Infrared thermography and ulcer prevention in the high-risk diabetic foot: data from a single-blind multicentre controlled clinical trial
| Autor: | Peter Plassmann, Nina L. Petrova, Nicholas K. Donaldson, R Simpson, A MacDonald, Graham Machin, A. Whittam, Ana Nora Donaldson, S Ainarkar, C Lomas, Ben Kluwe, John F. Allen, J Bevans, Leon Rogers, Michael Edmonds, Wegin Tang, Francis Ring, Nicola Leech, J L McMillan |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Diabetes mellitus Internal Medicine medicine Humans Single-Blind Method 030212 general & internal medicine Aged business.industry Hazard ratio Odds ratio Middle Aged medicine.disease Diabetic foot Diabetic Foot United Kingdom Clinical trial Diabetic foot ulcer Treatment Outcome Thermography Cohort Female business Foot (unit) |
| Zdroj: | Diabetic medicine : a journal of the British Diabetic AssociationReferences. 37(1) |
| ISSN: | 1464-5491 |
| Popis: | Aim: To assess the usefulness of monthly thermography and standard foot care to reduce diabetic foot ulcer recurrence. Methods: People with diabetes (n = 110), neuropathy and history of ≥ 1 foot ulcer participated in a single-blind multicentre clinical trial. Feet were imaged with a novel thermal imaging device (Diabetic Foot Ulcer Prevention System). Participants were randomized to intervention (active thermography + standard foot care) or control (blinded thermography + standard foot care) and were followed up monthly until ulcer recurrence or for 12 months. Foot thermograms of participants from the intervention group were assessed for hot spots (areas with temperature ≥ 2.2°C higher than the corresponding contralateral site) and acted upon as per local standards. Results: After 12 months, 62% of participants were ulcer-free in the intervention group and 56% in the control group. The odds ratios of ulcer recurrence (intervention vs control) were 0.82 (95% CI 0.38, 1.8; P = 0.62) and 0.55 (95% CI 0.21, 1.4; P = 0.22) in univariate and multivariate logistic regression analyses, respectively. The hazard ratios for the time to ulcer recurrence (intervention vs control) were 0.84 (95% CI 0.45, 1.6; P = 0.58) and 0.67 (95% CI 0.34, 1.3; P = 0.24) in univariate and multivariate Cox regression analyses, respectively. Conclusions: Monthly intervention with thermal imaging did not result in a significant reduction in ulcer recurrence rate or increased ulcer-free survival in this cohort at high risk of foot ulcers. This trial has, however, informed the design of a refined study with longer follow-up and group stratification, further aiming to assess the efficacy of thermography to reduce ulcer recurrence. |
| Databáze: | OpenAIRE |
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