{"title":"A Simple Guide to Systematic Reviews and Meta-Analyses.","authors":"Chrysanthi Mantsiou, Aris Liakos, Maria Mainou, Nikolaos Papanas, Apostolos Tsapas, Eleni Bekiari","doi":"10.1177/15347346231169842","DOIUrl":"10.1177/15347346231169842","url":null,"abstract":"<p><p>Systematic reviews and meta-analyses lie on the top of the evidence hierarchy because they utilize explicit methods for literature search and retrieval of studies relevant to the review question as well as robust methodology for quality assessment of included studies and quantitative synthesis of results. As opposed to narrative reviews which represent the authors' personal judgments, they may be more resource-intensive, but provide an unbiased answer to a specific clinical query. Clinical guidelines are usually supported by such evidence syntheses. Therefore, it is important that healthcare practitioners become competent in understanding and applying systematic review findings. This simple guide outlines the key principles regarding the design, conduct and interpretation of systematic reviews and meta-analyses.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"894-899"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9394465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohsen Agharazi, Sasan Gazerani, Mark Kenneth Huntington
{"title":"Topical Turmeric Ointment in the Treatment of Diabetic Foot Ulcers: A Randomized, Placebo-Controlled Study.","authors":"Mohsen Agharazi, Sasan Gazerani, Mark Kenneth Huntington","doi":"10.1177/15347346221143222","DOIUrl":"10.1177/15347346221143222","url":null,"abstract":"<p><p>Diabetic foot is a serious complication of diabetes which has significant medical and socioeconomic impacts. Turmeric is a popular Indian spice that has been used for centuries in herbal medicines for the treatment of a variety of ailments such as rheumatism, diabetic ulcers, anorexia, cough and sinusitis. Curcumin is the main ingredient presents in turmeric and responsible for its yellow color. We report here a randomized, placebo-controlled investigation into the effectiveness of topical turmeric ointment in the treatment of diabetic foot ulcers. Seventy-six patients enrolled in the study. They were randomly divided into two groups, one of which received topical turmeric ointment and the other received placebo. Preparations were applied twice daily after irrigation of the wound by normal saline and dressed. Image analysis software was used to evaluate photographs of the ulcers and quantify the difference between treatment and placebo groups. Topical turmeric ointment demonstrated statistically significant reduction (<i>p</i> < .001) in the size of diabetic ulcers at five weeks compared to placebo, independently of fasting blood sugar and HbA1C levels. Turmeric ointment may be an effective treatment for diabetic foot ulcers.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1063-1067"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10337274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Effect of Amnion Cell Culture Medium on Wound Healing: An Experimental Animal Study.","authors":"Tayfun Bilgic","doi":"10.1177/15347346231174342","DOIUrl":"10.1177/15347346231174342","url":null,"abstract":"<p><p>Background/objectiveFetal wound repair seems a relatively efficient process when compared to wound repair during adulthood, which may be explained by the effects of the fetal environment. This study examined the effects of an amnion cell culture medium (ACCM) on skin wound healing in a rat experimental model.MethodsSixteen adult female Wistar albino rats were used in this experimental animal study (treatment group, n = 8; control group, n = 8). Surgical wounds were formed on the dorsal skin of each rat. A commercially available ACCM was administered daily over each of the wound in the treatment group for 14 days and the control group did not receive any treatment. Wounds were evaluated for tissue perfusion with laser doppler, tissue superoxide dismutase (SOD), glutathione peroxidase (GPX), and malondialdehyde (MDA) levels as well as histopathological examination.ResultsControls had significantly higher tissue SOD levels when compared to the treatment group (10.0 ± 3.2 vs 6.7 ± 1.2, <i>P</i> = .005); however, the 2 groups did not differ in terms of tissue GPX and MDA levels. For open wounds, inflammation and neovascularization were more prominent in the ACCM group at day 14. However, at day 21 neovascularization and granulation were more prominent in controls. For closed wounds, neovascularization was more prominent in controls at days 14 and 21. The 2 groups did not differ in terms of tissue perfusion.ConclusionAlthough marginal difference was found between controls and ACCM group for several parameters, findings of this study do not support beneficial effect of ACCM on wound healing.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1173-1178"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9424699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kamil İnce, Savaş Güner, Ayşegül Büyükbebeci, Nursima İnce
{"title":"Are Thiol/Disulfide and 8-OHdG Levels in the Blood of Patients with Diabetic Foot a Risk Factor for Amputation?","authors":"Kamil İnce, Savaş Güner, Ayşegül Büyükbebeci, Nursima İnce","doi":"10.1177/15347346231177858","DOIUrl":"10.1177/15347346231177858","url":null,"abstract":"<p><p>ObjectiveAs diabetic patients live longer and there are more effective treatments available, the incidence of diabetes and its complications is increasing. The effects of oxidative stress and antioxidant processes on diabetes behavior, especially diabetic foot, are really direct. The goal of this research is to investigate the effects of oxidative stress and antioxidant mechanism on the outcome of amputation by examining the levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and thiol/disulfide in the blood of patients diagnosed with diabetic foot.MethodsThe research consisted of 76 patients with type 2 diabetes with associated diabetic foot, ages 40-65 (51 men, 25 women). Patients with diabetic foot wounds and accompanying peripheral artery disease were not included in the study. After a mean follow-up of 9.6 months, 28 patients resulted in amputation. Between patients who required amputation and those who did not, the levels of 8-OHdG, native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, and disulfide/total thiol ratio were compared. Additionally, the age, sex, Wagner stage, and amputation outcome of these 2 patient groups were compared.ResultsThe outcomes of amputation in diabetic foot patients were not related to the levels of native thiol, total thiol, disulfide, native thiol/total thiol ratio, disulfide/native thiol ratio, total thiol/disulfide ratio, or 8-OHdG (<i>P</i> > .05). However, patients with diabetic foot who were male, older, and at a more advanced Wagner stage had a higher rate of amputations (<i>P</i> < .05).ConclusionOxidative stress and antioxidant mechanism are effective on diabetes complications. However, since there are many factors affecting the outcome of amputation, they are not directly effective in terms of resulting amputation in patients with diabetic foot ulcer.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1217-1222"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Musab Yousef Al Ayed, Anas Ababneh, Asirvatham Alwin Robert, Rania Ahmed, Ibrahim Al Ghofaili, Abdulghani Al Saeed, Mohamed Abdulaziz Al Dawish
{"title":"Factors Associated With Self-Efficacy of Foot Self-Care Among Patients With Diabetes Attending a Tertiary Care Center in Saudi Arabia.","authors":"Musab Yousef Al Ayed, Anas Ababneh, Asirvatham Alwin Robert, Rania Ahmed, Ibrahim Al Ghofaili, Abdulghani Al Saeed, Mohamed Abdulaziz Al Dawish","doi":"10.1177/15347346221148820","DOIUrl":"10.1177/15347346221148820","url":null,"abstract":"<p><p>Several reports have shown self-efficacy to be a reliable way of predicting foot self-care behavior in patients with diabetes. However, at a global level in general, and in Saudi Arabia in particular, investigation of the factors related to self-efficacy in executing foot self-care continues to remain inadequate. This study endeavors to identify the factors associated with the self-efficacy of foot self-care among patients with diabetes in Saudi Arabia. From a tertiary diabetes care center in Saudi Arabia, 175 patients with diabetes were selected to participate in this cross-sectional study. Employing the Arabic version of the Foot Care Confidence Scale (FCCS), the principal end results and the sociodemographic, clinical, and psychosocial independent variables were collected and assessed. From the total reported FCCS score, the mean was found to be 28.1 ± 8.2. Multiple linear regression analysis indicated 2 independent factors were positively associated with a higher reported FCCS score; being middle-aged (< 60 years old) (β=0.31, <i>P</i>< .01) and having a higher score on the Foot Care Outcome Expectations Scale (FCOES) (β=0.36, <i>P</i>< .01). In conclusion, patients with diabetes in Saudi Arabia have a mild level of self-efficacy to perform the needed foot self-care. Therefore, this has turned the spotlight on the young or middle-aged < 60-year-old Saudi population with diabetes as the target group, making them the priority for future self-efficacy promotion programs to upgrade the level of foot self-care.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1086-1093"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10842774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Safak Ozer Balin, Mehmet Ali Aşan, Erhan Cahit Ozcan, Kader Uğur, Arzu Şenol
{"title":"The Course of Diabetic Foot Infection in Elderly Patients: Data of Patients From Turkey.","authors":"Safak Ozer Balin, Mehmet Ali Aşan, Erhan Cahit Ozcan, Kader Uğur, Arzu Şenol","doi":"10.1177/15347346231155584","DOIUrl":"10.1177/15347346231155584","url":null,"abstract":"<p><p>With the aging population, it is expected that diabetes and related complications will increase rapidly. The aim of this study was to examine the signs and symptoms of diabetic foot infection in elderly individuals. Patients with diabetic foot infection were grouped as mild, moderate, and severe. Patients aged <65 years and those who did not meet the diagnosis of diabetic foot infection were excluded from the study. Only the first applications of patients who applied to the hospital multiple times with diabetic foot infection diagnosis were evaluated. 314 patients were included in the study. The mean age of the patients was 71.5 (±12). The number of patients aged 75 and over was 125 (39.8%). Of the patients, 25.7% had mild, 61.7% moderate, and 12.4% severe clinical forms. 131 (41.7%) of the patients had osteomyelitis. Amputation was performed in 112 of the patients. Antibiotic treatment was given to 102 patients only. While 89 patients died, a significant correlation was found between all groups between amputation rate and mortality frequency and clinical severity of diabetic foot infection (<i>P</i> < .001). In our study, it was observed that the clinical severity of diabetic foot infection was more severe and the overall mortality rate was higher in geriatric patients. In light of all these data, it can be concluded that an early and comprehensive roadmap should be followed in geriatric patients with diabetic foot infection who have an increased risk of morbidity and mortality.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"1114-1118"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10658190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamed Elsharkawi, Baker Ghoneim, Miriam O'Sullivan, Aoife J Lowery, Daniel Westby, Wael Tawfick, Stewart R Walsh
{"title":"Role of Adipose Derived Stem Cells in Patients with Diabetic Foot Ulcers: Systematic Review and Meta-Analysis of Randomised Controlled Trials.","authors":"Mohamed Elsharkawi, Baker Ghoneim, Miriam O'Sullivan, Aoife J Lowery, Daniel Westby, Wael Tawfick, Stewart R Walsh","doi":"10.1177/15347346231174554","DOIUrl":"10.1177/15347346231174554","url":null,"abstract":"<p><p>Few studies to date have investigated the role of adipose derived stem cells (ADSCs) in patients with diabetic foot ulcers (DFU). We aimed to conduct a systematic search of the literature to explore the available evidence behind ADSCs application in patients with DFU to establish if it has any added benefit regarding healing rate and healing time in this cohort of patients. The PubMed and Embase databases were searched for eligible studies. Only randomised controlled trials which investigated the impact of ADSCs alone on the healing of DFU were considered eligible and were included for the review. Reported healing rates, time to healing and procedure related complications were collected and analysed. The initial search resulted in 160 papers. Following duplicate removal, 131 papers were screened for eligibility. Only four trials met the study criteria and were included for the final review and analysis. 97 out of 189 patients who were included in the four studies received ADSCs for treatment of DFU whereas the remaining 92 patients received standard measures (control). The median participant age was 62, predominantly male (72.5%). Complete healing was achieved in 83.5% (n = 81) of patients in the ADSC group compared to 52% (n = 48) for patients in the control group at 12 months (OR = 4.8, 95%CI = 2.25 to 10.24, P < 0.0001). Mean healing time in the ADSC group ranged from 31 to 85 days whereas mean healing time in the control group ranged from 42 to 85 days (Pooled weighted mean difference = -10.832856, 95%CI = -22.44 to 0.77, P = 0.0673). No significant procedure related complications were reported in either group. The use of ADSCs in patients with DFU appears to demonstrate improved healing rates. The procedure of ADSC harvest and administration appears to be safe based on the initial reports. Large, randomised trials are needed to establish its role in patients with diabetic foot wounds.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"542-549"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9501417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miltos K Lazarides, Irene-Zacharo Lazaridou, Nikolaos Papanas
{"title":"Bibliometric Analysis: Bridging Informatics With Science.","authors":"Miltos K Lazarides, Irene-Zacharo Lazaridou, Nikolaos Papanas","doi":"10.1177/15347346231153538","DOIUrl":"10.1177/15347346231153538","url":null,"abstract":"<p><p>Bibliometric analysis represents a new tool for classifying and quantitatively assessing bibliographic material (publications, citations, authors, institutions, etc) of a scientific discipline. Is a computer-assisted review and, therefore, it should follow the methodology of a systematic review. These analyses download bibliographic data from electronic databases analyzing them and extracting several indicators (such as the h-index). Analysis can be enhanced by adding scientific maps using specific software. These analyses are increasingly accepted in the medical literature to identify the most influential papers/authors/institutions on a given topic. During the last decade, there is a remarkable increase in the number of published bibliometric analysis articles.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"515-517"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10626040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Role of Nutrients and Diet Characteristics in the Management of Diabetic Foot Ulcers: A Systematic Review.","authors":"Kyriaki Apergi, Charilaos Dimosthenopoulos, Nikolaos Papanas","doi":"10.1177/15347346231153531","DOIUrl":"10.1177/15347346231153531","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFUs) are common complications of diabetes mellitus that affect patients' quality of life and pose a burden on the healthcare system. Although malnutrition and specific nutritional deficiencies can seriously impact wound healing in patients with chronic nonhealing wounds, the role of nutrition in the prevention and management of DFUs is still not clear. This review discusses the significance of frequent diet assessment and nutritional education of patients with DFUs with individualized correction of deficiencies and emphasis on adequate protein intake along with correction of vitamins D, C, E, and selenium status. Future research should clarify the impact of nutritional interventions, potentially involving the use of probiotics, zinc, and omega-3 fatty acids, and successfully translating the findings into practical guidelines for use in everyday clinical practice.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"525-541"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9195150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saurabh Kumar Gupta, Ashu Rastogi, Manmeet Kaur, Sunita Malhotra, P V M Lakshmi
{"title":"Foot Self-Care Behaviour among People with Type 2 Diabetes mellitus Living in Rural Underserved Area of North India: A Community-Based Cross-Sectional Study.","authors":"Saurabh Kumar Gupta, Ashu Rastogi, Manmeet Kaur, Sunita Malhotra, P V M Lakshmi","doi":"10.1177/15347346221110074","DOIUrl":"10.1177/15347346221110074","url":null,"abstract":"<p><p>The objective of this study was to ascertain the foot self-care behaviour and its associated factors among people with type 2 diabetes mellitus (T2DM) living in the rural resource-constrained health setting of Punjab, North India. A community based cross sectional study was undertaken in the randomly selected underserved rural area of District Fatehgarh Sahib, Punjab, North India. A pre-validated Nottingham Assessment of Functional Footcare (NAFF) scale was administered to assess foot self-care behaviour, and participants were classified based on the percentage of a maximum possible score of 84 on the scale, as poor, if the score was <50%, satisfactory if score 50%-70% and >70% good foot self-care behaviour. A total of 700 participants' responses were recorded. The study results revealed that 84% (588) of the respondents had poor, 16% (112) had satisfactory, and none were following good foot self-care behaviour. An outcome of multivariable logistics regression suggested satisfactory foot self-care behaviour was significantly associated with foot self-care education, with an adjusted odds ratio (aOR) of 2.83 (95%, CI:1.62 - 4.93; <i>p</i> <0.01) among respondents who had received foot self-care education, literate than illiterate (aOR 2.50 95%, CI:1.31- 4.74; <i>p</i> <0.01) and women compared to men (aOR 1.69 95%, CI: 1.06 -2.70; <i>p</i> -0.26). This study revealed that foot self-care behaviours were alarmingly low among people with T2DM living in rural resource-constrained health settings of Punjab, North India, suggesting an urgent need to disseminate foot self-care education to prevent diabetes foot related complications.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"678-690"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}