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Recurrent and other new foot ulcers after healed plantar forefoot diabetic ulcer

Author:
  • Hedvig Örneholm
  • Jan Apelqvist
  • Jan Larsson
  • Magnus Eneroth
Publishing year: 2017-03-01
Language: English
Pages: 309-315
Publication/Series: Wound Repair and Regeneration
Volume: 25
Issue: 2
Document type: Journal article
Publisher: Wiley-Blackwell

Abstract english

Diabetic foot ulcer is a serious complication in patients with diabetes. In most outcome studies of this condition, there is a combination of various types of ulcer and ulcer locations. Plantar ulcers are usually localized to the forefoot, and constitute a quarter of all diabetic foot ulcers. There are a limited number of studies regarding development of new ulcers following healing of a plantar forefoot ulcer, and there are no uniform definitions of recurrent and other new ulcers. The aim of this study was to evaluate the outcome of a large cohort of consecutively treated patients with diabetes mellitus and a healed planter forefoot ulcer (n = 617) with regard to development, characteristics, and outcome of recurrent and other new ulcers. Patients were followed consecutively and prospectively with a 2-year follow-up, according to a preset protocol. Out of 617 patients, 250 (41%) did not develop any new ulcer, 262 (42%) developed a new ulcer, 87 (14%) died and 18 (3%) were lost at 2 years following healing of a plantar forefoot ulcer. Thirty-four percent developed other new ulcers (112 on the same foot and 99 on the contralateral foot), whereas 51 patients (8%) developed a recurrent ulcer (at the same site and foot). Of the patients who died within 2 years, 30 patients had developed other new ulcers. The risk of a recurrent ulcer in patients with diabetes and a healed plantar forefoot ulcer was only 8% within 2 years, whereas other new ulcers, on the same foot or on the contralateral foot, was seen in 4 out of 10 patients indicating the need for further preventive measures and surveillance in these patients. We suggest a concise definition for new ulcer to be used in future research.

Keywords

  • Endocrinology and Diabetes

Other

Published
  • Orthopedics - Clinical and Molecular Osteoporosis Research
  • Genomics, Diabetes and Endocrinology
  • ISSN: 1067-1927
E-mail: jan [dot] apelqvist [at] med [dot] lu [dot] se

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