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Jan Apelqvist

Physician

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High probability of healing without amputation of plantar forefoot ulcers in patients with diabetes.

Author

  • Hedvig Örneholm
  • Jan Apelqvist
  • Jan Larsson
  • Magnus Eneroth

Summary, in English

Diabetic foot ulcer is an important entity which in many cases is the first serious complication in diabetes. Although a plantar forefoot location is common, there are few studies on larger cohorts and in such studies there is often a combination of various types of ulcer and ulcer locations. The purpose of this study is to discern the outcome of plantar forefoot ulcers and their specific characteristics in a large cohort. All patients (n=770), presenting with a plantar forefoot ulcer at a multidisciplinary diabetes foot clinic from January 1(st) 1983 to December 31(st) 2012 were considered for the study. 701 patients (median age 67 (22-95) fulfilled the inclusion criteria and were followed according to a pre-set protocol until final outcome (healing or death). Severe peripheral vascular disease (SPVD) was present in 26% of the patients and 14% had evidence of deep infection upon arrival at the foot clinic. Fifty-five per cent (385/701) of the patients healed without foot surgery, 25% (173/701) healed after major debridement, nine per cent (60/701) healed after minor or major amputation and 12% (83/701) died unhealed. Median healing time was 17 weeks. An ulcer classified as Wagner grade 1 or 2 at inclusion and independent living were factors associated with a higher healing rate. Seventy-nine per cent of 701 patients with diabetes and a plantar forefoot ulcer treated at a multidisciplinary diabetes foot clinic healed without amputation. For one third some form of foot surgery was needed to achieve healing. This article is protected by copyright. All rights reserved.

Department/s

  • Orthopedics - Clinical and Molecular Osteoporosis Research
  • Genomics, Diabetes and Endocrinology
  • Orthopaedics (Lund)

Publishing year

2015

Language

English

Pages

922-931

Publication/Series

Wound Repair and Regeneration

Volume

23

Issue

6

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Orthopedics

Status

Published

Research group

  • Orthopedics - Clinical and Molecular Osteoporosis Research
  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1524-475X