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The importance of peripheral pulses, peripheral oedema and local pain for the outcome of diabetic foot ulcers

Author:
  • Jan Apelqvist
  • J Larsson
  • Carl-David Agardh
Publishing year: 1990
Language: English
Pages: 590-594
Publication/Series: Diabetic Medicine
Volume: 7
Issue: 7
Document type: Journal article
Publisher: Wiley-Blackwell

Abstract english

In a prospective study, peripheral pulses, claudication, peripheral oedema, and rest pain were evaluated in 314 sequentially presenting diabetic patients with foot ulcers. In the ulcerated limb pedal pulses were found to be present in 44% of the patients, peripheral oedema in 38%, and rest pain in 19%. Twelve per cent had claudication. Presence of pedal pulses was more common in patients whose ulcers underwent primary healing (56%) than in those who healed after amputation (23%) or died (25%, p less than 0.001). Eighty per cent of the patients with pedal pulses present underwent primary healing. However, 49% of patients with absence of pedal pulses also underwent primary healing and 12 patients developed gangrene despite presence of pedal pulses. Peripheral oedema was more common in patients who required amputation (58%) or died (55%) than in patients with primary healing (26%, p less than 0.001). A tentative predisposing factor was identified in 95% of the patients, the most common factors being neuropathy, congestive heart failure, and previous deep venous thrombosis. Rest pain was more common in patients who required amputation (48%) or died (23%) than in those with primary healing (7%; p less than 0.001). Only 50% of patients with gangrene had rest pain and of these patients, only one underwent primary healing. The presence of pedal pulses, oedema, and rest pain give valuable but imperfect information on the possible primary healing of foot ulcers in diabetic patients.

Keywords

  • Endocrinology and Diabetes

Other

Published
  • Genomics, Diabetes and Endocrinology
  • ISSN: 1464-5491
E-mail: jan [dot] apelqvist [at] med [dot] lu [dot] se

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