Advanced

Heel ulcers do heal in patients with diabetes

Örneholm, Hedvig LU ; Apelqvist, Jan LU ; Larsson, Jan and Eneroth, Magnus LU (2017) In International Wound Journal 14(4). p.629-635
Abstract

A heel ulcer is considered to be a serious complication in patients with diabetes, and there is limited information regarding outcome. In most of the literature, a poor prognosis is described. The aim of this study was to investigate a large cohort of ulcers located in the heel in patients with diabetes. Seven hundred and sixty-eight patients [median age 73 (17-98)], presenting with a heel ulcer at a multidisciplinary diabetes foot clinic, fulfilled the inclusion criteria and were followed-up until final outcome. Fifty-eight per cent of the patients healed primarily; 7% healed after major debridement; 9% healed after amputation and 25% died unhealed. Median healing time was 17 weeks. Ulcer progression was seen in 19% of patients.... (More)

A heel ulcer is considered to be a serious complication in patients with diabetes, and there is limited information regarding outcome. In most of the literature, a poor prognosis is described. The aim of this study was to investigate a large cohort of ulcers located in the heel in patients with diabetes. Seven hundred and sixty-eight patients [median age 73 (17-98)], presenting with a heel ulcer at a multidisciplinary diabetes foot clinic, fulfilled the inclusion criteria and were followed-up until final outcome. Fifty-eight per cent of the patients healed primarily; 7% healed after major debridement; 9% healed after amputation and 25% died unhealed. Median healing time was 17 weeks. Ulcer progression was seen in 19% of patients. Thirty-one percent of patients had severe peripheral vascular disease. A creatinine level below 91 μmol/l was related to a higher probability for healing without major debridement or amputation, whereas vascular surgery, nephropathy and oedema were related to a lower probability for healing without major debridement or amputation. Two thirds of heel ulcers do heal in patients with diabetes despite patients being elderly and with extensive comorbidity. The extent of peripheral vascular disease, nephropathy, oedema and decreased renal function are important factors influencing outcome.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Diabetes, Healing, Heel ulcer, Outcome
in
International Wound Journal
volume
14
issue
4
pages
629 - 635
publisher
Wiley-Blackwell
external identifiers
  • scopus:84994477220
  • wos:000405302600005
ISSN
1742-4801
DOI
10.1111/iwj.12654
language
English
LU publication?
yes
id
0bf79e61-e2f5-4f96-a4bb-a1897c604e96
date added to LUP
2016-12-02 14:33:48
date last changed
2018-01-07 11:38:18
@article{0bf79e61-e2f5-4f96-a4bb-a1897c604e96,
  abstract     = {<p>A heel ulcer is considered to be a serious complication in patients with diabetes, and there is limited information regarding outcome. In most of the literature, a poor prognosis is described. The aim of this study was to investigate a large cohort of ulcers located in the heel in patients with diabetes. Seven hundred and sixty-eight patients [median age 73 (17-98)], presenting with a heel ulcer at a multidisciplinary diabetes foot clinic, fulfilled the inclusion criteria and were followed-up until final outcome. Fifty-eight per cent of the patients healed primarily; 7% healed after major debridement; 9% healed after amputation and 25% died unhealed. Median healing time was 17 weeks. Ulcer progression was seen in 19% of patients. Thirty-one percent of patients had severe peripheral vascular disease. A creatinine level below 91 μmol/l was related to a higher probability for healing without major debridement or amputation, whereas vascular surgery, nephropathy and oedema were related to a lower probability for healing without major debridement or amputation. Two thirds of heel ulcers do heal in patients with diabetes despite patients being elderly and with extensive comorbidity. The extent of peripheral vascular disease, nephropathy, oedema and decreased renal function are important factors influencing outcome.</p>},
  author       = {Örneholm, Hedvig and Apelqvist, Jan and Larsson, Jan and Eneroth, Magnus},
  issn         = {1742-4801},
  keyword      = {Diabetes,Healing,Heel ulcer,Outcome},
  language     = {eng},
  number       = {4},
  pages        = {629--635},
  publisher    = {Wiley-Blackwell},
  series       = {International Wound Journal},
  title        = {Heel ulcers do heal in patients with diabetes},
  url          = {http://dx.doi.org/10.1111/iwj.12654},
  volume       = {14},
  year         = {2017},
}