Diabetic foot ulcer, the effect of resource‐poor environments on healing time and direct cost: A cohort study during Syrian crisis

Alsabek, Mhd Belal; Aziz, Ayesha

doi:10.1111/iwj.13651

Cited by 13 publications

(15 citation statements)

References 13 publications

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“…This study included both male and female patients, with a male-to-female ratio of around 3:1. Other studies have also observed that men were at a higher risk of developing foot ulceration in comparison to females [ 11 , 12 ]. The mean age at presentation in our study population was 51 years and majority of patients fell in the age group of 50-59 years.…”

Section: Discussionmentioning

confidence: 95%

Effectiveness of Topical Sucralfate in the Management of Diabetic Foot Ulcers: An Open-Labeled Randomized Study

Chatterjee¹,

Ekka²,

Mahajan³

et al. 2023

Cureus

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Introduction: Diabetic foot ulcer (DFU) is a major cause of lower limb amputations. Many treatment recommendations have been proposed. This study was conducted to evaluate the effectiveness of topical sucralfate when combined with mupirocin ointment, in the treatment of diabetic foot ulcer in comparison to topical mupirocin alone, in terms of healing rates.Methods: This open-labeled randomized study was conducted on 108 patients to evaluate the effectiveness of topical sucralfate and mupirocin combination, compared to topical mupirocin alone. The patients were administered the same parenteral antibiotic, and wounds were subjected to daily dressing. The healing rates (determined by the percentage reduction in wound area) in the two groups were calculated. The mean healing rates in both groups were expressed in percentage and compared using the Student's t-test.Results: A total of 108 patients were included in the study. Male-to-female ratio was 3:1. The incidence of diabetic foot was the highest (50.9%) in the age group of 50-59 years. The mean age of the study population was 51 years. The incidence of diabetic foot ulcers was highest in the months of July-August (42%). A total of 71.2% patients had random blood sugar levels between 150-200 mg/dL, and 72.2% patients had diabetes for five to 10 years. The mean±standard deviation (SD) of the healing rates in the sucralfate and mupirocin combination group and the control group were 16.2±7.3% and 14.5±6.6%, respectively. Comparison of the means by Student's t-test failed to show a statistical difference in healing rates between the two groups (p=0.201). Conclusion:We concluded that the addition of topical sucralfate does not show any obvious benefits in terms of healing rates in diabetic foot ulcers as compared to mupirocin alone.

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Section: Discussionmentioning

confidence: 95%

Effectiveness of Topical Sucralfate in the Management of Diabetic Foot Ulcers: An Open-Labeled Randomized Study

Chatterjee¹,

Ekka²,

Mahajan³

et al. 2023

Cureus

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“…15 A SINBAD score <3 is associated with a healing rate of 60% at 12 weeks compared with 35% if the score is > 3, and a risk of MajA at 6 months of 2.7% versus 0.7%. 23 A 2021 study 27 28 Two recent studies found that a high SINBAD score was associated with the presence of DFU infection with extended-spectrum beta-lactamase (ESBL)-producing bacteria 29 or Meti-R Staph aureus. 30 In 2019, the IWGDF issued a strong recommendation to use the SINBAD system for communications among health professionals on the characteristics of a foot ulcer in a person with diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, Alasabeck et al. showed a median healing time of 14 weeks in patients with a SINBAD score ≥3 and 4 weeks in patients with a SINBAD score ≤ 2 28 …”

Section: Discussionmentioning

confidence: 99%

Use of the SINBAD score as a predicting tool for major adverse foot events in patients with diabetic foot ulcer: A French multicentre study

Van

Schuldiner

Sultan

et al. 2023

Diabetes Metabolism Res

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ObjectiveTo assess the relationship between the site, ischaemia, neuropathy, bacterial infection, area, depth (SINBAD) score and major adverse foot events in patients with diabetes and foot ulcers.MethodsFor this retrospective ancillary study, patients (n = 537) followed for a diabetic foot ulcer (DFU) in six French hospitals were included between 1 February 2019 and 17 March 2019, and between 1 February 2020 and 17 March 2020. The SINBAD score was assessed at inclusion. The frequency of a composite outcome consisting of eight major adverse foot events (MAFE) was assessed after 5–6 months of follow‐up: hospitalisation for DFU, septic surgery, revascularisation, minor amputation, major amputation, death, secondary infection and ulcer recurrence. A logistical regression explored the link between the SINBAD score and MAFE and each of its component.ResultsA low SINBAD score (from 0 to 3) was observed in 61% of patients and a high (from 4 to 6) in 39%. MAFE occurred in, respectively, 24% and 28% of these patients. Multivariate analyses showed a significant relationship between the SINBAD score and MAFE, with the continuous SINBAD score: odds ratio (OR) 1.72 [95% CI (1.51–1.97)] or dichotomic SINBAD score (values: 0–3 and 4–6): OR 3.71 [95% CI (2.54–5.42)]. The SINBAD score (continuous or dichotomic) at inclusion was also significantly associated with six out of the eight components of the MAFE.ConclusionsThe SINBAD score is a useful tool for predicting major adverse foot events.

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“…This is supported by several studies that suggest the ability of a classification system (eg, SINBAD) to predict future performance outcomes is dependent on external factors and internal validity 41–43 . Alsabek and Abdul Aziz 44 expanded on this to suggest that resource-poor environments can delay access to immediate DFU assessment and classification, therefore increasing the likelihood of lower-limb amputation.…”

Section: Validitymentioning

confidence: 91%

The Validity and Reliability of the SINBAD Classification System for Diabetic Foot Ulcers

Brocklehurst

2023

Adv Skin Wound Care

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Diabetic foot ulcers (DFUs) are a serious and costly complication of diabetes mellitus with a global prevalence of 6.3% and cost of £8,800 per unhealed DFU in the National Health Service. The three main types of DFU are neuropathic, ischemic, and neuroischemic, with an estimated prevalence of 35%, 15%, and 50%, respectively. Because 85% of lower-limb amputations in patients with diabetes are preceded by a DFU, the task of reducing the current and future burden of DFUs on an international level is of crucial importance. Classification of a DFU is an important and complex process with many independent variables that influence the wound severity. Correct classification of a DFU is important to prevent deterioration in the short term and lower-limb amputation in the long term. Both the accuracy of the clinician’s interpretation of categorical data from a classification model and grasp of contextual risk factors can refine diagnoses. The term SINBAD is an acronym for six independent variables: site, ischemia, neuropathy, bacterial infection, area, and depth. This system uses comprehensive parameters with strict criteria to facilitate quick and accurate clinical decisions to prevent lower-limb amputation. In addition to providing quantitative measurement, SINBAD also spotlights the multifaceted characteristics of DFUs. By evaluating the validity and reliability of the SINBAD classification system, its applicability for the assessment of DFUs and prevention of lower-limb amputation can be better understood.

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Diabetic foot ulcer, the effect of resource‐poor environments on healing time and direct cost: A cohort study during Syrian crisis

Cited by 13 publications

References 13 publications

Effectiveness of Topical Sucralfate in the Management of Diabetic Foot Ulcers: An Open-Labeled Randomized Study

Effectiveness of Topical Sucralfate in the Management of Diabetic Foot Ulcers: An Open-Labeled Randomized Study

Use of the SINBAD score as a predicting tool for major adverse foot events in patients with diabetic foot ulcer: A French multicentre study

The Validity and Reliability of the SINBAD Classification System for Diabetic Foot Ulcers

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