Surgery Versus Nonsurgical Methods in Treating Neuropathic Plantar Forefoot Ulcers: A Meta-Analysis of Comparative Studies.

The International Journal of Lower Extremity Wounds
Kaissar Yammine, Chahine Assi

Abstract

The treatment of diabetic foot ulcers (DFUs) is usually based on local debridement, topical agents, and nonsurgical off-loading. When compared with nonsurgical methods, a number of articles reported better results with surgery. The aim of this meta-analysis was to collate quantitative evidence on the outcomes of surgery versus nonsurgical treatment (NST) of DFUs. Databases were searched from inception to September 2019. PRISMA guidelines were followed, and the Joanna Briggs Institute critical appraisal tools were used to appraise studies' quality. Nine studies were included totalizing 436 ulcers (216 treated with surgery and 220 DFUs with NST). The primary outcome was the healing rate. The secondary outcomes were time to heal, recurrence rate, transfer rate, infection rate, and amputation/revision surgery rate. The risk differences (RDs) between the healing rates following surgery and NST for infected and noninfected ulcers were 17% (95% confidence interval [CI] = 0.012-0.328, P = .03) and 19.2% (95% CI = 0.050-0.334, P = .008), respectively, in favor of surgery. The amputation/revision surgery rate was significantly better following surgery for both types of ulcers. Noninfected ulcers demonstrated significantly lesser time to ...Continue Reading

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Citations

Mar 24, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Kaissar YammineChahine Assi
Jul 7, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Javier Aragón-SánchezMaría Eugenia López-Valverde
Jul 18, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Kaissar YammineChahine Assi
Sep 5, 2021·Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons·Kaissar YammineChahine Assi

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