Hyaluric acid derivatives may promote healing of diabetic foot ulcers

Diabetic foot ulcer

A recent systematic review looked at whether hyaluronic acid derivatives can be effective in dressings to promote wound healing. Clinical question: In people with burns or surgical or chronic wounds, do hyaluronic acid derivatives improve healing? The outcomes of interest were the percentage of patients whose wounds healed completely and the reduction in wound size. [read the full story…]

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Monofilament test alone may not rule in or rule out peripheral neuropathy

Feet

Different grades of monofilament are used to test the sensitivity of different areas of a patient’s foot. This systematic review set out to establish the accuracy of this method for diagnosing diabetic peripheral neuropathy. Clinical question: In diabetic patients does monofilament testing diagnose peripheral neuropathy? The evidence: Fourteen studies were included in the review, comprising [read the full story…]

Diabetics with chronic kidney disease were less likely to benefit from surgical revascularisation of ulcerated feet.

Diabetic foot ulcer

This observational cohort study looked at whether having chronic kidney disease (CKD) predicts outcome of revascularisation of ulcerated feet in a cohort of patients undergoing treatment at a vascular surgery unit in Finland. Clinical question: In people with diabetes and ulcerated foot, does CKD predict the outcome of surgical revascularisation? The evidence: The researchers collated [read the full story…]

In diabetic neuropathy, one in five partial foot amputations require reamputation.

Diabetic foot ulcer

This systematic review set out to establish the success rate of partial first ray (medial toe and metatarsal) amputation for patients with diabetic neuropathy and an infected, ulcerated foot. Clinical question: In people with diabetic peripheral neuropathy and infected, ulcerated foot, what is the outcome of partial first ray amputation? The evidence: The researchers found [read the full story…]

Lack of evidence for statins to prevent cardiovascular complications in type 2 diabetes.

A colourful selection of pills

Statins are widely used to lower cholesterol and prevent cardiovascular disease, in diabetic and non-diabetic patients.  NICE guidance recommends their use in patients with type 2 diabetes, depending on their cardiovascular risk.  However, although statins have been shown to reduce cardiovascular outcomes in large randomised trials  few trials have specifically looked for evidence of efficacy [read the full story…]

No evidence for alginate dressings in diabetic foot ulcers.

Yet another systematic review reports on wound dressings for diabetic foot ulcers.  This time the spotlight is on alginate dressings. Clinical question: In diabetic foot ulcers, do alginate dressings, as compared to other dressings, lead to improved healing? The reviewers searched the Cochrane Register of Controlled Trials, Medline, Embase and Cinahl for randomised trials comparing [read the full story…]

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No evidence for hydrocolloid dressings in diabetic foot ulcers.

Diabetic foot ulcer

A new Cochrane systematic review found no evidence to suggest that hydrocolloid dressings, which are resigned to help maintain a moist wound envirionment, improve the healing of diabetic foot ulcers. Clinical question: In people with diabetes and foot ulcers, do hydrocolloid dressings, as compared to alternative or usual treatment, lead to improved healing? The reviewers [read the full story…]

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No evidence for a dose-response effect for aspirin preventing cardiovascular events

This systematic review summarises the evidence for giving aspirin to all diabetic patients to prevent cardiovascular deaths at doses above 100 mg per day. Clinical question: In diabetes, does > 100mg/day aspirin prevent mortality? The reviewers stratified their analysis by dosage, and also looked at cardiovascular mortality, myocardial infarction and stroke. The evidence The reviewers [read the full story…]

No evidence for new therapies in treating diabetic foot ulcers

Diabetic foot ulcer

Diabetic foot ulcers are very problematic and have poor prognosis.  This review set out to evaluate whether new treatments, emerging in recent years, offer better treatment options. Clinical question In diabetic foot ulcers, do new treatments, as compared with standard care, improve healing? This is an update of a previous review, and includes evidence published [read the full story…]

Lack of clear evidence on surgery to prevent amputation in diabetic foot ulcers

Diabetic foot ulcer

Peripheral arterial disease (PAD) is a risk factor for amputation in diabetes with foot ulcers. This systematic review set out to evaluate the effectiveness of revascularisation of the ulcerated foot in patients with diabetes and PAD. Clinical question: In patients with diabetes, PAD and ulcerated feet, does surgical revascularisation, as compared with medical treatment, reduce [read the full story…]