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Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review.

Game, F L; Apelqvist, Jan LU ; Attinger, C; Hartemann, A; Hinchliffe, R J; Löndahl, M; Price, P E and Jeffcoate, W J (2015) In Diabetes/Metabolism Research Reviews
Abstract
The outcome of management of diabetic foot ulcers remains a challenge and there remains continuing uncertainty concerning optimal approaches to management. It is for these reasons that in 2008 and 2012 the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing published systematic reviews of the evidence to inform protocols for routine care and to highlight areas which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between June 2010 and June 2014. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate... (More)
The outcome of management of diabetic foot ulcers remains a challenge and there remains continuing uncertainty concerning optimal approaches to management. It is for these reasons that in 2008 and 2012 the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing published systematic reviews of the evidence to inform protocols for routine care and to highlight areas which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between June 2010 and June 2014. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network criteria. Selected studies fell into the following ten categories: sharp debridement and wound bed preparation with larvae or hydrotherapy; wound bed preparation using antiseptics, applications and dressing products; resection of the chronic wound; oxygen and other gases, compression or negative pressure therapy; products designed to correct aspects of wound biochemistry and cell biology associated with impaired wound healing; application of cells, including platelets and stem cells; bioengineered skin and skin grafts; electrical, electromagnetic, lasers, shockwaves and ultrasound and other systemic therapies which did not fit in the above categories. Heterogeneity of studies prevented pooled analysis of results. Of the 2161 papers identified, 30 were selected for grading following full text review. The present report is an update of the earlier IWGDF systematic reviews and the conclusion is similar: that with the possible, exception of negative pressure wound therapy in post operative wounds, there is little published evidence to justify the use of newer therapies. Analysis of the evidence continues to present difficulties in this field as controlled studies remain few and the majority continue to be of poor methodological quality. This article is protected by copyright. All rights reserved. (Less)
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author
organization
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Contribution to journal
publication status
published
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in
Diabetes/Metabolism Research Reviews
publisher
John Wiley & Sons
external identifiers
  • pmid:26344936
  • scopus:84956838166
  • wos:000369134100015
ISSN
1520-7552
DOI
10.1002/dmrr.2707
language
English
LU publication?
yes
id
4560dab2-6bb7-4199-969c-75371bd4180f (old id 8042965)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26344936?dopt=Abstract
date added to LUP
2015-10-04 16:49:55
date last changed
2017-11-12 04:08:43
@article{4560dab2-6bb7-4199-969c-75371bd4180f,
  abstract     = {The outcome of management of diabetic foot ulcers remains a challenge and there remains continuing uncertainty concerning optimal approaches to management. It is for these reasons that in 2008 and 2012 the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing published systematic reviews of the evidence to inform protocols for routine care and to highlight areas which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between June 2010 and June 2014. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network criteria. Selected studies fell into the following ten categories: sharp debridement and wound bed preparation with larvae or hydrotherapy; wound bed preparation using antiseptics, applications and dressing products; resection of the chronic wound; oxygen and other gases, compression or negative pressure therapy; products designed to correct aspects of wound biochemistry and cell biology associated with impaired wound healing; application of cells, including platelets and stem cells; bioengineered skin and skin grafts; electrical, electromagnetic, lasers, shockwaves and ultrasound and other systemic therapies which did not fit in the above categories. Heterogeneity of studies prevented pooled analysis of results. Of the 2161 papers identified, 30 were selected for grading following full text review. The present report is an update of the earlier IWGDF systematic reviews and the conclusion is similar: that with the possible, exception of negative pressure wound therapy in post operative wounds, there is little published evidence to justify the use of newer therapies. Analysis of the evidence continues to present difficulties in this field as controlled studies remain few and the majority continue to be of poor methodological quality. This article is protected by copyright. All rights reserved.},
  author       = {Game, F L and Apelqvist, Jan and Attinger, C and Hartemann, A and Hinchliffe, R J and Löndahl, M and Price, P E and Jeffcoate, W J},
  issn         = {1520-7552},
  language     = {eng},
  month        = {09},
  publisher    = {John Wiley & Sons},
  series       = {Diabetes/Metabolism Research Reviews},
  title        = {Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review.},
  url          = {http://dx.doi.org/10.1002/dmrr.2707},
  year         = {2015},
}