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A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease

Hinchliffe, R. J.; Andros, G.; Apelqvist, Jan LU ; Bakker, K.; Fiedrichs, S.; Lammer, J.; Lepantalo, M.; Mills, J. L.; Reekers, J. and Shearman, C. P., et al. (2012) In Diabetes/Metabolism Research Reviews 28(Suppl. 1). p.179-217
Abstract
In several large recent observational studies, peripheral arterial disease (PAD) was present in up to 50% of the patients with a diabetic foot ulcer and was an independent risk factor for amputation. The International Working Group on the Diabetic Foot therefore established a multidisciplinary working group to evaluate the effectiveness of revascularization of the ulcerated foot in patients with diabetes and PAD. A systematic search was performed for therapies to revascularize the ulcerated foot in patients with diabetes and PAD from 1980June 2010. Only clinically relevant outcomes were assessed. The research conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the Scottish Intercollegiate... (More)
In several large recent observational studies, peripheral arterial disease (PAD) was present in up to 50% of the patients with a diabetic foot ulcer and was an independent risk factor for amputation. The International Working Group on the Diabetic Foot therefore established a multidisciplinary working group to evaluate the effectiveness of revascularization of the ulcerated foot in patients with diabetes and PAD. A systematic search was performed for therapies to revascularize the ulcerated foot in patients with diabetes and PAD from 1980June 2010. Only clinically relevant outcomes were assessed. The research conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the Scottish Intercollegiate Guidelines Network methodological scores were assigned. A total of 49 papers were eligible for full text review. There were no randomized controlled trials, but there were three nonrandomized studies with a control group. The major outcomes following endovascular or open bypass surgery were broadly similar among the studies. Following open surgery, the 1-year limb salvage rates were a median of 85% (interquartile range of 8090%), and following endovascular revascularization, these rates were 78% (70.585.5%). At 1-year follow-up, 60% or more of ulcers had healed following revascularization with either open bypass surgery or endovascular revascularization. Studies appeared to demonstrate improved rates of limb salvage associated with revascularization compared with the results of medically treated patients in the literature. There were insufficient data to recommend one method of revascularization over another. There is a real need for standardized reporting of baseline demographic data, severity of disease and outcome reporting in this group of patients. Copyright (C) 2012 John Wiley & Sons, Ltd. (Less)
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publication status
published
subject
keywords
diabetic foot, ulcer, peripheral arterial disease, amputation, diabetes
in
Diabetes/Metabolism Research Reviews
volume
28
issue
Suppl. 1
pages
179 - 217
publisher
John Wiley & Sons
external identifiers
  • wos:000299377700027
  • scopus:84856138342
ISSN
1520-7552
DOI
10.1002/dmrr.2249
language
English
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yes
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fd94783a-002a-4b25-834a-235537693cf6 (old id 2348733)
date added to LUP
2012-03-01 11:23:12
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2017-10-22 03:00:57
@article{fd94783a-002a-4b25-834a-235537693cf6,
  abstract     = {In several large recent observational studies, peripheral arterial disease (PAD) was present in up to 50% of the patients with a diabetic foot ulcer and was an independent risk factor for amputation. The International Working Group on the Diabetic Foot therefore established a multidisciplinary working group to evaluate the effectiveness of revascularization of the ulcerated foot in patients with diabetes and PAD. A systematic search was performed for therapies to revascularize the ulcerated foot in patients with diabetes and PAD from 1980June 2010. Only clinically relevant outcomes were assessed. The research conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the Scottish Intercollegiate Guidelines Network methodological scores were assigned. A total of 49 papers were eligible for full text review. There were no randomized controlled trials, but there were three nonrandomized studies with a control group. The major outcomes following endovascular or open bypass surgery were broadly similar among the studies. Following open surgery, the 1-year limb salvage rates were a median of 85% (interquartile range of 8090%), and following endovascular revascularization, these rates were 78% (70.585.5%). At 1-year follow-up, 60% or more of ulcers had healed following revascularization with either open bypass surgery or endovascular revascularization. Studies appeared to demonstrate improved rates of limb salvage associated with revascularization compared with the results of medically treated patients in the literature. There were insufficient data to recommend one method of revascularization over another. There is a real need for standardized reporting of baseline demographic data, severity of disease and outcome reporting in this group of patients. Copyright (C) 2012 John Wiley & Sons, Ltd.},
  author       = {Hinchliffe, R. J. and Andros, G. and Apelqvist, Jan and Bakker, K. and Fiedrichs, S. and Lammer, J. and Lepantalo, M. and Mills, J. L. and Reekers, J. and Shearman, C. P. and Valk, G. and Zierler, R. E. and Schaper, N. C.},
  issn         = {1520-7552},
  keyword      = {diabetic foot,ulcer,peripheral arterial disease,amputation,diabetes},
  language     = {eng},
  number       = {Suppl. 1},
  pages        = {179--217},
  publisher    = {John Wiley & Sons},
  series       = {Diabetes/Metabolism Research Reviews},
  title        = {A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease},
  url          = {http://dx.doi.org/10.1002/dmrr.2249},
  volume       = {28},
  year         = {2012},
}