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The Superiority of Removable Contact Splints in the Healing of Diabetic Foot during Postoperative Care
Joint Authors
Fejfarová, Vladimíra
Bém, Robert
Dubský, Michal
Wosková, Veronika
Jirkovská, Alexandra
Němcová, Andrea
Lánská, Věra
Pavlů, Jaroslav
Sixta, Bedřich
Sutoris, Karol
Thieme, Filip
Vrátná, Eliška
Hazdrová, Jitka
Armstrong, David G.
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-09-15
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Objective.
Off-loading is one of the crucial components of diabetic foot (DF) therapy.
However, there remains a paucity of studies on the most suitable off-loading for DF patients under postoperative care.
The aim of our study was to evaluate the effect of different protective off-loading devices on healing and postoperative complications in DF patients following limb preservation surgery.
Methods.
This observational study comprised 127 DF patients.
All enrolled patients had undergone foot surgery and were off-loaded empirically as follows: wheelchair+removable contact splint (RCS) (group R: 29.2%), wheelchair only (group W: 48%), and wheelchair+removable prefabricated device (group WP: 22.8%).
We compared the primary (e.g., the number of healed patients, healing time, and duration of antibiotic (ATB) therapy) and secondary outcomes (e.g., number of reamputations and number and duration of rehospitalizations) with regard to the operation regions across all study groups.
Results.
The lowest number of postoperative complications (number of reamputations: p=0.028; rehospitalizations: p=0.0085; and major amputations: p=0.02) was in group R compared to groups W and WP.
There was a strong trend toward a higher percentage of healed patients (78.4% vs.
55.7% and 65.5%; p=0.068) over a shorter duration (13.7 vs.
16.5 and 20.3 weeks; p=0.055) in the R group, as well.
Furthermore, our subanalysis revealed better primary outcomes in patients operated in the midfoot and better secondary outcomes in patients after forefoot surgery—odds ratios favouring the R group included healing at 2.5 (95% CI, 1.04-6.15; p=0.037), reamputations at 0.32 (95% CI, 0.12-0.84; p=0.018), and rehospitalizations at 0.22 (95% CI, 0.08-0.58; p=0.0013).
Conclusions.
This observational study suggests that removable contact splint combined with a wheelchair is better than a wheelchair with or without removable off-loading device for accelerating wound healing after surgical procedures; it also minimises overall postoperative complications, reducing the number of reamputations by up to 77% and the number of rehospitalizations by up to 66%.
American Psychological Association (APA)
Fejfarová, Vladimíra& Pavlů, Jaroslav& Bém, Robert& Wosková, Veronika& Dubský, Michal& Němcová, Andrea…[et al.]. 2019. The Superiority of Removable Contact Splints in the Healing of Diabetic Foot during Postoperative Care. Journal of Diabetes Research،Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1173084
Modern Language Association (MLA)
Fejfarová, Vladimíra…[et al.]. The Superiority of Removable Contact Splints in the Healing of Diabetic Foot during Postoperative Care. Journal of Diabetes Research No. 2019 (2019), pp.1-10.
https://search.emarefa.net/detail/BIM-1173084
American Medical Association (AMA)
Fejfarová, Vladimíra& Pavlů, Jaroslav& Bém, Robert& Wosková, Veronika& Dubský, Michal& Němcová, Andrea…[et al.]. The Superiority of Removable Contact Splints in the Healing of Diabetic Foot during Postoperative Care. Journal of Diabetes Research. 2019. Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1173084
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1173084