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Heel ulcers do heal in patients with diabetes

Author:
  • Hedvig Örneholm
  • Jan Apelqvist
  • Jan Larsson
  • Magnus Eneroth
Publishing year: 2017
Language: English
Pages: 629-635
Publication/Series: International Wound Journal
Volume: 14
Issue: 4
Document type: Journal article
Publisher: Wiley-Blackwell

Abstract english

A heel ulcer is considered to be a serious complication in patients with diabetes, and there is limited information regarding outcome. In most of the literature, a poor prognosis is described. The aim of this study was to investigate a large cohort of ulcers located in the heel in patients with diabetes. Seven hundred and sixty-eight patients [median age 73 (17-98)], presenting with a heel ulcer at a multidisciplinary diabetes foot clinic, fulfilled the inclusion criteria and were followed-up until final outcome. Fifty-eight per cent of the patients healed primarily; 7% healed after major debridement; 9% healed after amputation and 25% died unhealed. Median healing time was 17 weeks. Ulcer progression was seen in 19% of patients. Thirty-one percent of patients had severe peripheral vascular disease. A creatinine level below 91 μmol/l was related to a higher probability for healing without major debridement or amputation, whereas vascular surgery, nephropathy and oedema were related to a lower probability for healing without major debridement or amputation. Two thirds of heel ulcers do heal in patients with diabetes despite patients being elderly and with extensive comorbidity. The extent of peripheral vascular disease, nephropathy, oedema and decreased renal function are important factors influencing outcome.

Keywords

  • Endocrinology and Diabetes
  • Diabetes
  • Healing
  • Heel ulcer
  • Outcome

Other

Published
  • Orthopedics - Clinical and Molecular Osteoporosis Research
  • Genomics, Diabetes and Endocrinology
  • ISSN: 1742-4801
E-mail: jan [dot] apelqvist [at] med [dot] lu [dot] se

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