Ankle Brachial Index vs Transcutaneous Partial Pressure of Oxygen for Predicting Healing of Diabetic Foot Ulcers with Peripheral Arterial Disease: a Comparative Study

Thottiyen, Salahudheen; Kuruvilla, Rojan; George, Amal; Rajan, Prabha; Sajan, P; C, Subhash V; Varghese, Jenimol Chacko

doi:10.1007/s12262-020-02587-z

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…The factor that was most named in the clinical indicators was the reduced value of the ABI for DFU and CLTI, however, we did not reach a consensus on the reference value (ABI < 0.9, 20 <0.65 58 and <0.52 43 ). The Best Practice Recommendations for the Prevention and Management of Peripheral Arterial Ulcers consider abnormal values <0.9 or > 1.4 18 .…”

Section: Discussionmentioning

confidence: 74%

“… ABI < 0.9, 20 < 0.65 58 and < 0.52 43 TcPO2 < 28.5 mmHg 43 and < 27.5 mmHg 58 Monophasic Doppler waveform 20 Moderate or severe decrease in eGFR (mL/min per 1.73 m 2 ) 59 Proteinuria 40 Baseline HbA1c > 9.5% 60 and HbA1c ≥7% 40 NRL >4.2 44 MRSA initial wound culture 72 h of admission 25 Microbiota community‐type stability 50 Greater percent abundance of the Bacteroidales and Lactobacillales at baseline 61 High concentration of MMP‐9 (>0.38 pg/μg), high MMP‐9/TIMP‐1 ratio (>9.06), and low MMP‐1/TIMP‐1 ratio (<0.056) at baseline 62 A gradient of ≥1°C between average temperature of affected foot and that of unaffected foot at baseline or at any time healing 63 Low infrared perfusion index 43 Low grip strength assessment using an isometric hand dynamometer 48 …”

Section: Resultsmentioning

confidence: 98%

“…The mentioned factors were related to the characteristics of patients and ulcers, with less homogeneity in clinical indicators. Renal disease, 33,34,40,43,59 dialysis, 29‐32 peripheral arterial disease (PAD), 26,38,40 diabetes mellitus (DM), 20,31,35,36,43 age ≥65 years, 41,42,43 high‐stage WIfI classification, 29,34,35,36,37,39,48,51,52 high‐grade UT classification, 31,33,41,53 wound area, 20,26,27,38,39 wound location, 20,27,31 infection, 20,25,31,40,44,50,61 gangrene, 31,34,40 time from wound onset to first assessment, 39,40,52 existence of previous ulcers, 38,47,49 low ABI 20,34,43,58 and low albumin level <3 g/dL 31,35,37 were the factors cited three or more times by the studies. These factors justify the analysis of a systematic review with meta‐analysis to obtain the highest level of evidence.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic factors for delayed healing of complex wounds in adults: A scoping review

Silva

Lopes

Ramos

et al. 2023

International Wound Journal

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Complex or hard‐to‐heal wounds continue to be a challenge because of the negative impact they have on patients, caregivers, and all the associated costs. This study aimed to identify prognostic factors for the delayed healing of complex wounds. Five databases and grey literature were the sources used to research adults with pressure ulcers/injuries, venous leg ulcers, critical limb‐threatening ischaemia, or diabetic foot ulcers and report the prognostic factors for delayed healing in all care settings. In the last 5 years, a total of 42 original peer‐reviewed articles were deemed eligible for this scoping review that followed the JBI recommendations and checklist PRISMA‐ScR. The most frequent prognostic factors found with statistical significance coinciding with various wound aetiologies were: gender (male), renal disease, diabetes, peripheral arterial disease, the decline in activities of daily life, wound duration, wound area, wound location, high‐stage WIfI classification, gangrene, infection, previous ulcers, and low ankle brachial index. It will be essential to apply critical appraisal tools and assessment risk of bias to the included studies, making it possible to make recommendations for clinical practice and build prognostic models. Future studies are recommended because the potential for healing through identification of prognostic factors can be determined, thus allowing an appropriate therapeutic plan to be developed.

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Section: Discussionmentioning

confidence: 74%

Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic factors for delayed healing of complex wounds in adults: A scoping review

Silva

Lopes

Ramos

et al. 2023

International Wound Journal

View full text Add to dashboard Cite

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Early identification of delayed wound healing in complex diabetic foot ulcers treated with a dermal regeneration template: a novel clinical target and its risk factors

Tai,

Lin,

Chang

et al. 2023

International Journal of Surgery

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Background: The dermal regeneration template (DRT), a tissue-engineered skin substitute composing a permanent dermal matrix and an upper temporary silicone layer that serves as the epidermis, has demonstrated efficacy in treating uncomplicated diabetic foot ulcers (DFUs). Our institution has obtained good outcomes with DRT in patients with more complicated DFUs. Because of its chronicity, we are working to identify a clinical target that anticipates delayed healing early in the treatment in addition to determining the risk factors linked to this endpoint to increase prevention. Materials and methods: This retrospective single-center study analyzed patients with DFUs who underwent wound reconstruction using DRT between 2016 and 2021. The patients were categorized into poor or good graft-take groups based on their DRT status on the 21st day after the application. Their relationship with complete healing rate at day 180 was analyzed. Variables were collected for risk factors for poor graft take at day 21. Independent risk factors were identified after multivariable analysis. The causes of poor graft take were also reported. Results: This study examined 80 patients (38 and 42 patients in the poor and good graft-take groups, respectively). On day 180, the complete healing rate was 86.3% overall, but the poor graft-take group had a significantly lower complete healing rate (76.3% vs. 95.2%, P = 0.021) than the good graft-take group. Our analysis identified four independent risk factors: transcutaneous oxygen pressure < 30 mmHg (odds ratio, 154.14), off-loading device usage (0.03), diabetic neuropathy (6.51), and toe wound (0.20). The most frequent cause of poor graft take was infection (44.7%), followed by vascular compromise (21.1%) and hematoma (15.8%). Conclusion: Our study introduces the novel concept of poor graft take at day 21 associated with delayed wound healing. Four independent risk factors were identified, which allows physicians to arrange interventions to mitigate their effects or select patients more precisely. DRT represents a viable alternative to address DFUs, even in complicated wounds. A subsequent split-thickness skin graft is not always necessary to achieve complete healing.

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Ankle Brachial Index vs Transcutaneous Partial Pressure of Oxygen for Predicting Healing of Diabetic Foot Ulcers with Peripheral Arterial Disease: a Comparative Study

Cited by 2 publications

References 19 publications

Prognostic factors for delayed healing of complex wounds in adults: A scoping review

Prognostic factors for delayed healing of complex wounds in adults: A scoping review

Early identification of delayed wound healing in complex diabetic foot ulcers treated with a dermal regeneration template: a novel clinical target and its risk factors

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