort Studies ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Meta Analysis ◽  
Negative Effect ◽  
Retrospective Cohort Studies ◽  
Leave One Out

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.

Healing Rate of Diabetic Foot Wounds When Treated with Serial Debridement in the Presence of Antithrombotic Therapy

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Jack Route
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Antithrombotic Therapy ◽  
Healing Rate ◽  
Standard Of Care ◽  
Significant Negative Correlation ◽  
Arterial Disease ◽  
Wound Area ◽  
Negative Effect ◽  
Peripheral Arterial

Background Previous study indicates that pharmacologic antithrombotic therapy may be an inhibitory factor for wound healing and should merit consideration among the other core factors in wound healing optimization. Methods This study provides a retrospective analysis of the effect of antithrombotic therapy on wound healing rates of uncomplicated diabetic foot ulcerations. Wounds treated with standard of care in the presence of clinical anticoagulation were compared to control wounds. Results The results indicate a statistically significant negative correlation between antithrombotic therapy and diabetic foot wound healing rate. This represents the first study focusing on this correlation in the uncomplicated diabetic foot wound. Conclusions This retrospective study demonstrates that antithrombotic therapy has a statistically significant negative effect on healing rates of uncomplicated diabetic foot ulcerations. Both wound area and depth improvement over 4 weeks was significantly better in treated patients who were not on antithrombotic therapy for comorbidity not associated with peripheral arterial disease.

scholarly journals The Effects of Silver-Releasing Foam Dressings on Diabetic Foot Ulcer Healing

2021 ◽  
Vol 10 (7) ◽  
pp. 1495
Author(s):  
Yu-Chi Wang ◽  
Hsiao-Chen Lee ◽  
Chien-Lin Chen ◽  
Ming-Chun Kuo ◽  
Savitha Ramachandran ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Early Period ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Control Group ◽  
Diabetic Patients ◽  
High Morbidity

Diabetic foot ulcers (DFUs) are a serious complication in diabetic patients and lead to high morbidity and mortality. Numerous dressings have been developed to facilitate wound healing of DFUs. This study investigated the wound healing efficacy of silver-releasing foam dressings versus silver-containing cream in managing outpatients with DFUs. Sixty patients with Wagner Grade 1 to 2 DFUs were recruited. The treatment group received silver-releasing foam dressing (Biatain® Ag Non-Adhesive Foam dressing; Coloplast, Humlebaek, Denmark). The control group received 1% silver sulfadiazine (SSD) cream. The ulcer area in the silver foam group was significantly reduced compared with that in the SSD group after four weeks of treatment (silver foam group: 76.43 ± 7.41%, SSD group: 27.00 ± 4.95%, p < 0.001). The weekly wound healing rate in the silver foam group was superior to the SSD group during the first three weeks of treatment (p < 0.05). The silver-releasing foam dressing is more effective than SSD in promoting wound healing of DFUs. The effect is more pronounced in the initial three weeks of the treatment. Thus, silver-releasing foam could be an effective wound dressing for DFUs, mainly in the early period of wound management.

scholarly journals Effect of Earthworm on Wound Healing: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Dong Wang ◽  
Zhen Ruan ◽  
Rongchao Zhang ◽  
Xuejing Wang ◽  
Ruihui Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Healing Rate ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Healing Process ◽  
Risk Of Bias ◽  
Mean Difference ◽  
Cochrane Library ◽  
Weighted Mean

Background: Earthworm, also called dilong (Chinese language), has been used as a traditional Chinese medicine for thousands of years. Recently, some scientists believe that earthworm extracts (EE) can promote wound healing. However, its effectiveness remains controversial. We conducted a meta-analysis to evaluate the effect of EE on wound healing based on the healing rate.Methods: We comprehensively reviewed literature that mentioned EE for wound healing in the PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP database for Chinese Technical Periodicals, and WanFang database that have been published until January 2021. We computed weighted mean difference (WMD) for analysis with RevMan 5.3 software in animal and human models groups. Two researchers independently selected studies and evaluated the risk of bias with the Cochrane Collaboration tool. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO (CRD42020168400).Results: From 2,486 articles, we selected 16 studies for analysis. EE treatment was associated with improvements in wound healing performance based on wound healing rate (mouse model: weighted mean difference (WMD) = 3.55, 95% confidence interval (CI): 2.34–4.77, p &lt; 0.00001; rat model: WMD = 17.29, 95% CI: 5.75–28.82, p = 0.003; rabbit model: WMD = 19.29, 95% CI: 9.95–28.64, p &lt; 0.0001). Clinical studies also confirmed that EE could reduce healing time in hospital (WMD = −8.94, 95% CI: −17.75 to −0.14, p = 0.05).Conclusion: The results of this meta-analysis demonstrated the efficacy of EE on wound healing process. As a corollary, EE can be a useful natural product for wound healing drug development.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168400, identifier CRD42020168400.

Biological effects of amniotic membrane on diabetic foot wounds: a systematic review

2018 ◽  
Vol 27 (Sup2) ◽  
pp. S19-S25 ◽  
Author(s):  
André Oliveira Paggiaro ◽  
Andriws Garcia Menezes ◽  
Alexandra Donizetti Ferrassi ◽  
Viviane Fernandes De Carvalho ◽  
Rolf Gemperli
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Amniotic Membrane ◽  
Diabetic Foot ◽  
Biological Effects ◽  
Meta Analysis ◽  
Healing Process ◽  
Intervention Group ◽  
Risk Of Bias ◽  
Control Group

Objective: The amniotic membrane has biological properties that are beneficial to the wound healing process of diabetic foot ulcers (DFU). Our aim is to analyse the scientific evidence found in literature on the use of the amniotic membrane to stimulate DFU healing. Method: A systematic review of amniotic membrane's influence was undertaken, using the search terms ‘placenta’ ‘diabetic foot’ ‘amnion’ and biological dressing’, assessing the outcomes ‘wound healing’ and ‘wound healing time’, in DFU. Following the inclusion and exclusion criteria, randomised controlled trials (RCT) were identified, and the risk of bias was analysed according to the Cochrane risk of bias tool. We conducted a meta-analysis of the two outcomes to evaluate the level of evidence. Results: We identified six clinical trials, with a total of 331 patients. The most common risks of bias in the studies were selection, attrition, and detection biases. From the meta-analysis, the difference of the intervention group (amnion) in relation to the control group was statistically significant. We found that wound healing in the group treated with amniotic membrane occurs 2.32 times more often and is 32 days faster in comparison with the group that used conventional dressings. Conclusion: There is statistical evidence to support the effectiveness of amniotic membrane in comparison with other conventional dressings. In addition, there is a clear tendency for the use of amniotic membrane treatment to result in a larger number of DFUs healing at a quicker rate.

scholarly journals Maternal Exposure to Alcohol and Low Birthweight: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 41 (05) ◽  
pp. 333-347
Author(s):  
Priscilla Perez da Silva Pereira ◽  
Fabiana Araújo Figueiredo Da Mata ◽  
Ana Claudia Morais Godoy Figueiredo ◽  
Roberta Borges Silva ◽  
Maurício Gomes Pereira
Keyword(s):  
Systematic Review ◽  
Alcohol Consumption ◽  
Cohort Studies ◽  
Retrospective Cohort ◽  
Literature Search ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Case Control ◽  
Case Control Studies ◽  
Retrospective Cohort Studies

Objective To investigate the relationship between maternal exposure to alcohol and low birthweight (LBW). Methods The literature search was performed in January 2017 using the following electronic databases: Medline, Embase, LILACS, SciELO, Web of Science, Scopus, CINHAL, Proquest, and PsychInfo. The search strategy used the following terms: alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol addiction/use/abuse/consumption, light/moderate/social/low drinking, low birthweight, case-control studies, retrospective studies, and cohort studies. No restrictions regarding language or publication date were considered. The literature search yielded 2,383 articles, and after screening and eligibility assessment, 39 articles were included in the systematic review, and 38 studies were included in the meta-analysis. Results Maternal alcohol consumption was associated with LBW among retrospective cohort studies (relative risk [RR] = 1.37; 95%CI [confidence interval]:1.10–1.77; I2 = 98.4%; p < 0.01). Prospective cohort studies (RR = 1.11; 95%CI: 0.98–1.25; I2 = 81.5%; p < 0.01), and case-control studies (odds ration [OR] = 1.16; 95%CI: 0.68–1.97; I2 = 61.2%; p = 0.05) showed no association between alcohol and LBW. No publication bias was identified, and the meta-regression showed that the sample size influenced the high heterogeneity among retrospective cohort studies. The subgroup analysis showed differences in association between groups when compared by sample size, type of adjustment, or crude measures and publication year. Conclusions We have not found an association between alcohol consumption during gestation and LBW in the analysis in all of the subgroups. In addition, we have found a high heterogeneity between the primary studies, which is related to methodological differences in the conduction of these studies.

scholarly journals Effectiveness of Long-Acting Injectable vs Oral Antipsychotics in Patients With Schizophrenia: A Meta-analysis of Prospective and Retrospective Cohort Studies

2017 ◽  
Vol 44 (3) ◽  
pp. 603-619 ◽  
Author(s):  
Taishiro Kishimoto ◽  
Katsuhiko Hagi ◽  
Masahiro Nitta ◽  
Stefan Leucht ◽  
Mark Olfson ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Retrospective Cohort ◽  
Meta Analysis ◽  
Retrospective Cohort Studies ◽  
Long Acting

scholarly journals Relationship between serum uric acid, all-cause mortality and cardiovascular mortality in peritoneal dialysis patients: systematic review and meta-analysis of cohort studies

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052274
Author(s):  
Xue Xue ◽  
Chun-Li Lu ◽  
Xin-Yan Jin ◽  
Xue-Han Liu ◽  
Min Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Uric Acid ◽  
Cohort Studies ◽  
Retrospective Cohort ◽  
Meta Analysis ◽  
Case Control ◽  
Case Control Studies ◽  
All Cause Mortality ◽  
Retrospective Cohort Studies ◽  
The Relationship

ObjectivesTo analyse the relationship between serum uric acid (SUA), all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients to inform clinical practice and future research.DesignA systematic review of observational studies.Data sourcesPubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), SinoMed, Chinese Science and Technology Journal Database (VIP) and Wan Fang databases were searched from their inception to January 2021 for cohort and case–control studies reporting SUA and mortality in patients with PD.MethodsThe Newcastle-Ottawa Quality Assessment Scale was used to appraise quality of cohort and case–control studies. Effect estimates were presented as HRs with 95% CIs in a meta-analysis using STATA V.16.0. Data not suitable for pooling were synthesised qualitatively.ResultsFourteen cohort studies with 24 022 patients were included. No case–control studies were identified. For prospective cohort studies, pooled results for the highest SUA category were significantly greater than the lowest for all-cause (one study; 1278participants; HR 1.79; 95% CI 1.17 to 2.75) and CV mortality (one study; 1278 participants; HR 2.63; 1.62–4.27). An increase of 1 mg/dL in SUA level was associated with a 16% increased risk of all-cause mortality (one study; 1278 participants; HR 1.16; 1.03–1.32) and 34% increased CV mortality risk (one study; 1278 participants; HR 1.34; 1.16–1.55). For retrospective cohort studies, the highest SUA category did not demonstrate an elevated all-cause (five studies; 4570 participants; HR 1.09; 0.70–1.70) or CV mortality (three studies; 3748 participants; HR 1.00; 0.44–2.31) compared with the lowest SUA category. Additionally, there was no increase in all-cause (eight studies; 11 541 participants; HR 0.94; 0.88–1.02) or CV mortality (three studies; 7427 participants; HR 0.90; 0.76–1.06) for every 1 mg/dL increase in SUA level.ConclusionsResults of prospective and retrospective cohort studies were inconsistent. Consequently, prospective, multicentre, long-term follow-up studies are required to confirm the relationship between SUA and mortality in patients with PD.

scholarly journals Comparative Safety of Therapies for Hyperthyroidism Planning Pregnancy: A Network Meta-analysis

2020 ◽  
Author(s):  
Xiaohua Fang ◽  
Huibin Huang ◽  
Wei Lin ◽  
Jixing Liang ◽  
Junping Wen ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cohort Studies ◽  
Lower Risk ◽  
Birth Defect ◽  
Meta Analysis ◽  
Research Direction ◽  
Future Research ◽  
Retrospective Cohort Studies ◽  
Comparative Safety ◽  
Future Pregnancy

Objective: Our intention was to compare the pregnancy safety in women with hyperthyroidism seeking future pregnancy after ATD, RAI or thyroidectomy treatment and to explore the optimum treatment strategy. We hope the results will guide the choice for endocrinologists and patients, and be beneficial for promoting eugenics. Methods: We searched multiple databases though December 2019. The outcome indicators were abortion, preterm birth, IUGR and birth defect. We conducted a frequency-framework network meta-analysis by using Stata and R software. The results of the intervention comparison were expressed as OR with 95%CI, and ranking was assessed using surface under the cumulative ranking (SUCRA) probabilities. Results: The network meta-analysis included 4 retrospective cohort studies with a total enrollment of 480 patients. 1)Thyroidectomy had a lower risk of abortion than RAI [OR=0.77, 95%CI (0.23, 2.56)] and ATD [OR=0.68, 95%CI (0.21, 2.21)]. RAI had a lower risk of abortion than ATD [OR=0.88, 95%CI (0.45, 1.75)]. Based on SUCRA results, thyroidectomy (0.698) was followed by RAI (0.494), ATD (0.308). Thyroidectomy (60.7%) had the highest probability of being first compared to RAI (27.0%) and ATD (12.4%). 2)Thyroidectomy had a lower risk of preterm birth than RAI [OR=0.80, 95%CI (0.26, 2.44)] and ATD [OR=0.79, 95%CI (0.39, 1.59)]. RAI had a lower risk of preterm birth than ATD [OR=0.98, 95%CI (0.42, 2.33)]. Based on SUCRA results, thyroidectomy (0.703) was followed by RAI (0.430), ATD (0.367). Thyroidectomy (57.8%) had the highest probability of being first compared with RAI (30.5%) and ATD (11.8%). 3)Thyroidectomy had a lower risk of IUGR than RAI [OR=0.28, 95%CI (0.03, 3.02)] and ATD [OR=0.83, 95%CI (0.14, 4.86)]. RAI had a higher risk of IUGR than ATD [OR=3.02, 95%CI (0.60, 15.27)]. Based on SUCRA results, thyroidectomy (0.717) was followed by ATD (0.663), RAI (0.120). Thyroidectomy (56.6%) had the highest probability of being first compared with RAI (5.4%) and ATD (37.9%). 4)Thyroidectomy had a lower risk of birth defect than RAI [OR=0.70, 95%CI (0.02, 30.34)] and ATD [OR=0.23, 95%CI (0.01, 4.52)]. RAI had a lower risk of birth defect than ATD [OR=0.32, 95%CI (0.03, 3.12)] (Table 2). Based on SUCRA results, thyroidectomy (0.70) was followed by RAI (0.629), ATD (0.171). Thyroidectomy (55.9%) had the highest probability of being first compared with RAI (41.3%) and ATD (2.8%). Conclusion: Thyroidectomy was the optimum option for women with hyperthyroidism seeking near future pregnancy. The future research direction is to include more samples to conduct head-to-head randomized controlled trials or prospective cohort studies, establish inclusion criteria for various pre-pregnancy conditions or further subgroup analysis, and develop more acceptable, safer, and more manageable treatments that allow for the remission of both thyroid function and autoimmune abnormalities.

Sign in / Sign up

Export Citation Format

Share Document