- Title
- Do toe blood pressures predict healing after minor lower limb amputation in people with diabetes? A systematic review and meta-analysis
- Creator
- Linton, Clare; Searle, Angela; Hawke, Fiona; Tehan, Peta Ellen; Sebastian, Mathew; Chuter, Vivienne
- Relation
- Diabetes and Vascular Disease Research Vol. 17, Issue 3
- Publisher Link
- http://dx.doi.org/10.1177/1479164120928868
- Publisher
- Sage Publications
- Resource Type
- journal article
- Date
- 2020
- Description
- Purpose of study: To investigate toe systolic blood pressure and/or toe-brachial pressure index in predicting healing post minor diabetic foot amputations. Key methods: A systematic search of EMBASE and PubMed (including Medline and The Cochrane Library) was conducted from database inception to 9 March 2020. Two authors independently reviewed and selected relevant studies. Quality was assessed with a modified Critical Appraisal Skill Programme checklist. Main results: Ten studies met the inclusion criteria. Nine studies investigating toe systolic blood pressure reported healing occurred at mean toe systolic blood pressure values ⩾30 mmHg, ranging between 30 and 83.6 mmHg. The meta-analysis (four studies) found toe systolic blood pressure <30 mmHg had 2.09 times the relative risk of non-healing post amputation, compared to toe systolic blood pressure ⩾30 mmHg (relative risk = 2.09, 95% confidence interval: 1.37–3.20, p = 0.001). Two studies investigating toe-brachial pressure index report successful healing where toe-brachial pressure index >0.2, with one study reporting a higher value of 0.8. Main conclusions: Successful post-amputation healing outcomes were reported at mean toe systolic blood pressure ⩾30 mmHg, and the results varied considerably between the studies. Further research should identify whether variables, including amputation level, method of wound closure and length of post-operative follow-up periods, affect the values of toe systolic blood pressure and toe-brachial pressure index observed in this review.
- Subject
- diabetes; amputation; foot; healing; toe systolic blood pressure; toe-brachial pressure index; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1421508
- Identifier
- uon:37741
- Identifier
- ISSN:1479-1641
- Rights
- Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
- Language
- eng
- Full Text
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