跖下脂肪垫增强治疗和预防糖尿病相关足溃疡的系统综述。

IF 2.2 3区 医学 Q1 ORTHOPEDICS
Christopher Ashmore, Jagdeep Virdee, Peter Culmer, Jennifer Edwards, Heidi Siddle, James Warren, David Russell
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引用次数: 0

摘要

背景:糖尿病相关性足部溃疡(DFU)是发病率和卫生服务经济负担的重要和日益增加的原因。手术卸载在预防和治疗DFU方面显示出巨大的效果。本综述的目的是评估跖下足底脂肪垫调节在预防DFU方面的有效性,并描述用于此目的的不同生物材料的特征。方法:本研究在PROSPERO上注册。对PubMed、CINAHL和Cochrane生物医学数据库进行检索策略。任何探讨调节足底跖下脂肪垫预防或治疗成人DFU的研究都被纳入。干预后的主要结果是溃疡的发生。结果:在检索到的3162项研究中,10项研究符合纳入标准,描述了76名参与者的112个溃疡或溃疡前期区域的结果。四项研究报告了55名参与者注射液体硅酮的结果,四项研究报告了8名参与者使用脱细胞异体移植物,两项研究报告了11名参与者的自体脂肪移植,一项研究报告了两名参与者使用注射胶原蛋白的结果。只有一项随机对照试验被确定,其余研究为观察性、病例系列或病例报告。在平均32.4个月的随访中,溃疡的总发生率为27/112。讨论:虽然足底脂肪垫调节作为DFU的手术卸载策略有希望,但缺乏高质量的试验数据妨碍了对其优点的有意义的解释。用于调节的生物材料的异质性使情况进一步复杂化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A Systematic Review of Submetatarsal Fat Pad Augmentation for the Treatment and Prevention of Diabetes-Related Foot Ulceration.

A Systematic Review of Submetatarsal Fat Pad Augmentation for the Treatment and Prevention of Diabetes-Related Foot Ulceration.

A Systematic Review of Submetatarsal Fat Pad Augmentation for the Treatment and Prevention of Diabetes-Related Foot Ulceration.

A Systematic Review of Submetatarsal Fat Pad Augmentation for the Treatment and Prevention of Diabetes-Related Foot Ulceration.

Background: Diabetes-related foot ulceration (DFU) represents a significant and increasing cause of morbidity and economic burden to health services. Surgical offloading has shown great effectiveness in the prevention and healing of DFU. The objective of this review is to assess the effectiveness of submetatarsal plantar fat pad modulation in preventing DFU and to characterise the different biomaterials used to this end.

Methods: The study was registered on PROSPERO. A search strategy of the PubMed, CINAHL and Cochrane biomedical databases was conducted. Any study which explored the modulation of the plantar submetatarsal fat pad for the prevention or treatment of DFU in adults was included. The main outcome was the occurrence of ulceration following intervention.

Results: Of the 3162 retrieved studies, 10 studies met inclusion criteria, describing outcomes for 76 participants with 112 ulcers or pre-ulcerative areas. Four studies report results of injectable liquid silicone in 55 participants, four studies included the use of an acellular allograft in eight participants, two studies included autolipotransplantation in 11 participants and one study reports on the use of injectable collagen in two participants. Only one randomised control trial was identified while the remainder of the studies were observational, case-series, or case-reports. The overall ulcer occurrence was 27/112 over an average follow-up of 32.4 months.

Discussion: While plantar fat pad modulation shows promise as a surgical offloading strategy for DFU, insufficient high-quality trial data preclude meaningful interpretation of its merits. This is further complicated by heterogeneity in the biomaterial employed for modulation.

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来源期刊
CiteScore
4.50
自引率
10.30%
发文量
83
审稿时长
>12 weeks
期刊介绍: Journal of Foot and Ankle Research, the official journal of the Australian Podiatry Association and The College of Podiatry (UK), is an open access journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. Journal of Foot and Ankle Research covers a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submissions from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. The Australian Podiatry Association and the College of Podiatry (UK) have reserve funds to cover the article-processing charge for manuscripts submitted by its members. Society members can email the appropriate contact at Australian Podiatry Association or The College of Podiatry to obtain the corresponding code to enter on submission.
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