{"title":"Factors associated with the recurrence of foot ulcers in Japanese patients with diabetes.","authors":"Kou Ino, Yuji Tajiri, Hisashi Migita, Keigo Morinaga, Hideaki Rikimaru, Kensuke Kiyokawa","doi":"10.1007/s13340-024-00768-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Patients with diabetes are frequently complicated with diabetic foot ulcers (DFUs) which are vulnerable to recurrence after healing. We retrospectively surveyed the recurrence of foot ulcer and related factors in Japanese patients with DFUs.</p><p><strong>Subjects and methods: </strong>Forty-two feet of 39 patients were initially recruited in this study. During the follow-up period, the recurrence of foot ulcers was observed in nine feet. Peak planter pressure (PPP) distribution on the affected side was measured at three pressure levels. Photographs of the plantar scar were superimposed on the high-pressure plantar area, and the concordance of both lesions was counted.</p><p><strong>Results: </strong>The recurrence of foot ulcer was significantly related to higher body weight, a history of discontinued or unused insole, the existence of scar at the sole concomitant with load, and longer observation period. The existence of scar was further selected as a significant predictive variable in multiple logistic regression analysis. Furthermore, the recurrence rate significantly increased in parallel with the increment of the concordance rate at 250 kPa or more level of pressure (<i>P</i> = 0.0199, odds ratio = 22.054).</p><p><strong>Conclusions: </strong>For the prevention of the recurrence of foot ulcers, education on the continuous use of insole and adequate treatments of scar at the sole, concomitant with load especially in patients with higher body weight and longer observation period, is required. It is plausible that the concordance of PPP and scar lesions properly predicts the recurrences of foot ulcers, which may help to avoid unnecessary amputations in the future in Japanese patients with diabetes.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"16 1","pages":"100-106"},"PeriodicalIF":1.3000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769888/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13340-024-00768-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: Patients with diabetes are frequently complicated with diabetic foot ulcers (DFUs) which are vulnerable to recurrence after healing. We retrospectively surveyed the recurrence of foot ulcer and related factors in Japanese patients with DFUs.
Subjects and methods: Forty-two feet of 39 patients were initially recruited in this study. During the follow-up period, the recurrence of foot ulcers was observed in nine feet. Peak planter pressure (PPP) distribution on the affected side was measured at three pressure levels. Photographs of the plantar scar were superimposed on the high-pressure plantar area, and the concordance of both lesions was counted.
Results: The recurrence of foot ulcer was significantly related to higher body weight, a history of discontinued or unused insole, the existence of scar at the sole concomitant with load, and longer observation period. The existence of scar was further selected as a significant predictive variable in multiple logistic regression analysis. Furthermore, the recurrence rate significantly increased in parallel with the increment of the concordance rate at 250 kPa or more level of pressure (P = 0.0199, odds ratio = 22.054).
Conclusions: For the prevention of the recurrence of foot ulcers, education on the continuous use of insole and adequate treatments of scar at the sole, concomitant with load especially in patients with higher body weight and longer observation period, is required. It is plausible that the concordance of PPP and scar lesions properly predicts the recurrences of foot ulcers, which may help to avoid unnecessary amputations in the future in Japanese patients with diabetes.
期刊介绍:
Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.