Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: A systematic review

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http://hdl.handle.net/10138/324378

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Forsythe , R O , Apelqvist , J , Boyko , E J , Fitridge , R , Hong , J P , Katsanos , K , Mills , J L , Nikol , S , Reekers , J , Venermo , M , Zierler , R E , Schaper , N C & Hinchliffe , R J 2020 , ' Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: A systematic review ' , Diabetes / Metabolism Research and Reviews , vol. 36 , no. S1 , 3278 . https://doi.org/10.1002/dmrr.3278

Title: Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: A systematic review
Author: Forsythe, Rachael O.; Apelqvist, Jan; Boyko, Edward J.; Fitridge, Robert; Hong, Joon Pio; Katsanos, Konstantinos; Mills, Joseph L.; Nikol, Sigrid; Reekers, Jim; Venermo, Maarit; Zierler, R. Eugene; Schaper, Nicolaas C.; Hinchliffe, Robert J.
Contributor: University of Helsinki, Verisuonikirurgian yksikkö
Date: 2020-03-16
Number of pages: 16
Belongs to series: Diabetes / Metabolism Research and Reviews
ISSN: 1520-7552
URI: http://hdl.handle.net/10138/324378
Abstract: Abstract Clinical outcomes of patients with diabetes, foot ulceration, and peripheral artery disease (PAD) are difficult to predict. The prediction of important clinical outcomes, such as wound healing and major amputation, would be a valuable tool to help guide management and target interventions for limb salvage. Despite the existence of a number of classification tools, no consensus exists as to the most useful bedside tests with which to predict outcome. We here present an updated systematic review from the International Working Group of the Diabetic Foot, comprising 15 studies published between 1980 and 2018 describing almost 6800 patients with diabetes and foot ulceration. Clinical examination findings as well as six non-invasive bedside tests were evaluated for their ability to predict wound healing and amputation. The most useful tests to inform on the probability of healing were skin perfusion pressure?≥?40?mmHg, toe pressure?≥?30?mmHg, or TcPO2 ≥?25?mmHg. With these thresholds, all of these tests increased the probability of healing by greater than 25% in at least one study. To predict major amputation, the most useful tests were ankle pressure?
Subject: 3121 Internal medicine
amputation
diabetes
diabetic foot
ulcer
peripheral artery disease
prognosis
DIAGNOSTIC-TEST
MAJOR AMPUTATION
ANKLE-BRACHIAL INDEX
DISEASE
FOCUS
BLOOD-PRESSURE
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