The management of neuropathic ulcers of the foot in diabetes by shock wave therapy

Moretti, Biagio

doi:10.1186/isrctn21800909

Cited by 21 publications

(96 citation statements)

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“…Gender distribution was not reported in two studies (32,34). However, the majority of the participants in the remaining nine studies were male (58%) (26)(27)(28)(29)(30)(31)(35)(36)(37).…”

Section: Search Resultsmentioning

confidence: 97%

“…Overall, five studies were conducted in Europe (30,31,(35)(36)(37), five studies in Asia (26)(27)(28)32,34) and one study in Africa (29). These studies included seven RCTs (27)(28)(29)(30)32,34,35), one clinical controlled trial (CCT) (36) and three case series studies (CSS) (26,31,37). The studies were critically evaluated.…”

Section: Search Resultsmentioning

confidence: 99%

“…The studies were critically evaluated. Eight studies were categorised as level II (27)(28)(29)(30)32,(34)(35)(36), two studies as level III (31,37) and one study as level V (26). Table 2 summarises the participant characteristics and initial wound parameters.…”

Section: Search Resultsmentioning

confidence: 99%

“…ESWT is considered feasible for healing of the chronic wound in humans (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). However, the findings of studies conducted so far are still inconclusive, and the clinical use for wound healing is under investigation.…”

Section: Key Messagesmentioning

confidence: 99%

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Extracorporeal shockwave therapy for the treatment of chronic wound of lower extremity: current perspective and systematic review

Omar

Gwada

Shaheen

et al. 2017

International Wound Journal

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The purpose of this study was to provide an up-to-date review for the accurate estimation of the efficacy of extracorporeal shock wave therapy (ESWT) on the healing of chronic wounds on the lower extremity (CWLE). A systematic review of 10 databases for clinical trials about ESWT in the management of CWLE published between 2000 and 2016 was performed. A total of 11 studies with 925 patients were found. Expert therapists assessed the methodological qualities of the selected studies using the Physiotherapy Evidence Database (PEDro) scale and categorised each study according to Sackett's levels of evidence. Eight studies were categorised as level II; two studies were categorised as level III and one study was categorised as level V. In conclusion, this review demonstrated mild to moderate evidence to support the use of ESWT as an adjuvant therapy with a standardised wound care programme. However, it is difficult to draw firm conclusions about the efficacy of ESWT. So, future researches with high methodological quality are required to assess the efficacy and cost-effectiveness of this relatively new physical therapy application.

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“…Gender distribution was not reported in two studies (32,34). However, the majority of the participants in the remaining nine studies were male (58%) (26)(27)(28)(29)(30)(31)(35)(36)(37).…”

Section: Search Resultsmentioning

confidence: 97%

Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

Section: Key Messagesmentioning

confidence: 99%

See 2 more Smart Citations

Extracorporeal shockwave therapy for the treatment of chronic wound of lower extremity: current perspective and systematic review

Omar

Gwada

Shaheen

et al. 2017

International Wound Journal

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“…For completeness, studies that were previously reported in the 2016 systematic review that are not discussed in the present document have been included in the supplementary tables. [204][205][206][207][208][209][210][211][212][213][214][215][216][217][218] We would like to thank the following external experts for their These sponsors did not have any communication related to the systematic reviews of the literature or related to the guidelines with working group members during the writing of the guidelines and have not seen any guideline or guideline-related document before publication.…”

Section: Acknowledgementsmentioning

confidence: 99%

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

Vas

Rayman

Dhatariya

et al. 2020

Diabetes Metabolism Res

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The management of diabetic foot ulcers (DFU) remains a challenge, and there is continuing uncertainty concerning optimal approaches to wound healing. The International Working Group of the Diabetic Foot (IWGDF) working group on wound healing has previously published systematic reviews of the evidence in 2008, 2012 and 2016 to inform protocols for routine care and to highlight areas which should be considered for further study. The working group has now updated this review by considering papers on the interventions to improve the healing of DFU's published between June 2014 and August 2018. Methodological quality of selected studies was independently assessed by a minimum of two reviewers using the recently published 21‐point questionnaire as recommended by IWGDF/European Wound Management Association, as well as the previously incorporated Scottish Intercollegiate Guidelines Network criteria. Of the 2275 papers identified, 97 were finally selected for grading following full text review. Overall, there has been an improvement in study design and a significant rise in the number of published studies. While previous systematic reviews did not find any evidence to justify the use of newer therapies, except for negative pressure wound therapy in post‐surgical wounds, in this review we found additional evidence to support some interventions including a sucrose‐octasulfate dressing, the combined leucocyte, fibrin and platelet patch as well as topical application of some placental membrane products, all when used in addition to usual best care. Nonetheless, the assessment and comparison of published trials remains difficult with marked clinical heterogeneity between studies: in patient selection, study duration, standard of usual care provision and the timing and description of the clinical endpoints.

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Present and new techniques and devices in the treatment of DFU: a critical review of evidence

Gottrup

Apelqvist

2012

Diabetes Metabolism Res

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SummaryManagement of foot ulcer in individuals with diabetes remains a major therapeutic challenge throughout the world. We performed a critical review of evidence of present and new techniques and devices in the treatment of diabetic foot ulcer. The golden standard for optimal evidence in the Cochrane system is level I -randomized controlled trials, and meta-analyses of several randomized controlled trials. Available evidence on different types of wound debridement; use of antimicrobials; use of dressings in wounds; topical negative pressure, hyperbaric oxygen treatment; electrical, electromagnetic, laser, shockwave, and ultrasound therapies; growth and cell biology factors; cell products and tissue engineering; bioengineered skin and skin grafts; and adjuvant therapies were evaluated. The results of this review show that there is limited evidence on the highest level to justify a change in routine clinical practice. There is a paucity of high-quality evidence, because the studies are often based on inadequate sample size, short follow-up, nonrandom allocation to treatment arms, nonblinded assessment of outcomes, poor description of control, and concurrent intervention. The heterogeneity of the population (of both people and ulcers), with multiple factors contributing to both ulcer onset and failure to heal, makes the trial design difficult in this field. Another fundamental reason for the lack of evidence is the general use of the outcome measure 'complete healing'. In conclusion, when the results of this updated review are taken together with those of the earlier reports, they provide limited evidence to justify a change in routine clinical practice. For this reason, there is an urgent need to increase the quality of clinical studies. A re-evaluation of which type of research is acceptable for producing evidence in the wound area may be important in the future.

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The management of neuropathic ulcers of the foot in diabetes by shock wave therapy

Cited by 21 publications

References 0 publications

Extracorporeal shockwave therapy for the treatment of chronic wound of lower extremity: current perspective and systematic review

Extracorporeal shockwave therapy for the treatment of chronic wound of lower extremity: current perspective and systematic review

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

Present and new techniques and devices in the treatment of DFU: a critical review of evidence

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