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High probability of healing without amputation of plantar forefoot ulcers in patients with diabetes.

Örneholm, Hedvig LU ; Apelqvist, Jan LU ; Larsson, Jan and Eneroth, Magnus LU (2015) In Wound Repair and Regeneration 23(6). p.922-931
Abstract
Diabetic foot ulcer is an important entity which in many cases is the first serious complication in diabetes. Although a plantar forefoot location is common, there are few studies on larger cohorts and in such studies there is often a combination of various types of ulcer and ulcer locations. The purpose of this study is to discern the outcome of plantar forefoot ulcers and their specific characteristics in a large cohort. All patients (n=770), presenting with a plantar forefoot ulcer at a multidisciplinary diabetes foot clinic from January 1(st) 1983 to December 31(st) 2012 were considered for the study. 701 patients (median age 67 (22-95) fulfilled the inclusion criteria and were followed according to a pre-set protocol until final... (More)
Diabetic foot ulcer is an important entity which in many cases is the first serious complication in diabetes. Although a plantar forefoot location is common, there are few studies on larger cohorts and in such studies there is often a combination of various types of ulcer and ulcer locations. The purpose of this study is to discern the outcome of plantar forefoot ulcers and their specific characteristics in a large cohort. All patients (n=770), presenting with a plantar forefoot ulcer at a multidisciplinary diabetes foot clinic from January 1(st) 1983 to December 31(st) 2012 were considered for the study. 701 patients (median age 67 (22-95) fulfilled the inclusion criteria and were followed according to a pre-set protocol until final outcome (healing or death). Severe peripheral vascular disease (SPVD) was present in 26% of the patients and 14% had evidence of deep infection upon arrival at the foot clinic. Fifty-five per cent (385/701) of the patients healed without foot surgery, 25% (173/701) healed after major debridement, nine per cent (60/701) healed after minor or major amputation and 12% (83/701) died unhealed. Median healing time was 17 weeks. An ulcer classified as Wagner grade 1 or 2 at inclusion and independent living were factors associated with a higher healing rate. Seventy-nine per cent of 701 patients with diabetes and a plantar forefoot ulcer treated at a multidisciplinary diabetes foot clinic healed without amputation. For one third some form of foot surgery was needed to achieve healing. This article is protected by copyright. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Wound Repair and Regeneration
volume
23
issue
6
pages
922 - 931
publisher
Wiley-Blackwell
external identifiers
  • pmid:26084518
  • wos:000365725100015
  • scopus:84948402055
ISSN
1524-475X
DOI
10.1111/wrr.12328
language
English
LU publication?
yes
id
7491276e-62bc-4f8e-bc12-d2156cf89e9b (old id 7476354)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26084518?dopt=Abstract
date added to LUP
2015-07-11 09:22:17
date last changed
2017-08-06 03:10:03
@article{7491276e-62bc-4f8e-bc12-d2156cf89e9b,
  abstract     = {Diabetic foot ulcer is an important entity which in many cases is the first serious complication in diabetes. Although a plantar forefoot location is common, there are few studies on larger cohorts and in such studies there is often a combination of various types of ulcer and ulcer locations. The purpose of this study is to discern the outcome of plantar forefoot ulcers and their specific characteristics in a large cohort. All patients (n=770), presenting with a plantar forefoot ulcer at a multidisciplinary diabetes foot clinic from January 1(st) 1983 to December 31(st) 2012 were considered for the study. 701 patients (median age 67 (22-95) fulfilled the inclusion criteria and were followed according to a pre-set protocol until final outcome (healing or death). Severe peripheral vascular disease (SPVD) was present in 26% of the patients and 14% had evidence of deep infection upon arrival at the foot clinic. Fifty-five per cent (385/701) of the patients healed without foot surgery, 25% (173/701) healed after major debridement, nine per cent (60/701) healed after minor or major amputation and 12% (83/701) died unhealed. Median healing time was 17 weeks. An ulcer classified as Wagner grade 1 or 2 at inclusion and independent living were factors associated with a higher healing rate. Seventy-nine per cent of 701 patients with diabetes and a plantar forefoot ulcer treated at a multidisciplinary diabetes foot clinic healed without amputation. For one third some form of foot surgery was needed to achieve healing. This article is protected by copyright. All rights reserved.},
  author       = {Örneholm, Hedvig and Apelqvist, Jan and Larsson, Jan and Eneroth, Magnus},
  issn         = {1524-475X},
  language     = {eng},
  number       = {6},
  pages        = {922--931},
  publisher    = {Wiley-Blackwell},
  series       = {Wound Repair and Regeneration},
  title        = {High probability of healing without amputation of plantar forefoot ulcers in patients with diabetes.},
  url          = {http://dx.doi.org/10.1111/wrr.12328},
  volume       = {23},
  year         = {2015},
}