Percutaneous Flexor Tenotomy for Treatment of Neuropathic Toe Ulceration Secondary to Toe Contracture in Persons with Diabetes: A Systematic Review

Roukis, Thomas S.; Schade, Valerie L.

doi:10.1053/j.jfas.2009.06.004

Cited by 19 publications

(17 citation statements)

References 45 publications

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“…To prevent foot ulcers, various interventions have been studied and are used in clinical practice. The effectiveness of some of these interventions has been systematically reviewed, that is, on complex interventions , patient education , interventions studied in randomized controlled trials , population‐based screening , podiatry , therapeutic footwear , footwear and offloading interventions , insoles , flexor tenotomy and cost‐effectiveness of interventions . However, all these reviews have used different inclusion criteria for their study selection, non‐uniform patient populations and a variety of outcomes, which limits comparison.…”

Section: Introductionmentioning

confidence: 99%

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Netten

Raspovic

Lavery

et al. 2016

Diabetes Metabolism Res

282

226

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Background Prevention of foot ulcers in patients with diabetes is extremely important to help reduce the enormous burden of foot ulceration on both patient and health resources. A comprehensive analysis of reported interventions is not currently available, but is needed to better inform caregivers about effective prevention. The aim of this systematic review is to investigate the effectiveness of interventions to prevent first and recurrent foot ulcers in persons with diabetes who are at risk for ulceration.

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Section: Introductionmentioning

confidence: 99%

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Netten

Raspovic

Lavery

et al. 2016

Diabetes Metabolism Res

282

226

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“…However, limited patient information was provided in those studies, leaving relevant questions unanswered [4]. For example, the influence on healing and time to heal of preoperative treatment, ulcer duration before flexor tenotomy, ulcer location or infection at the moment of flexor tenotomy are all unknown.…”

Section: Introductionmentioning

confidence: 99%

The effect of flexor tenotomy on healing and prevention of neuropathic diabetic foot ulcers on the distal end of the toe

Netten

Bril

Baal

2013

Journal of Foot and Ankle Research

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BackgroundFlexor tenotomy is a minimally invasive surgical alternative for the treatment of neuropathic diabetic foot ulcers on the distal end of the toe. The influence of infection on healing and time to heal after flexor tenotomy is unknown. Flexor tenotomy can also be used as a prophylactic treatment. The effectiveness as a prophylactic treatment has not been described before.MethodsA retrospective study was performed with the inclusion of all consecutive flexor tenotomies from one hospital between January 2005 and December 2011.ResultsFrom 38 ulcers, 35 healed (92%), with a mean time to heal of 22 ± 26 days. The longest duration for healing was found for infected ulcers that were penetrating to bone (35 days; p = .042). Cases of prophylactic flexor tenotomies (n=9) did not result in any ulcer or other complications during follow-up.ConclusionsThe results of this study suggest that flexor tenotomy may be beneficial for neuropathic diabetic foot ulcers on the distal end of the toe, with a high healing percentage and a short mean time to heal. Infected ulcers that penetrated to bone took a significantly longer time to heal. Prospective research, to confirm the results of this retrospective study, should be performed.

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“…Three systematic reviews including four meta-analyses [24,35,57] and 10 systematic reviews without a meta-analysis [69,70,74,79,81,86,88,93,98,112] (Table 4 ; Additional files 4 and 6) examined healing improvements of diabetic foot/leg ulcers. Three had an AMSTAR score ≥8 [24,74,98].…”

Section: Resultsmentioning

confidence: 99%

Seeking effective interventions to treat complex wounds: an overview of systematic reviews

Tricco

Antony

Vafaei

et al. 2015

BMC Med

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BackgroundNumerous, often multi-faceted regimens are available for treating complex wounds, yet the evidence of these interventions is recondite across the literature. We aimed to identify effective interventions to treat complex wounds through an overview of systematic reviews.MethodsMEDLINE (OVID interface, 1946 until October 26, 2012), EMBASE (OVID interface, 1947 until October 26, 2012), and the Cochrane Database of Systematic Reviews (Issue 10 of 12, 2012) were searched on October 26, 2012. Systematic reviews that examined adults receiving care for their complex wounds were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool.ResultsOverall, 99 systematic reviews were included after screening 6,200 titles and abstracts and 422 full-texts; 54 were systematic reviews with a meta-analysis (including data on over 54,000 patients) and 45 were systematic reviews without a meta-analysis. Overall, 44% of included reviews were rated as being of high quality (AMSTAR score ≥8). Based on data from systematic reviews including a meta-analysis with an AMSTAR score ≥8, promising interventions for complex wounds were identified. These included bandages or stockings (multi-layer, high compression) and wound cleansing for venous leg ulcers; four-layer bandages for mixed arterial/venous leg ulcers; biologics, ultrasound, and hydrogel dressings for diabetic leg/foot ulcers; hydrocolloid dressings, electrotherapy, air-fluidized beds, and alternate foam mattresses for pressure ulcers; and silver dressings and ultrasound for unspecified mixed complex wounds. For surgical wound infections, topical negative pressure and vacuum-assisted closure were promising interventions, but this was based on evidence from moderate to low quality systematic reviews.ConclusionsNumerous interventions can be utilized for patients with varying types of complex wounds, yet few treatments were consistently effective across all outcomes throughout the literature. Clinicians and patients can use our results to tailor effective treatment according to type of complex wound. Network meta-analysis will be of benefit to decision-makers, as it will permit multiple treatment comparisons and ranking of the effectiveness of all interventions.Please see related article: http://dx.doi.org/10.1186/s12916-015-0326-3Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0288-5) contains supplementary material, which is available to authorized users.

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Percutaneous Flexor Tenotomy for Treatment of Neuropathic Toe Ulceration Secondary to Toe Contracture in Persons with Diabetes: A Systematic Review

Cited by 19 publications

References 45 publications

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review

The effect of flexor tenotomy on healing and prevention of neuropathic diabetic foot ulcers on the distal end of the toe

Seeking effective interventions to treat complex wounds: an overview of systematic reviews

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