D J Margolis1, J Kantor, J A Berlin. 1. Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia 19104, USA. dmargoli@cceb.med.upenn.edu
Abstract
OBJECTIVE: The aim of the study was to determine the percentage of individuals with neuropathic diabetic foot ulcers receiving good wound care who heal within a defined period of time. RESEARCH DESIGN AND METHODS: We conducted a systematic review of the control groups of clinical trials that evaluated a treatment for diabetic neuropathic foot ulcers. The meta-analytic techniques used include an estimation of the weighted mean percentage healed by end point, an evaluation of the homogeneity of trials, and an estimate of the 95% CI of the grouped data. Grouped-data univariate and multivariate logistic regression was conducted to assess the impact of mean age, ulcer size, and duration on the percentage of ulcers healed at end point. RESULTS: We found a total of 10 control groups meeting our criteria. Six control groups used 20 weeks as the end point for healing or nonhealing. For the six control arms with a 20-week end point, we found a weighted mean healing rate of 30.9% (95% CI 26.6-35.1). A similar analysis for the four 12-week arms found a mean healing rate of 24.2% (19.5-28.8). We failed to detect any statistically significant heterogeneity for either the 20-week or the 12-week trials. CONCLUSIONS: After 20 weeks of good wound care, approximately 31% of diabetic neuropathic ulcers heal. Similarly, after 12 weeks of good care, approximately 24% of neuropathic ulcers attain complete healing. Further patient-level analyses are necessary to definitively determine the associations of age, wound size, and wound duration with likelihood of healing.
OBJECTIVE: The aim of the study was to determine the percentage of individuals with neuropathic diabetic foot ulcers receiving good wound care who heal within a defined period of time. RESEARCH DESIGN AND METHODS: We conducted a systematic review of the control groups of clinical trials that evaluated a treatment for diabetic neuropathic foot ulcers. The meta-analytic techniques used include an estimation of the weighted mean percentage healed by end point, an evaluation of the homogeneity of trials, and an estimate of the 95% CI of the grouped data. Grouped-data univariate and multivariate logistic regression was conducted to assess the impact of mean age, ulcer size, and duration on the percentage of ulcers healed at end point. RESULTS: We found a total of 10 control groups meeting our criteria. Six control groups used 20 weeks as the end point for healing or nonhealing. For the six control arms with a 20-week end point, we found a weighted mean healing rate of 30.9% (95% CI 26.6-35.1). A similar analysis for the four 12-week arms found a mean healing rate of 24.2% (19.5-28.8). We failed to detect any statistically significant heterogeneity for either the 20-week or the 12-week trials. CONCLUSIONS: After 20 weeks of good wound care, approximately 31% of diabetic neuropathic ulcers heal. Similarly, after 12 weeks of good care, approximately 24% of neuropathic ulcers attain complete healing. Further patient-level analyses are necessary to definitively determine the associations of age, wound size, and wound duration with likelihood of healing.
Authors: Marissa J Carter; Carelyn P Fylling; William W Li; Jean de Leon; Vickie R Driver; Thomas E Serena; Janice Wilson Journal: Int Wound J Date: 2011-09-13 Impact factor: 3.315
Authors: Martin P Than; Robert A Smith; Catherine Hammond; Robert Kelly; Clive Marsh; Andrea D Maderal; Robert S Kirsner Journal: J Clin Aesthet Dermatol Date: 2012-12
Authors: Lisa Gould; Peter Abadir; Harold Brem; Marissa Carter; Teresa Conner-Kerr; Jeff Davidson; Luisa DiPietro; Vincent Falanga; Caroline Fife; Sue Gardner; Elizabeth Grice; John Harmon; William R Hazzard; Kevin P High; Pamela Houghton; Nasreen Jacobson; Robert S Kirsner; Elizabeth J Kovacs; David Margolis; Frances McFarland Horne; May J Reed; Dennis H Sullivan; Stephen Thom; Marjana Tomic-Canic; Jeremy Walston; Jo Anne Whitney; John Williams; Susan Zieman; Kenneth Schmader Journal: J Am Geriatr Soc Date: 2015-03-06 Impact factor: 5.562
Authors: Lisa Gould; Peter Abadir; Harold Brem; Marissa Carter; Teresa Conner-Kerr; Jeff Davidson; Luisa DiPietro; Vincent Falanga; Caroline Fife; Sue Gardner; Elizabeth Grice; John Harmon; William R Hazzard; Kevin P High; Pamela Houghton; Nasreen Jacobson; Robert S Kirsner; Elizabeth J Kovacs; David Margolis; Frances McFarland Horne; May J Reed; Dennis H Sullivan; Stephen Thom; Marjana Tomic-Canic; Jeremy Walston; JoAnne Whitney; John Williams; Susan Zieman; Kenneth Schmader Journal: Wound Repair Regen Date: 2015-02-13 Impact factor: 3.617