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

J. J. van Netten, P. E. Price, L. A. Lavery, M. Monteiro-Soares, A. Rasmussen, Y. Jubiz, S. A. Bus, Tricia Price

Diabetes/Metabolism Research and Reviews, Volume: 32, Pages: 84 - 98

Swansea University Author: Tricia Price

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DOI (Published version): 10.1002/dmrr.2701

Abstract

BackgroundPrevention 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 ab...

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Published in: Diabetes/Metabolism Research and Reviews
ISSN: 15207552
Published: 2016
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URI: https://cronfa.swan.ac.uk/Record/cronfa48709
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spelling v2 48709 2019-02-05 Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review 72b4943af96c97ef72977c31b9c29624 Tricia Price Tricia Price true false 2019-02-05 FGMHL BackgroundPrevention 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.MethodsThe available medical scientific literature in PubMed, EMBASE, CINAHL and the Cochrane database was searched for original research studies on preventative interventions. Both controlled and non‐controlled studies were selected. Data from controlled studies were assessed for methodological quality by two independent reviewers.ResultsFrom the identified records, a total of 30 controlled studies (of which 19 RCTs) and another 44 non‐controlled studies were assessed and described. Few controlled studies, of generally low to moderate quality, were identified on the prevention of a first foot ulcer. For the prevention of recurrent plantar foot ulcers, multiple RCTs with low risk of bias show the benefit for the use of daily foot skin temperature measurements and consequent preventative actions, as well as for therapeutic footwear that demonstrates to relieve plantar pressure and that is worn by the patient. To prevent recurrence, some evidence exists for integrated foot care when it includes a combination of professional foot treatment, therapeutic footwear and patient education; for just a single session of patient education, no evidence exists. Surgical interventions can be effective in selected patients, but the evidence base is small.ConclusionThe evidence base to support the use of specific self‐management and footwear interventions for the prevention of recurrent plantar foot ulcers is quite strong, but is small for the use of other, sometimes widely applied, interventions and is practically nonexistent for the prevention of a first foot ulcer and non‐plantar foot ulcer. Journal Article Diabetes/Metabolism Research and Reviews 32 84 98 15207552 26 1 2016 2016-01-26 10.1002/dmrr.2701 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2023-06-28T15:28:26.0748542 2019-02-05T16:26:31.9183757 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine J. J. van Netten 1 P. E. Price 2 L. A. Lavery 3 M. Monteiro-Soares 4 A. Rasmussen 5 Y. Jubiz 6 S. A. Bus 7 Tricia Price 8
title Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review
spellingShingle Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review
Tricia Price
title_short Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review
title_full Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review
title_fullStr Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review
title_full_unstemmed Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review
title_sort Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review
author_id_str_mv 72b4943af96c97ef72977c31b9c29624
author_id_fullname_str_mv 72b4943af96c97ef72977c31b9c29624_***_Tricia Price
author Tricia Price
author2 J. J. van Netten
P. E. Price
L. A. Lavery
M. Monteiro-Soares
A. Rasmussen
Y. Jubiz
S. A. Bus
Tricia Price
format Journal article
container_title Diabetes/Metabolism Research and Reviews
container_volume 32
container_start_page 84
publishDate 2016
institution Swansea University
issn 15207552
doi_str_mv 10.1002/dmrr.2701
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
active_str 0
description BackgroundPrevention 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.MethodsThe available medical scientific literature in PubMed, EMBASE, CINAHL and the Cochrane database was searched for original research studies on preventative interventions. Both controlled and non‐controlled studies were selected. Data from controlled studies were assessed for methodological quality by two independent reviewers.ResultsFrom the identified records, a total of 30 controlled studies (of which 19 RCTs) and another 44 non‐controlled studies were assessed and described. Few controlled studies, of generally low to moderate quality, were identified on the prevention of a first foot ulcer. For the prevention of recurrent plantar foot ulcers, multiple RCTs with low risk of bias show the benefit for the use of daily foot skin temperature measurements and consequent preventative actions, as well as for therapeutic footwear that demonstrates to relieve plantar pressure and that is worn by the patient. To prevent recurrence, some evidence exists for integrated foot care when it includes a combination of professional foot treatment, therapeutic footwear and patient education; for just a single session of patient education, no evidence exists. Surgical interventions can be effective in selected patients, but the evidence base is small.ConclusionThe evidence base to support the use of specific self‐management and footwear interventions for the prevention of recurrent plantar foot ulcers is quite strong, but is small for the use of other, sometimes widely applied, interventions and is practically nonexistent for the prevention of a first foot ulcer and non‐plantar foot ulcer.
published_date 2016-01-26T15:28:22Z
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score 11.036334

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