Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 997 - файл
.pdf
56 D. Dixon and M. Edmonds
Near Infrared (NIR) Optical Imaging
The use of near infrared (NIR) optical imaging to map haemodynamic changes in
diabetic foot ulcers has been an area of interest. The technology is non-invasive and
non-ionizing and requires no contact. It utilises near infrared light between 650 and
1000 nm which is minimally absorbed and allows deep tissue imaging (Kaile and
Godavarty 2019). NIR has been used as an adjunct to improving surgical
debridement techniques by quantifying the level of tissue oxygenation around areas
of callus after debridement. This was reported from a small multi-centre trial
between Florida and India, to show a greater than 80% change in tissue oxygenation
following debridement (Kaile et al. 2021). Development of smart phone technology
using NIR to aid with non-contact 2D and 3D wound image analysis is still in the
early stages, but is currently being used in a different modality (contact) to aid with
skin cancer assessment and brain imaging (Kaile and Godavarty 2019).
Innovative Technology in Wound Applications to Accelerate
Healing
Historically, there has been a scarcity of evidence-based topical therapy to accelerate the healing of diabetic foot ulcers In 2019, the IWGDF made several recommendations (Rayman et al. 2020). It advised that practitioners consider the use
of the sucrose-octasulfate impregnated dressing in non-infected, neuro-ischaemic
diabetic foot ulcers that are difficult to heal despite best standard of care, following
on from the Explorer study which reported the benefit of sucrose octasulphate
dressing when applied to ulcers in neuroischaemic feet (Edmonds et al. 2018). The
use of LeucoPatch was also recommended as he LeucoPatch study had reported the
benefit of a multi-layered patch comprising autologous leucocytes, platelets, and
fibrin, which releases cytokines and growth factors involved in tissue repair, in a
multinational, observer blinded, randomised, controlled trial (Game et al. 2018).
The IWGDF also recommended the use of placental derived products as an
adjunctive treatment in addition to best standard of care, when the latter alone has
failed to reduce the size of the wound (Tettelbach et al. 2019). Recommendations
were also made by the IWGDF to consider the use of systemic hyperbaric oxygen
therapy as an adjunctive treatment in non-healing ischaemic diabetic foot ulcers
despite best standard of care, and the use of negative pressure wound therapy
(NWPT) to reduce wound size, in addition to best standard of care, in patients with
diabetes and a post-operative (surgical) wound on the foot. In one well-designed
RCT, Armstrong and Lavery (2005) compared NPWT to standard moist wound
care in 162 people with diabetes who had partial foot amputations up to the
transmetatarsal level. They found a healing rate at 16 weeks of 56% compared to
39% in the standard care group. A systematic review and meta-analysis performed
by Liu et al. (
from 11 RCTs involving 1,044 patients concluded that NPWT was 1.48 times more
likely than conventional dressings to heal wounds, with a decreased time to closure
(by 8 days) and a reduced risk of amputation (relative risk 0.31). Three RCTs have
2017)
also compared NPWT to conventional dressings. This analysis
The Diabetic Foot, Its Complications, Role of Technology … 57
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
compared conventional NPWT to NPWT with saline instillation. Lavery et al.
showed no difference in a study of 150 patients (Lavery et al. 2020). However, Giri
et al. reported a decreased bacterial burden and decreased wound size in 48 patients
(Giri et al. 2021). Kim et al. found no differences in their primary endpoints but did
demonstrate a 3.1-fold decrease in readmission of patients treated with saline
instillation and NPWT compared to NPWT alone (Kim et al.
2020; Boulton et al.
2022). Although previous studies have been criticized as providing low-certainty
evidence from trials with risk of bias and imprecision, NWPT has become standard
treatment of complex diabetic foot ulcers (Boulton et al. 2022). Overall, there is
evidence that this form of therapy increases granulation tissue, and prospective
RCTs have shown that it accelerates wound healing.
Recently there has been new evidence to support the technology for topical
oxygen therapy (TOT). There are three general types of delivery systems for TOT,
each of which allows for ambulatory or home-based treatment: (1) those generating
continuous delivery of oxygen (CDO) at negligible pressures, (2) low constant
pressure delivery in a contained chamber, and (3) higher cyclically pressurized and
humidified delivery in a contained extremity chamber (Boulton et al. 2022). Using
the cyclically pressurized topical wound oxygen device for healing recalcitrant
diabetic foot ulcers, a robust multicentre, sham-controlled, double-blinded RCT
was reported in 2020 (Frykberg et al. 2020). At the first planned (a priori) interim
analysis point, the active therapy was found to be superior to the sham, with a
closure rate at 12 weeks of 41.7% compared to 13.5% (P = 0.007). Improved
healing rates in the TOT group were also demonstrated by adjusted Cox proportional hazards modelling that yielded a hazard ratio of 4.66 (97.8% CI 1.36–15.98,
P = 0.004). The real-world impact of this device on hospitalizations and amputations in 202 patients with diabetic foot ulcers was reported in
a retrospective,
comparative cohort study (Yellin et al. 2021). It found that 6.6 and 12.1% of those
using cyclically pressurized topical oxygen had hospitalizations and amputations,
respectively, at 1 year, compared to 54.1 and 41.4%, respectively, of those who had
not used this adjunctive topical oxygen modality (each P < 0.0001).
Innovative Technology in Cellular and Molecular Therapies
to Accelerate Healing
Stem Cell Therapy
The use of stem cell therapy to enhance the physiological processes of wound
healing in diabetic foot ulcers has led to the development of various dressings and
topical applications These techniques facilitate the delivery of growth factors,
cytokines and chemokines within a structure or medium which maximises exposure
of the wound to the relevant components to aid wound healing.
Using stem cell therapy to develop mesenchymal and mononuclear cell lineages
has been shown to produce higher levels of collagen and growth factors, leadi ng to
faster wound healing compared to standard care alone (Albehairy et al. 2018).
There were significantly higher rates of ulcer surface area reduction in those treated
58 D. Dixon and M. Edmonds
with mesenchymal or mononuclear groups of stem cells [68% with mesenchymal,
59% with mononuclear] compared to the controls [6.25%, p < 0.05] at 12 weeks
(Albehairy et al. 2018). There was no significant difference in ulcer healing between
the two stem cell treated groups. Adipose stem cells, known to be an abundant
source of mesenchymal stem cells, showed 80% healing at 6 months post
lower-limb min or amputation, compared with 46% in the control group of standard
care alone (p = 0.0064) (Lonardi et al.
2019).Ameta-anal
ysis of the efficacy of
stem cell therapy in the treatment of diabetic foot ulcers looked at 14 studies with
683 participants. It concluded that stem cell therapy was more effective than
standard treatment regarding ulcer healing, improving lower extremity ischaemia,
increasing pain free walking distance and reducing rest-pain score compared with
conventional therapy. It also demonstrated a reduction in amputation rates (Sun
et al. 2022). However, there is a need for larger studies, involving multi-centre
involvement with randomized double-blind placebo controlled trials to further
evaluate long term efficacy of this treatment.
Gene Therapy
Developments in gene therapy using viral vectors to deliver growth factors to sites
of ulcers is still in the early phases. Initial trials show some promise with the use of
non-viral vectors in terms of lower risk of stimulating adverse side effects such as
exaggerated immune responses, carcinogenesis and insertional mutagenesis.
However, the use of viral vectors has demonstrated better therapeutic effects with
lower levels of adverse effects (Kwon et al. 2012; Dixon and Edmonds 2021).
Nanotechnology
There are a number of trials in the early stages of investigation looking at different
medium
o deliver targeted gene therapy to affected sites including those using
s t
nanotechnology. Exploration of the use of lipid nano-carriers (liposomes, solid lipid
nanoparticles, niosomes and ethosomes) as drug delivery systems has shown promise in aiding diabetic foot ulcer healing (Kandregula et al. 2022). The lipid
nano-carriers can be used to encapsulate nucleic acids like siRNA and miRNA to
silence the expression of inflammatory cytokines which are often seen in chronic
wounds. They can also be used to encapsulate proteins, peptides and growth factors
which can be d elivered to the wound bed and facilitate wound healing (Kandregula
et al. 2022)
Devel
efits
.
opments in nanotechnology to aid wound healing have shown early ben-
in animal models of rats with diabetic neuropathy and ulceration. The use of
Poly lactic-co-glycolic-acid (PLGA) as a synthetic polymer material on which to
load growth factors to deliver directly to wounds has been shown to improve wound
healing in animal models (He et al. 2021). The main focus with developing
nanoparticle therapies is on properties which demonstrate structural similarity,
biocompatibility and biodegradability between the different polymers and skin (He
et al.
PLGA has many of these properties and is therefore one of the more
2021).
studied polymers in nano-technology. PLGA microspheres loaded with recombinant human Epidermal Growth Factor (EGF) nanoparticles showed faster
The Diabetic Foot, Its Complications, Role of Technology … 59
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
proliferation of fibroblasts and faster healing rates when compared with PLGA and
recombinant human EGF. Similar effects have been demon strated with the use of
curcumin nanoparticle gelatin microspheres, loaded into hydrogels. There was
improved wound healing, collagen formation and neovascularisation (He et al.
2021; Liu et al. 2018).
Evidence for the Use of Technology on Offloading
Plantar pressure measurements have been shown to be useful in the design and
assessment of therapeutic footwear for high risk diabetic patients: in particular,
in-shoe plantar pressure analysis is an effective means to evaluate and guide
footwear modifications that reduce pressure in the neuropathic diabetic foot. By this
means the quality of footwear can be improved and hence, reduce the risk for
pressure-related plantar foot ulcers (Bus et al. 2011; Waaijman et al. 2012). The
offloading capability of therapeutic insoles or orthopaedic footwear can thus be
improved when guided by plantar pressure measurement and the risk of ulcer
recurrence reduced by 46–65%, assuming that the footwear is actually worn. This
has been a pivotal step forward as footwear was previously designed and assessed
on the expertise and skills of the prescribing physician and orthotist, and efficacy
was gauged according to whether a foot ulcer subsequently occurred or not.
Covid 19 Pandemic and Management of the Diabetic Foot
One concern during the pandemic, was to find a balance between reducing
unnecessary travel to hospital for foot clinic appointments, and ensuring there was
appropriate foot care for those with moderate to severe ulceration or new ulcers
requiring specialist input. The use of technology to facilitate this judgement
included mobile apps that encrypted messages and photographs with patient sensitive data. In South East London, the use of a communication app which also
allowed seamless sharing of photos and encrypted patient information was
approved through information governance in much shorter time frames than would
normally take. The roll out of the app across 5 hospitals allowed the seamless
sharing of information about clinical cases across a region where expert advice on
wound care, dressing management and decisions for surgical intervention could be
made as needed without the patient having to travel unnecessarily. It also allowed
support across community, primary and secondary care teams. Across the world,
there was a noticed reduction in visits to diabetes foot clinics with visits falling as
much as 70% in Los Angeles and 50% in Manchester UK to 29% in Argentina
(Miranda et al. 2022). The International Working Group on Diabetic Foot and
D-Foot International developed a ‘fast-track pathway’ for non-specialist health care
professionals with the aim to reduce late referrals with foot ulcers and reduce
diabetes related foot admissions to hospital (Meloni et al. 2021). It gave guidelines
60 D. Dixon and M. Edmonds
on time to see a specialist foot service with regard to severity of ulceration at
presentation. Foot in Diabetes UK (FDUK) also wrote a guidance document
stressing the importance of recognising foot and leg complications that are limb- or
life-threatening and referring them to multidisciplinary clinics which remained open
in the UK (Foot in Diabetes UK 2020).
There was a variability in technology across different countries to facilitate
telemedi
tions rather than video consultations. Despite this variability, a meta-analysis of four
controlled-trials demonstrated that treating of diabetic foot ulcers via telemedicine
was an effective alternative when face to face consultations are reduced or not
possible (Yammine and Estephan 2022). A qualitative survey in Tuscany demonstrated patient satisfaction with telemedi cine as a means to monitor diabetic foot
ulcers and would be happy for future use in monitoring the condition when needed
(Iacopi et al. 2021).
cine
revie
ws.Often
the
term
telemedicine referred to telephone consulta-
Conclusion
We have described the usefulness of technology and evidence to aid diagnosis and
management of diabetic foot ulcers. Technological advances have been made in the
diagnosis and assessment of neuropathy, which successfully permit the prediction
of ulcers but not as yet in the prevention of ulcers. Advances have been made in the
measurement of plantar pressure to facilitate the development of efficient footwear
which can reduce the risk of ulcer recurrence. Advances in the measurement of skin
temperature have permitted the early diagnosis of skin breakdown. Foot skin
temperature monitoring has prevented a first or a recurrent foot ulcer in high risk
patients, at between 65 and 75% compared with usual care. Point-of-care fluorescence imaging has aided the characterisation of infection and ulcer healing rates
have been improved.
Technological advances have been made in the treatment of ulcers and the
e ba
evidenc
trolled clinical trials. Their usefulness in real life is more difficult to gauge and
further multicentre studies would be helpful. Also, some of these technologies
especially gene therapy and nanotechnology are in the early stages of development
and research and will require further studies in the clinical arena.
Whilst the treatment of ulcers and thus the prevention of amputations may be
facilitated
to be synchronised and harmonised into an organised multidisciplinary treatment of
the diabet ic foot ulcer which embraces mechanical, microbiological, vascular and
educational aspects of care in addition to the direct treatment of the ulcer itself. It is
only then that patients will fully benefit from the impact of these technologies and
experience successful ulcer healing which is so eagerly desired but still eludes
many of them.
se for many of these technologies has been established by well con-
by individual therapeutic innovations in technology, such advances have
The Diabetic Foot, Its Complications, Role of Technology … 61
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
References
Abbott CA, Chatwin KE, Foden P, Hasan AN, Sange C, Rajbhandari SM, et al. Innovative
intelligent insole system reduces diabetic foot ulcer recurrence at plantar sites: a prospective,
randomised, proof-of-concept study. Lancet
Alahakoon C, Fernando M, Galappaththy C, Matthews EO, Lazzarini P, Moxon J V., et al.
Meta-analyses of randomized controlled trials reporting the effect of home foot temperature
monitoring, patient education or offloading footwear on the incidence of diabetes-related foot
ulcers. Diabet Med. 2020;37.
Albehairy A, Kyrillos F, Gawish H, State O, Abdelghaffar H, Elbaz O, et al. Autologous
mononuclear versus mesenchymal stem cells in healing of recalcitrant neuropathic diabetic foot
ulcers. Diabetologia. 2018;61.
Armstrong DG, Lavery LA. Negative pressure wound therapy after partial diabetic foot
amputation: a multicentre, randomised controlled trial. Lancet. 2005;366(9498).
Armstrong DG, Zelen C. 30-LB: multicenter, randomized controlled clinical investigation
evaluating a unique micro water jet technology device versus standard debridement in the
treatment of diabetic foot. Diabetes [Internet]. 2022;71(Suppl 1):30–LB. https://doi.org/10.
2337/db22-30-LB
Armstrong DG, Lavery LA, Liswood PJ, Todd WF, Tredwell JA. Infrared dermal thermometry for
the high-risk diabetic foot. Phys Ther. 1997;77(2).
Armstrong DG, Holtz-Neiderer K, Wendel C, Mohler MJ, Kimbriel HR, Lavery LA. Skin
temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients. Am J
Med. 2007;120(12).
Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med
[Internet]. 2017;376(24):2367–75. https://doi.org/10.1056/NEJMra1615439
Bauman JH, Brand PW. Measurement of pressure between foot and shoe. Lancet. 1963;281(7282).
Beach C, Cooper G, Weightman A, Hodson-Tole EF, Reeves ND, Casson AJ. Monitoring of
dynamic plantar foot temperatures in diabetes with personalised 3d-printed wearables. Sensors.
2021;21(5).
Bergtholdt HT, Brand PW. Thermography: an aid in the management of insensitive feet and
stumps. Arch Phys Med Rehabil. 1975;56(5).
Booth J, Young MJ. Differences in the performance of commercially available 10-g monofila-
ments. Diabetes Care. 2000;23(7):984–8.
Boulton AJM, Armstrong DG, Löndahl M, Frykberg RG, Game FL, Edmonds ME, et al. New
evidence-based therapies for complex diabetic foot wounds. Compendia [Internet]. 2022;2022
(2):1–23. https://doi.org/10.2337/db2022-02
Brownrigg JRW, Apelqvist J, Bakker K, Schaper NC, Hinchliffe RJ. Evidence-based management
of PAD & the diabetic foot. Eur J Vasc Endovasc Surg. 2013;45.
Bus SA, Haspels R, Busch-Westbroek TE. Evaluation and optimization of therapeutic footwear for
neuropathic diabetic foot patients using in-shoe plantar pressure analysis. Diabetes Care
[Internet]. 2011;34(7):1595–600. https://doi.org/10.2337/dc10-2206
Bus SA, Lavery LA, Monteiro-Soares M, Rasmussen A, Raspovic A, Sacco ICN, et al. Guidelines
on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update). Diabetes
Metab Res Rev. 2020;36(S1).
Bus SA, Aan De Stegge WB, Van Baal JG, Busch-Westbroek TE, Nollet F, Van Netten JJ. Effec-
tiveness of at-home skin temperature monitoring in reducing the incidence of foot ulcer
recurrence in people with diabetes: a multicenter randomized controlled trial (DIATEMP).
BMJ Open Diabetes Res Care. 2021;9(1).
Bus SA, Busch-Westbroek T, Hulshof C, Peters E, Pijnappels M, Sabelis L, et al. A comprehensive
model of foot ulceration in diabetic foot disease: DIALOAD Project (ongoing) [Internet].
2022 [cited 2022 Sep 4]. https://www.amsterdamumc.org/en/research/institutes/amsterdam-
movement-sciences/highlights/a-comprehensive-model-of-foot-ulceration-in-diabetic-foot-
disease.htm
Digit Heal. 2019;1(6).
62 D. Dixon and M. Edmonds
Campitiello F, Mancone M, Corte A Della, Guerniero R, Canonico S. An evaluation of an
ultrasonic debridement system
in patients with diabetic foot ulcers: a case series. J Wound
Care. 2018;27(4).
Chappell FM, Crawford F, Horne M, Leese GP, Martin A, Weller D, et al. Development and
validation of a clinical prediction rule for development of diabetic foot ulceration: an analysis
of data from five cohort studies. BMJ Open Diabetes Res Care. 2021;9(1).
Chatwin KE, Abbott CA, Boulton AJM, Bowling FL, Reeves ND. The role of foot pressure
measurement in the prediction and prevention of diabetic foot ulceration—a comprehensive
review. Diabetes/Metab Res Rev. 2020;36.
Crawford F, Nicolson DJ, Amanna AE, Martin A, Gupta S, Leese GP, et al. Preventing foot
ulceration in diabetes: systematic review and meta-analyses of RCT data. Diabetologia.
2020;63.
NHS Digital. National diabetes foot care audit fourth annual report. Natl Diabetes Foot Care Audit
Rep. 2019;1(May).
Dixon D, Edmonds M. Managing diabetic foot ulcers: pharmacotherapy for wound healing. Drugs.
2021;81.
Dros J, Wewerinke A, Bindels PJ, Van Weert HC. Accuracy of monofilament testing to diagnose
peripheral neuropathy: a systematic review. Ann Fam Med. 2009;7(6).
Edmonds ME, Foster AVM. Managing the diabetic foot, 3rd ed. Wiley; 2014.
Edmonds M, Lázaro-Martínez JL, Alfayate-García JM, Martini J, Petit JM, Rayman G, et al.
Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic
foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial.
Lancet Diabetes Endocrinol. 2018;6(3).
Edwards J, Stapley S. Debridement of diabetic foot ulcers. Cochrane Database Syst Rev. 2010;1:
CD003556.
Ena J, Carretero-Gomez J, Arevalo-Lorido JC, Sanchez-Ardila C, Zapatero-Gaviria A,
Gómez-Huelgas R. The association between elevated foot skin temperature and the incidence
of diabetic foot ulcers: a meta-analysis. Int J Low Extrem Wounds. 2021;20(2).
Flores-Escobar S, Álvaro-Afonso FJ, García-Álvarez Y, López-Moral M, Lázaro-Martínez JL,
García-Morales E. Ultrasound-assisted wound (UAW) debridement in the treatment of diabetic
foot ulcer: a systematic review and meta-analysis. J Clin Med. 2022;11(7).
Foot in Diabetes UK. Covid-19 situation v1.3 lower limb amputation prevention guidance. Diabet
Foot J. 2020;23(1):2.
Frykberg RG, Gordon IL, Reyzelman AM, Cazzell SM, Fitzgerald RH, Rothenberg GM, et al.
Feasibility and efficacy of a smart mat technology to predict development of diabetic plantar
ulcers. Diabetes Care. 2017.
Frykberg RG, Franks PJ, Edmonds M, Brantley JN, Téot L, Wild T, et al. A multinational,
multicenter, randomized, double-blinded, placebo-controlled trial to evaluate the efficacy of
cyclical topical wound oxygen (TWO
the TWO
study. Diabetes Care. 2020;43(3).
2
) therapy in the treatment of chronic diabetic foot ulcers:
2
Game F, Jeffcoate W, Tarnow L, Jacobsen JL, Whitham DJ, Harrison EF, et al. LeucoPatch system
for the management of hard-to-heal diabetic foot ulcers in the UK, Denmark, and Sweden: an
observer-masked, randomised controlled trial. Lancet Diabetes Endocrinol. 2018;6(11).
Gin H, Rigalleau V, Baillet L, Rabemanantsoa C. Comparison between monofilament, tuning fork
and vibration perception tests for screening patients at risk of foot complication. Diabetes
Metab. 2002;28(6 I).
Giri P
rishnaraj B, Chandra Sistla S, Sistla S, Basu D, Shankar G, et al. Does negative pressure
, K
wound therapy with saline instillation improve wound healing compared to conventional
negative pressure wound therapy? A randomized controlled trial in patients with extremity
ulcers. Ann Med Surg. 2021;61.
He Y, Al-Mureish A, Wu N. Nanotechnology in the treatment of diabetic complications: a
comprehensive narrative review. J Diabetes Res. 2021;2021.
The Diabetic Foot, Its Complications, Role of Technology … 63
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Iacopi E, Pieruzzi L, Goretti C, Piaggesi A. I fear COVID but diabetic foot (DF) is worse: a survey
on patients’ perception of a telemedicine service for DF during lockdown. Acta Diabetol.
2021;58(5).
International Diabetes Federation. IDF clinical practice recommendations on
the diabetic foot –
2017. Int Diabet Fed. 2017.
Jia L, Parker CN, Parker TJ, Kinnear EM, Derhy PH, Alvarado AM, et al. Incidence and risk
factors for developing infection in patients presenting with uninfected diabetic foot ulcers.
PLoS One. 2017;12(5).
Johani K, Malone M, Jensen S, Gosbell I, Dickson H, Hu H, et al. Microscopy visualisation
confirms multi-species biofilms are ubiquitous in diabetic foot ulcers. Int Wound J. 2017;14(6).
Jones LM, Dunham D, Rennie MY, Kirman J, Lopez AJ, Keim KC, et al. In vitro detection of
porphyrin-producing wound bacteria with real-time fluorescence imaging. Future Microbiol.
2020;15(5).
Kaile K, Godavarty A. Development and validation of a smartphone-based near-infrared optical
imaging device to measure physiological changes in-vivo. Micromachines. 2019;10(3).
Kaile K, Mahadevan J, Leiva K, Khandavilli D, Narayanan S, Muthukrishnan V, et al.
Effectiveness of scalpel debridement in diabetics using near infrared imaging technology for
ulcer prevention. 2021.
Kandregula B, Narisepalli S, Chitkara D, Mittal A. Exploration of lipid-based nanocarriers as drug
delivery systems in diabetic foot ulcer. Mol Pharm. 2022;19(7):1977–98.
Katsilambros N, Dounis E, Makrilakis K, Tentolouris N, Tsapogas P. Atlas of the diabetic foot.
Atlas Diabet Foot. 2011.
Kerr M. Foot care in diabetes: the economic case for change. 2012.
Kerr M. Insight health economics diabetic foot care in England: an economic study. 2017.
Kerr M, Rayman G, Jeffcoate WJ. Cost of diabetic foot disease to the National Health Service in
England. Diabet Med. 2014;31(12).
Kim PJ, Lavery LA, Galiano RD, Salgado CJ, Orgill DP, Kovach SJ, et al. The impact of
negative-pressure wound therapy with instillation on wounds requiring operative debridement:
pilot randomised, controlled trial. Int Wound J. 2020;17(5).
Klenerman L, McCabe C, Cogley D, Crerand S, Laing P, White M. Screening for patients at risk
of diabetic foot ulceration in a general diabetic outpatient clinic. Diabet Med. 1996;13(6).
Kwon MJ, An S, Choi S, Nam K, Jung HS, Yoon CS, et al. Effective healing of diabetic skin
wounds by using nonviral gene therapy based on minicircle vascular endothelial growth factor
DNA and a cationic dendrimer. J Gene Med. 2012;14(4).
Lantis JC, Marston WA, Farber A, Kirsner RS, Zhang Y, Lee TD, et al. The in fluence of patient
and wound variables on healing of venous leg ulcers in a randomized controlled trial of
growth-arrested allogeneic keratinocytes and fibroblasts. J Vasc Surg. 2013;58(2).
Lauria G, Hsieh ST, Johansson O, Kennedy WR, Leger JM, Mellgren SI, et al. European
federation of neurological societies/peripheral nerve society guideline on the use of skin biopsy
in the diagnosis of small fiber neuropathy. Report of a joint task force of the European
federation of neurological societies and the peripheral nerve society. Eur J Neurol. 2010;17.
Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJM. Predictive value of foot
pressure assessment as part of a population based diabetes disease management program.
Diabetes Care. 2003;26(4).
Lavery LA, Higgins KR, Lanctot DR, Constantinides GP, Zamorano RG, Armstrong DG, et al.
Home monitoring of foot skin temperatures to prevent ulceration. Diabetes Care. 2004;27(11).
Lavery LA, Higgins KR, Lanctot DR, Constantinides GP, Zamorano RG, Athanasiou KA, et al.
Preventing diabetic foot ulcer recurrence in high-risk patients: use of temperature monitoring as
a self-assessment tool. Diabetes Care. 2007;30(1).
Lavery LA, Davis KE, La Fontaine J, Farrar JD, Bhavan K, Oz OK, et al. Does negative pressure
wound therapy with irrigation improve clinical outcomes? A randomized clinical trial in
patients with diabetic foot infections. Am J Surg. 2020;220(4).
64 D. Dixon and M. Edmonds
Lazzarini PA, Pacella RE, Armstrong DG, van Netten JJ. Diabetes-related lower-extremity
complications are a leading cause of the global burden of disability. Diabet Med. 2018;35.
Le L, Baer M,
point-of-care fluorescence imaging for the detection of bacterial burden in wounds: results from
the 350-patient fluorescence imaging assessment and guidance trial. Adv Wound Care.
2021;10(3).
Lipsky BA, Senneville É, Abbas ZG, Aragón-Sánchez J, Diggle M, Embil JM, et al. Guidelines on
the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update).
Diabetes Metab Res Rev. 2020;36(S1).
Liu C, van Netten JJ, van Baal JG, Bus SA, van der Heijden F. Automatic detection of diabetic
foot complications with infrared thermography by asymmetric analysis. J Biomed Opt. 2015;
20(2).
Liu S, He C zhu, Cai Y ting, Xing Q ping, Guo Y zhen, Chen Z long, et al. Evaluation of
negative-pressure wound therapy for patients with diabetic foot ulcers: systematic review and
meta-analysis. Therapeut Clin Risk Manag. 2017;13.
Liu J, Chen Z, Wang J, Li R, Li T, Chang M, et al. Encapsulation of curcumin nanoparticles with
MMP9-responsive and thermos-sensitive hydrogel improves diabetic wound healing. ACS
Appl Mater Interfaces. 2018;10(19).
Lonardi R, Leone N, Gennai S, Trevisi Borsari G, Covic T, Silingardi R. Autologous
micro-fragmented adipose tissue for the treatment of diabetic foot minor amputations: a
randomized controlled single-center clinical trial (MiFrAADiF). Stem Cell Res Ther. 2019;
10(1).
Lullove E, Winters C. Point-counterpoint: is hydrosurgery more efficacious than ultrasonic
debridement in the diabetic foot? Podiatry Today. 2019.
McCabe CJ, Stevenson RC, Dolan AM. Evaluation of a diabetic foot screening and protection
programme. Diabet Med. 1998;15(1).
Meloni M, Bouillet B, Ahluwalia R, et al. Fast-track pathway for diabetic foot ulceration during
COVID-19 crisis: a document from international diabetic foot care group and D-foot
international. Diabetes Metab Res Rev. 2021;37: e3396.
Miranda C, Zanette G, Da Ros R. Diabetic foot disease during the COVID-19 pandemic: lessons
learned for our future. Arch Med Sci – Atheroscler Dis. 2022;7(1):94–103.
Mottolini N. 2022. Diabetes and lower limb complications A thematic review of clinical
negligence claims [Internet]. [cited 2022 Sep 4]. https://resolution.nhs.uk/wp-content/uploads/
2022/06/Diabetes_and_Lower_Limb_Complications.pdf
Oropallo AR, Andersen C, Abdo R, Hurlow J, Kelso M, Melin M, et al. Guidelines for
point-of-care fluorescence imaging for detection of wound bacterial burden based on delphi
consensus. Diagnostics. 2021;11(7).
Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation: basis for prevention.
Diabetes Care. 1990;13(5).
Petrova NL, Donaldson NK, Tang W, MacDonald A, Allen J, Lomas C, et al. Infrared
thermography and ulcer prevention in the high-risk diabetic foot: data from a single-blind
multicentre controlled clinical trial. Diabet Med. 2020;37(1).
Pham H, Armstrong DG, Harvey C, Harkless LB, Giurini JM, Veves A. Screening techniques to
identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes
Care. 2000;23(5).
Piaggesi A, Schipani E, Campi F, Romanelli M, Baccetti F, Arvia C, et al. Conservative surgical
approach versus non-surgical management for diabetic neuropathic foot ulcers: a randomized
trial. Diabet Med [Internet]. 1998;15(5):412–7. http://www.ncbi.nlm.nih.gov/pubmed/9609364
Public H
ealth E
Rahma S, Woods J, Brown S, Nixon J, Russell D. The use of point-of-care bacterial
autofluorescence imaging in the management of diabetic foot ulcers: a pilot randomized
controlled trial. Diabetes Care. 2022;45(7):1601–9.
Briggs P, Bullock N, Cole W, Dimarco D, et al. Diagnostic accuracy of
ngland. National diabetes foot care report. Natl Cardiovasc Intell Netw. 2021.
The Diabetic Foot, Its Complications, Role of Technology … 65
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Raizman R, Little W, Smith AC. Rapid diagnosis of Pseudomonas aeruginosa in wounds with
point-of-care fluorescence imaing. Diagnostics. 2021;11(2).
Rayman G, Vas P, Dhatariya K, Driver V, Hartemann A, Londahl M, et al.
Guidelines on use of
interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update).
Diabetes Metab Res Rev. 2020;36(S1).
Reber M, Nussbaumer P. Effective debridement with micro water jet technology (MWT): a
retrospective clinical application observation of 90 patients with acute and chronic wounds.
Wound Med. 2018;20.
Ruby Chang YJ, Perry J, Cross K. Low-frequency ultrasound debridement in chronic wound
healing: a systematic review of current evidence. Plast Surg. 2017;25(1).
Saap LJ, Falanga V. Debridement performance index and its correlation with complete closure of
diabetic foot ulcers. Wound Repair Regen. 2002;10(6).
Serena TE, Bowler PG, Schultz GS, D’souza A, Rennie MY. Are semi-quantitative clinical
cultures inadequate? Comparison to quantitative analysis of 1053 bacterial isolates from 350
wounds. Diagnostics. 2021;11(7).
Shy ME, Frohman EM, So YT, Arezzo JC, Cornblath DR, Giuliani MJ, et al. Quantitative sensory
testing: report of the therapeutics and technology assessment subcommittee of the American
academy of neurology. Neurology. 2003;60.
Bus SiA, Waaijman R, Arts M, Haart M De, Busch-Westbroek T, Van Baal J, et al. Effect of
custom-made footwear on foot ulcer recurrence in diabetes: a multicenter randomized
controlled trial. Diabetes Care. 2013;36(12).
Sun Y, Zhao J, Zhang L, Li Z, Lei S. Effectiveness and safety of stem cell therapy for diabetic foot:
a meta-analysis update. Stem Cell Res Ther. 2022;13(1):416.
Swanson T, Lázaro-Martínez JL, Braumann C, Kirchhoff JB, Gächter B, Van Acker K.
Ultrasonic-assisted wound debridement: Report from a closed panel meeting. J Wound Care.
2020;29(2).
Tan LS. The clinical use of the 10g monofilament and its limitations: a review. Diabet Res Clin
Pract. 2010;90.
Tavakoli M, Quattrini C, Abbott C, Kallinikos P, Marshall A, Finnigan J, et al. Corneal confocal
microscopy: a novel noninvasive test to diagnose and stratify the severity of human diabetic
neuropathy. Diabetes Care. 2010;33(8).
Tettelbach W, Cazzell S, Reyzelman AM, Sigal F, Caporusso JM, Agnew PS. A confirmatory
study on the efficacy of dehydrated human amnion/chorion membrane dHACM allograft in the
management of diabetic foot ulcers: a prospective, multicentre, randomised, controlled study of
110 patients from 14 wound clinics. Int Wound J. 2019;16(1).
Ulbrecht JS, Hurley T, Mauger DT, Cavanagh PR.. Prevention of recurrent foot ulcers with plantar
pressure-based in-shoe orthoses: the CareFUL prevention multicenter randomized controlled
trial. Diabetes Care. 2014;37(7).
van Doremalen RFM, van Netten JJ, van Baal JG, Vollenbroek-Hutten MMR, van der Heijden F.
Validation of low-cost smartphone-based thermal camera for diabetic foot assessment.
Diabetes Res Clin Pract. 2019;149.
Vas PRJ, Rayman G. Validation of the modified LDIFlare technique: a simple and quick method
to assess C-fiber function. Muscle Nerve. 2013;47(3).
Vas PRJ, Sharma S, Rayman G. Distal sensorimotor neuropathy: improvements in diagnosis. Rev
Diabet Stud. 2015;12(1).
Waaijman R, Arts MLJ, Haspels R, Busch-Westbroek TE, Nollet F, Bus SA. Pressure-reduction
and preservation in custom-made footwear of patients with diabetes and a history of plantar
ulceration. Diabet Med [Internet]. 2012;29(12):1542–9. http://www.ncbi.nlm.nih.gov/pubmed/
22540919
Willits I, Cole H, Jones R, Dimmock P, Arber M, Craig J, et al. VibraTip
TM
for testing vibration
perception to detect diabetic peripheral neuropathy: a NICE medical technology guidance.
Appl Health Econ Health Policy. 2015;13.
Соседние файлы в папке @xirurgi_2025