Evidence map›Paper›PMID 32639434›Full record

ArticlePlastic and reconstructive surgery2020

Outcomes and Predictors of Wound Healing among Patients with Complex Diabetic Foot Wounds Treated with a Dermal Regeneration Template (Integra).

Caitlin W Hicks, George Q Zhang, Joseph K Canner, Nestoras Mathioudakis, Devin Coon, Ronald L Sherman, Christopher J Abularrage

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Plastic and reconstructive surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
2.0field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 28 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
  9. Article
  10. Use of Biologic Agents in Extremity Reconstruction.Seminars in plastic surgery · 2022
    Review
  11. Review
  12. Review
  13. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Caitlin W HicksFrom the Diabetic Foot and Wound Service, Division of Vascular Surgery and Endovascular Therapy and the Center for Surgical Trials and Outcomes Research, Department of Surgery, the Division of Endocrinology and Metabolism, Department of Medicine, and the Department of Plastic Surgery, The Johns Hopkins Hospital; and The Johns Hopkins University School of Medicine.
George Q ZhangFrom the Diabetic Foot and Wound Service, Division of Vascular Surgery and Endovascular Therapy and the Center for Surgical Trials and Outcomes Research, Department of Surgery, the Division of Endocrinology and Metabolism, Department of Medicine, and the Department of Plastic Surgery, The Johns Hopkins Hospital; and The Johns Hopkins University School of Medicine.
Joseph K CannerFrom the Diabetic Foot and Wound Service, Division of Vascular Surgery and Endovascular Therapy and the Center for Surgical Trials and Outcomes Research, Department of Surgery, the Division of Endocrinology and Metabolism, Department of Medicine, and the Department of Plastic Surgery, The Johns Hopkins Hospital; and The Johns Hopkins University School of Medicine.
Nestoras MathioudakisFrom the Diabetic Foot and Wound Service, Division of Vascular Surgery and Endovascular Therapy and the Center for Surgical Trials and Outcomes Research, Department of Surgery, the Division of Endocrinology and Metabolism, Department of Medicine, and the Department of Plastic Surgery, The Johns Hopkins Hospital; and The Johns Hopkins University School of Medicine.
Devin CoonFrom the Diabetic Foot and Wound Service, Division of Vascular Surgery and Endovascular Therapy and the Center for Surgical Trials and Outcomes Research, Department of Surgery, the Division of Endocrinology and Metabolism, Department of Medicine, and the Department of Plastic Surgery, The Johns Hopkins Hospital; and The Johns Hopkins University School of Medicine.
Ronald L ShermanFrom the Diabetic Foot and Wound Service, Division of Vascular Surgery and Endovascular Therapy and the Center for Surgical Trials and Outcomes Research, Department of Surgery, the Division of Endocrinology and Metabolism, Department of Medicine, and the Department of Plastic Surgery, The Johns Hopkins Hospital; and The Johns Hopkins University School of Medicine.
Christopher J AbularrageFrom the Diabetic Foot and Wound Service, Division of Vascular Surgery and Endovascular Therapy and the Center for Surgical Trials and Outcomes Research, Department of Surgery, the Division of Endocrinology and Metabolism, Department of Medicine, and the Department of Plastic Surgery, The Johns Hopkins Hospital; and The Johns Hopkins University School of Medicine.
Johns Hopkins University · USJohns Hopkins Medicine · US

Funding

Risk Factors and Outcomes Associated with Late-Life Diabetic Peripheral NeuropathyK23DK124515 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HICKS, CAITLIN WHITNEY · 2020 to 2024
$898k
NIDDK NIH HHS K23 DK124515
6 · The paper itself

Abstract

backgroundThe utility of dermal regeneration templates for treating high-risk diabetic foot wounds is unclear. The authors report wound healing and major amputation outcomes among a cohort of diabetic patients with complex diabetic foot wounds treated in a multidisciplinary setting.

methodsAll patients with complex diabetic foot wounds treated with a dermal regeneration template (March of 2013 to February of 2019) were captured in a prospective institutional database. Wound severity was classified according to the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system to determine limb salvage prognosis at baseline. Wound healing and major amputation rates were reported using Kaplan-Meier analyses. A stepwise Cox proportional hazards model was used to identify independent characteristics associated with wound healing.

resultsEighty-five patients with 107 complex diabetic foot wounds were treated (mean age, 61.2 ± 3.3 years; 63.5 percent male and 61.2 percent African American). Most diabetic foot wounds were high-risk (wound, ischemia, and foot infection stage 3 or 4, 93.5 percent), corresponding to a predicted 25 to 50 percent risk of major amputation at 1 year. Dermal regeneration template use resulted in successful wound granulation in 66.7 percent of cases, with a mean time to complete wound healing of 198 ± 18 days. Twelve- and 18-month wound healing rates were 79.0 ± 5.0 percent and 93.0 ± 3.3 percent, respectively. Major amputation was required in 11.2 percent of patients. Independent predictors of poor wound healing included lack of bone involvement, higher WIfI stage, and prior dermal regeneration template failure.

conclusionApplication of a dermal regeneration template to complex diabetic foot wounds at high risk for major amputation results in good wound healing and excellent limb salvage outcomes among diabetic patients treated in a multidisciplinary setting. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Indexed as

Tissue ScaffoldsWound HealingAmputation, SurgicalDiabetic FootFemaleForecastingHumansMaleMiddle AgedProspective StudiesSkin Physiological PhenomenaTreatment Outcome

Identifiers

PMID32639434
PMCPMC7718978
OpenAlexW3041399043

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.