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

F. L. Game, J. Apelqvist, C. Attinger, A. Hartemann, R. J. Hinchliffe, M. Löndahl, P. E. Price, W. J. Jeffcoate, Tricia Price

Diabetes/Metabolism Research and Reviews, Volume: 32, Pages: 154 - 168

Swansea University Author: Tricia Price

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DOI (Published version): 10.1002/dmrr.2707

Abstract

The outcome of management of diabetic foot ulcers remains a challenge, and there remains continuing uncertainty concerning optimal approaches to management. It is for these reasons that in 2008 and 2012, the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing publ...

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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/cronfa50577
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first_indexed 2019-06-05T11:07:52Z
last_indexed 2020-09-29T03:10:42Z
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spelling v2 50577 2019-05-30 Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review 72b4943af96c97ef72977c31b9c29624 Tricia Price Tricia Price true false 2019-05-30 FGMHL The outcome of management of diabetic foot ulcers remains a challenge, and there remains continuing uncertainty concerning optimal approaches to management. It is for these reasons that in 2008 and 2012, the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing published systematic reviews of the evidence to inform protocols for routine care and to highlight areas, which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between June 2010 and June 2014. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network criteria. Selected studies fell into the following ten categories: sharp debridement and wound bed preparation with larvae or hydrotherapy; wound bed preparation using antiseptics, applications and dressing products; resection of the chronic wound; oxygen and other gases, compression or negative pressure therapy; products designed to correct aspects of wound biochemistry and cell biology associated with impaired wound healing; application of cells, including platelets and stem cells; bioengineered skin and skin grafts; electrical, electromagnetic, lasers, shockwaves and ultrasound and other systemic therapies, which did not fit in the aforementioned categories. Heterogeneity of studies prevented pooled analysis of results. Of the 2161 papers identified, 30 were selected for grading following full text review. The present report is an update of the earlier IWGDF systematic reviews, and the conclusion is similar: that with the possible exception of negative pressure wound therapy in post‐operative wounds, there is little published evidence to justify the use of newer therapies. Analysis of the evidence continues to present difficulties in this field as controlled studies remain few and the majority continue to be of poor methodological quality. Journal Article Diabetes/Metabolism Research and Reviews 32 154 168 15207552 31 12 2016 2016-12-31 10.1002/dmrr.2707 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2023-06-28T15:27:49.4087814 2019-05-30T16:11:24.3112587 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine F. L. Game 1 J. Apelqvist 2 C. Attinger 3 A. Hartemann 4 R. J. Hinchliffe 5 M. Löndahl 6 P. E. Price 7 W. J. Jeffcoate 8 Tricia Price 9
title Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review
spellingShingle Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review
Tricia Price
title_short Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review
title_full Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review
title_fullStr Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review
title_full_unstemmed Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review
title_sort Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review
author_id_str_mv 72b4943af96c97ef72977c31b9c29624
author_id_fullname_str_mv 72b4943af96c97ef72977c31b9c29624_***_Tricia Price
author Tricia Price
author2 F. L. Game
J. Apelqvist
C. Attinger
A. Hartemann
R. J. Hinchliffe
M. Löndahl
P. E. Price
W. J. Jeffcoate
Tricia Price
format Journal article
container_title Diabetes/Metabolism Research and Reviews
container_volume 32
container_start_page 154
publishDate 2016
institution Swansea University
issn 15207552
doi_str_mv 10.1002/dmrr.2707
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 The outcome of management of diabetic foot ulcers remains a challenge, and there remains continuing uncertainty concerning optimal approaches to management. It is for these reasons that in 2008 and 2012, the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing published systematic reviews of the evidence to inform protocols for routine care and to highlight areas, which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between June 2010 and June 2014. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network criteria. Selected studies fell into the following ten categories: sharp debridement and wound bed preparation with larvae or hydrotherapy; wound bed preparation using antiseptics, applications and dressing products; resection of the chronic wound; oxygen and other gases, compression or negative pressure therapy; products designed to correct aspects of wound biochemistry and cell biology associated with impaired wound healing; application of cells, including platelets and stem cells; bioengineered skin and skin grafts; electrical, electromagnetic, lasers, shockwaves and ultrasound and other systemic therapies, which did not fit in the aforementioned categories. Heterogeneity of studies prevented pooled analysis of results. Of the 2161 papers identified, 30 were selected for grading following full text review. The present report is an update of the earlier IWGDF systematic reviews, and the conclusion is similar: that with the possible exception of negative pressure wound therapy in post‐operative wounds, there is little published evidence to justify the use of newer therapies. Analysis of the evidence continues to present difficulties in this field as controlled studies remain few and the majority continue to be of poor methodological quality.
published_date 2016-12-31T15:27:45Z
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score 11.036334

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