Evidence map›Paper›PMID 38489054›Full record

SynthesisActa diabetologica2024

Offloading systems for the treatment of neuropathic foot ulcers in patients with diabetes mellitus: a meta-analysis of randomized controlled trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

Carlotta Gauna, Francesco Romeo, Alessia Scatena, Cesare Miranda, Luigi Uccioli, Cristiana Vermigli, Antonio Volpe, Corrado Bordieri, Rodolfo Tramonta, Benedetta Ragghianti and 4 more

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Acta diabetologica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
3.6field-weighted citation impact, top 6% 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

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 1 country.

Carlotta GaunaEndocrinology and Metabolism, Azienda Sanitaria Locale Città di Torino, Turin, Italy. carlotta.gauna@aslcittaditorino.it.ORCID http://orcid.org/0009-0002-6559-0788
Francesco RomeoSC Territorial Diabetology, Azienda Sanitaria Locale Torino 5, Turin, Italy.
Alessia ScatenaOspedale San Donato, Arezzo, Italy.
Cesare MirandaPordenone Hospital, Pordenone, Italy.
Luigi UccioliUniversity of Rome Tor Vergata, Rome, Italy.
Cristiana VermigliAzienda Ospedaliera Santa Maria della Misericordia, Ospedale di Perugia, Perugia, Italy.
Antonio VolpePoliclinico Abano Terme, Padua, Italy.
Corrado BordieriUniversità Cattolica del Sacro Cuore di Roma, Rome, Italy.
Rodolfo TramontaAsl Roma 4, Civitavecchia, Italy.
Benedetta RagghiantiAzienda Ospedaliero Universitaria Careggi and University of Florence, Florence, Italy.
Giulia BandiniAzienda Ospedaliero Universitaria Careggi and University of Florence, Florence, Italy.
Matteo MonamiAzienda Ospedaliero Universitaria Careggi and University of Florence, Florence, Italy.
Luca MongeAMD-Italian Association of Clinical Diabetologists, Rome, Italy.
Panel of the Italian Guidelines for the Treatment of Diabetic Foot Syndrome* and on behalf of SID and AMD
Azienda Ospedaliero-Universitaria Careggi · ITASL Roma · ITAssociazione Medici Diabetologi · ITAzienda Ospedaliera di Perugia · ITFondazione Cassa di Risparmio Civitavecchia · ITOspedale San Donato · ITPoliclinico Abano Terme · ITUniversità Cattolica del Sacro Cuore · ITUniversity of Rome Tor Vergata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo compare the effectiveness of commonly used offloading devices for the treatment of neuropathic foot ulcers in patients with diabetes mellitus. This meta-analysis (MA) has been performed for giving an answer to clinical questions on this topic of the Italian guideline on diabetic foot syndrome.

methodsThe present MA includes randomized controlled studies (duration > 12 weeks) comparing, in patients with diabetes mellitus and non-infected neuropathic foot ulcer: any offloading device vs either no offloading device or conventional footwear; removable versus non-removable offloading devices; surgical procedure vs other offloading approaches. The primary endpoint was ulcer healing.

resultsA total of 184 studies were identified, and 18 were considered eligible for the analysis. We found that: any plantar off-loading, when compared to the absence of plantar offloading device, is associated with a higher ulcer healing (MH-OR: 3.13 [1.08, 9.11], p = 0.04, I

conclusionsAny plantar offloading, compared to the absence of plantar offloading device, is associated with a higher ulcer healing rate. Total contact cast or nonremovable knee-high walker, compared to other offloading devices, is preferable. Surgical offloading for active ulcers, in combination with post-surgery offloading devices, achieves a higher ulcer healing rate when compared to other offloading devices alone. Further studies with a larger cohort of patients with diabetic neuropathic foot ulcers and extended follow-up periods are necessary.

Indexed as

Diabetic FootRandomized Controlled Trials as TopicWound HealingCasts, SurgicalHumansItalyPractice Guidelines as TopicShoesTreatment OutcomeWeight-BearingDiabetes mellitusNeuropathic foot ulcerOffloading

Identifiers

PMID38489054
OpenAlexW4392851358

What OpenQuestion holds

Textmetadata
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.