Reduction in Foot Ulcer Incidence

Calle-Pascual, Alfonso; Durán, Alejandra; Benedi, Angeles; Calvo, María Isabel; Charro, Aniceto; Díaz, José; Calle, José Ramón Caballero de la; Gil, Esther; Ibarra, J.I. Sáez de; Marañes, Juan P.; Cabezas-Cerrato, J

doi:10.2337/diacare.24.2.405

Cited by 38 publications

(35 citation statements)

References 8 publications

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“…Programs of preventive care in the form of screening for high-risk patients and then enrollment in a foot protection program achieved a reduction in foot ulcer incidence and amputations. 80,81 The community-based Integrated Diabetic Foot Care Project in Exeter, UK, demonstrated that patients' knowledge of and attitudes towards their foot care as well as the knowledge and behavior of health professionals can be measurably enhanced, relatively inexpensively, in a fairly short time. 82,83 Initiatives to support the team approach.…”

Section: Team Approach In Europe (1980-2010)mentioning

confidence: 99%

History of the team approach to amputation prevention: Pioneers and milestones

Sanders

Robbins

Edmonds

2010

Journal of Vascular Surgery

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Section: Team Approach In Europe (1980-2010)mentioning

confidence: 99%

History of the team approach to amputation prevention: Pioneers and milestones

Sanders

Robbins

Edmonds

2010

Journal of Vascular Surgery

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“…Studies are urgently needed to better define the categories of patients that will benefit from preventative interventions and what specific types of interventions should be included. Costs and cost‐effectiveness have not been investigated for any of the interventions described in this guidance, and more attention to cost aspects is warranted. The vast majority of studies underlying this guidance are single intervention studies, yet preventative foot care for at‐risk patients with diabetes nearly always consists of an integrated care approach. While studies on integrated foot care show some evidence of effectiveness in preventing a recurrent ulcer, unfortunately, the exact content of this integrated strategy is frequently poorly described, hampering generalizability to other settings. Adherence to an intervention has been shown to be crucial in preventing foot ulcers . It is consistently reported that patients who do not adhere present with higher rates of ulceration.…”

Section: Key Controversiesmentioning

confidence: 99%

IWGDF guidance on the prevention of foot ulcers in at‐risk patients with diabetes

Bus

Netten

Lavery

et al. 2016

Diabetes Metabolism Res

291

345

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Recommendations1. To identify a person with diabetes at risk for foot ulceration, examine the feet annually to seek evidence for signs or symptoms of peripheral neuropathy and peripheral artery disease. (GRADE strength of recommendation: strong; Quality of evidence: low) 2. In a person with diabetes who has peripheral neuropathy, screen for a history of foot ulceration or lower-extremity amputation, peripheral artery disease, foot deformity, pre-ulcerative signs on the foot, poor foot hygiene and ill-fitting or inadequate footwear. (Strong; Low) 3. Treat any pre-ulcerative sign on the foot of a patient with diabetes. This includes removing callus, protecting blisters and draining when necessary, treating ingrown or thickened toe nails, treating haemorrhage when necessary and prescribing antifungal treatment for fungal infections. (Strong; Low) 4. To protect their feet, instruct an at-risk patient with diabetes not to walk barefoot, in socks only, or in thin-soled standard slippers, whether at home or when outside. (Strong; Low) 5. Instruct an at-risk patient with diabetes to daily inspect their feet and the inside of their shoes, daily wash their feet (with careful drying particularly between the toes), avoid using chemical agents or plasters to remove callus or corns, use emollients to lubricate dry skin and cut toe nails straight across. (Weak; Low) 6. Instruct an at-risk patient with diabetes to wear properly fitting footwear to prevent a first foot ulcer, either plantar or non-plantar, or a recurrent non-plantar foot ulcer. When a foot deformity or a pre-ulcerative sign is present, consider prescribing therapeutic shoes, custom-made insoles or toe orthosis. (Strong; Low) 7. To prevent a recurrent plantar foot ulcer in an at-risk patient with diabetes, prescribe therapeutic footwear that has a demonstrated plantar pressure-relieving effect during walking (i.e. 30% relief compared with plantar pressure in standard of care therapeutic footwear) and encourage the patient to wear this footwear. (Strong; Moderate) 8. To prevent a first foot ulcer in an at-risk patient with diabetes, provide education aimed at improving foot care knowledge and behaviour, as well as encouraging the patient to adhere to this foot care advice. (Weak; Low) 9. To prevent a recurrent foot ulcer in an at-risk patient with diabetes, provide integrated foot care, which includes professional foot treatment, adequate footwear and education. This should be repeated or re-evaluated once every 1 to 3 months as necessary. (Strong; Low)

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“…Foot ulceration affects 15% of patients with DM at some point in their lives 1 . Ulcerative foot lesions lead to amputations and represent a substantial proportion of healthcare expenditure for treating patients with DM [2][3][4][5] . Early identification of risk factors for ulceration is necessary to prevent injuries to the feet of these subjects.…”

Section: Introductionmentioning

confidence: 99%

Confiabilidade intra e interexaminador da análise por padrões de impressão de plantigrafias de pessoas diabéticas obtidas com o Harris Mat

Cisneros¹,

Fonseca²,

Abreu³

2010

Rev. bras. fisioter.

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Introduction: High plantar pressure is a proven risk factor for ulceration among individuals with diabetes mellitus. The Harris and Beath footprinting mat is one of the tools used in screening for foot ulceration risk among these subjects. There are no reports in the literature on the reliability of footprint analysis using print pattern criteria. Objective: The aim of this study was to evaluate the inter-and intra-examiner reliability of the analysis of footprint patterns obtained using the Harris and Beath footprinting mat. Methods: Footprints were taken from 41 subjects using the footprinting mat. The images were subjected to analysis by three independent examiners. To investigate the intra-examiner reliability, the analysis was repeated by one of the examiners one week later. Results: The weighted kappa coefficient was excellent (K w >0.80) for the inter-and intra-examiner analyses for most of the points studied on both feet. Conclusions:The criteria for analyzing footprint patterns obtained using the Harris and Beath footprinting mat presented good reliability and high to excellent inter-and intra-examiner agreement. This method is reliable for analyses involving one or more examiners.Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number ACTRN12609000693224.Key words: plantar pressure; footprint; reliability; diabetic foot. ResumoIntrodução: A hiperpressão plantar é um fator de risco comprovado para a ulceração em portadores de diabetes mellitus. O "Harris Palavras-chave: pressões plantares; impressão plantar; confiabilidade; pé diabético.

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Reduction in Foot Ulcer Incidence

Cited by 38 publications

References 8 publications

History of the team approach to amputation prevention: Pioneers and milestones

History of the team approach to amputation prevention: Pioneers and milestones

IWGDF guidance on the prevention of foot ulcers in at‐risk patients with diabetes

Confiabilidade intra e interexaminador da análise por padrões de impressão de plantigrafias de pessoas diabéticas obtidas com o Harris Mat

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