The Difference Between the Healing and the Nonhealing Diabetic Foot Ulcer: A Review of the Role of the Microcirculation
- Resource Type
- Authors
- Parth Narendran; Danielle Lowry; Alok Tiwari; Mujahid Saeed
- Source
- Journal of diabetes science and technology. 11(5)
- Subject
- medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Biomedical Engineering
030209 endocrinology & metabolism
Bioengineering
Disease
030204 cardiovascular system & hematology
Revascularization
Microcirculation
03 medical and health sciences
0302 clinical medicine
Special Section: Technology to Diagnose and Treat Diabetic Foot Wounds, Part 2
Internal medicine
Statistical significance
Diabetes mellitus
Internal Medicine
medicine
Humans
Skin
Wound Healing
business.industry
Foot
medicine.disease
Diabetic foot
Diabetic Foot
Surgery
Diabetic foot ulcer
Cohort
Cardiology
business
- Language
- ISSN
- 1932-2968
Diabetic foot disease carries a high morbidity and is a leading cause of lower limb amputation. This may in part be due to the effect diabetes mellitus (DM) has on the microcirculation including in the skin.We conducted a review of studies that have examined the relationship between microcirculatory function and wound healing in patients with DM. A search of the Medline, Embase, and Web of Science databases was performed coupled with a review of references for the period 1946 to March 2015.Nineteen studies of diverse methodology and cohort selection were identified. Poor function of the microcirculation was related to poor outcome. Transcutaneous oxygen pressure (TcPOWhile it is not possible to draw firm conclusions from the evidence currently available there are clear areas that warrant research. Good microcirculation unsurprisingly appears to associate with better wound healing. The influence of DM is not clear, and neither is the degree of improvement required to achieve healing. Studies that examine a clearly defined cohort both with and without DM are urgently required. Accurate quantitative assessment of microcirculation will aid prediction of wound healing identifying those at greatest risk of amputation.