Evidence map›Paper›PMID 40887711›Full record

SynthesisJournal of foot and ankle research2025

A Systematic Review of Submetatarsal Fat Pad Augmentation for the Treatment and Prevention of Diabetes-Related Foot Ulceration.

Christopher Ashmore, Jagdeep Virdee, Peter Culmer, Jennifer Edwards, Heidi Siddle, James Warren, David Russell

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of foot and ankle research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

7 authors.

Christopher AshmoreUniversity of Leeds Faculty of Medicine and Health, University of Leeds, Leeds, UK.ORCID https://orcid.org/0000-0003-0244-5241
Jagdeep VirdeeRoyal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Peter CulmerUniversity of Leeds School of Mechanical Engineering, University of Leeds, Leeds, UK.
Jennifer EdwardsFaculty of Biological Sciences, Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK.
Heidi SiddleLeeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
James WarrenFaculty of Biological Sciences, Institute of Medical and Biological Engineering, University of Leeds, Leeds, UK.
David RussellLeeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.

Funding

Christopher Ashmore and David Russell are supported in part by the National Institute for Health and Care Research NIHR Leeds Biomedical Research Centre BRC NIHR203331David Russell is also funded through an NIHR Advanced Fellowship NIHR300633
6 · The paper itself

Abstract

backgroundDiabetes-related foot ulceration (DFU) represents a significant and increasing cause of morbidity and economic burden to health services. Surgical offloading has shown great effectiveness in the prevention and healing of DFU. The objective of this review is to assess the effectiveness of submetatarsal plantar fat pad modulation in preventing DFU and to characterise the different biomaterials used to this end.

methodsThe study was registered on PROSPERO. A search strategy of the PubMed, CINAHL and Cochrane biomedical databases was conducted. Any study which explored the modulation of the plantar submetatarsal fat pad for the prevention or treatment of DFU in adults was included. The main outcome was the occurrence of ulceration following intervention.

resultsOf the 3162 retrieved studies, 10 studies met inclusion criteria, describing outcomes for 76 participants with 112 ulcers or pre-ulcerative areas. Four studies report results of injectable liquid silicone in 55 participants, four studies included the use of an acellular allograft in eight participants, two studies included autolipotransplantation in 11 participants and one study reports on the use of injectable collagen in two participants. Only one randomised control trial was identified while the remainder of the studies were observational, case-series, or case-reports. The overall ulcer occurrence was 27/112 over an average follow-up of 32.4 months. DISCUSSION: While plantar fat pad modulation shows promise as a surgical offloading strategy for DFU, insufficient high-quality trial data preclude meaningful interpretation of its merits. This is further complicated by heterogeneity in the biomaterial employed for modulation.

Indexed as

Adipose TissueDiabetic FootAdultAgedBiocompatible MaterialsCollagenFemaleHumansMaleMiddle AgedSiliconesTreatment OutcomeWound HealingBiocompatible MaterialsCollagenSiliconesadipose tissueallograftsautograftsdiabetesdiabetic footdiabetic foot ulcerfat pad

Identifiers

PMID40887711
PMCPMC12399362

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.