@article{bff0a93ad2dd47afbeb65a5be81ad5bd,
title = "Performance of prognostic markers in the prediction of wound healing or amputation among patients with foot ulcers in diabetes: A systematic review",
abstract = "Clinical outcomes of patients with diabetes, foot ulceration, and peripheral artery disease (PAD) are difficult to predict. The prediction of important clinical outcomes, such as wound healing and major amputation, would be a valuable tool to help guide management and target interventions for limb salvage. Despite the existence of a number of classification tools, no consensus exists as to the most useful bedside tests with which to predict outcome. We here present an updated systematic review from the International Working Group of the Diabetic Foot, comprising 15 studies published between 1980 and 2018 describing almost 6800 patients with diabetes and foot ulceration. Clinical examination findings as well as six non-invasive bedside tests were evaluated for their ability to predict wound healing and amputation. The most useful tests to inform on the probability of healing were skin perfusion pressure >= 40mmHg, toe pressure >= 30mmHg, or TcPO2 >= 25mmHg. With these thresholds, all of these tests increased the probability of healing by greater than 25% in at least one study. To predict major amputation, the most useful tests were ankle pressure",
keywords = "amputation, diabetes, diabetic foot, ulcer, peripheral artery disease, prognosis, ANKLE-BRACHIAL INDEX, MAJOR AMPUTATION, DIAGNOSTIC-TEST, BLOOD-PRESSURE, DISEASE, FOCUS",
author = "Forsythe, {Rachael O.} and Jan Apelqvist and Boyko, {Edward J.} and Robert Fitridge and Hong, {Joon Pio} and Konstantinos Katsanos and Mills, {Joseph L.} and Sigrid Nikol and Jim Reekers and Maarit Venermo and Zierler, {R. Eugene} and Schaper, {Nicolaas C.} and Hinchliffe, {Robert J.}",
note = "Funding Information: We would like to thank the following external experts for their review of our PICOs for clinical relevance: Stephan Morbach (Germany), Heidi Corcoran (Hongkong), Vilma Urban{\v c}i{\v c} (Slovenia), Rica Tanaka (Japan), Florian Dick (Switzerland), Taha Wassila (Egypt), Abdul Basit (Pakistan), Yamile Jubiz (Colombia), Sriram Narayanan (Singapore), and Eduardo Alvarez (Cuba). We would like to thank Sicco Bus (on behalf of the IWGDF editorial board) and Kim Houlind (independent external expert) for their peer review of the manuscript. We would also like to thank Jack Brownrigg for his input in the previous version of this systematic review. Funding Information: Production of the 2019 IWGDF Guidelines was supported by unrestricted grants from Molnlycke Healthcare, Acelity, ConvaTec, Urgo Medical, Edixomed, Klaveness, Reapplix, Podartis, Aurealis, SoftOx, Woundcare Circle, and Essity. 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. All individual conflict of interest statement of authors of this guideline can be found at https://iwgdfguidelines.org/about-iwgdf-guidelines/biographies/ . Publisher Copyright: {\textcopyright} 2020 John Wiley & Sons Ltd",
year = "2020",
month = mar,
doi = "10.1002/dmrr.3278",
language = "English",
volume = "36",
journal = "Diabetes-metabolism Research and Reviews",
issn = "1520-7552",
publisher = "Wiley",
number = "S1",
}