• 1

    Apelqvist J, Ragnarson-Tennvall G, Larsson J, et al: Long-term costs for foot ulcers in diabetic patients in a multidisciplinary setting.Foot Ankle Int 16::388. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Payne CB: Diabetes-related lower-limb amputations in Australia.Med J Aust 173::352. ,2000. .

  • 3

    Apelqvist J, Tennvall GR, Persson U, et al: Diabetic foot ulcers in a multidisciplinary setting: an economic analysis of primary healing and healing with amputation.J Intern Med 235::463. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Holzer SE, Camerota A, Martens L, et al: Costs and duration of care for lower extremity ulcers in patients with diabetes.Clin Ther 20::169. ,1998. .

  • 5

    Reiber GE, Lipsky BA, Gibbons GW: The burden of diabetic foot ulcers.Am J Surg 176::5S. ,1998. .

  • 6

    International Working Group on the Diabetic Foot. International Consensus on the Diabetic Foot [CD-ROM], International Working Group on the Diabetic Foot, Brussels,2003. .

  • 7

    International Working Group on the Diabetic Foot: International Consensus on the Diabetic Foot, International Working Group on the Diabetic Foot, Maastricht, The Netherlands,1999. .

  • 8

    Peters EJ, Armstrong DG, Lavery LA: Risk factors for recurrent diabetic foot ulcers: site matters.Diabetes Care 30::2077. ,2007. .

  • 9

    Frykberg RG, Zgonis T, Armstrong DG, et al: Diabetic foot disorders: a clinical practice guideline.J Foot Ankle Surg 45::S1. ,2006. .

  • 10

    Apelqvist J, Larsson J, Agardh CD: Long-term prognosis for diabetic patients with foot ulcers.J Intern Med 233::485. ,1993. .

  • 11

    Helm PA, Walker SC, Pullium GF: Recurrence of neuropathic ulceration following healing in a total contact cast.Arch Phys Med Rehabil 72::967. ,1991. .

  • 12

    Sinacore DR, Mueller MJ, Diamond JE, et al: Diabetic plantar ulcers treated by total contact casting: a clinical report.Phys Ther 67::1543. ,1987. .

  • 13

    Jude EB, Tentolouris N, Appleton I, et al: Role of neuropathy and plasma nitric oxide in recurrent neuropathic and neuroischaemic diabetic foot ulcers.Wound Repair Regen 9::353. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Dargis V, Pantelejeva O, Jonushaite A, et al: Benefits of a multidisciplinary approach in the management of recurrent diabetic foot ulceration in Lithuania.Diabetes Care 22::1428. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Faglia E, Favales F, Morabito A: New ulceration, new major amputation and survival rates in diabetic subjects hospitalized for foot ulceration from 1990 to 1993.Diabetes Care 24::78. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Busch K, Chantelau E: Effectiveness of a new brand of stock diabetic shoes to protect against diabetic foot ulcer relapse: a prospective cohort study.Diabet Med 20::665. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Reiber GE, Smith DG, Wallace C, et al: Effect of therapeutic footwear on foot reulceration in patients with diabetes.JAMA 287::2552. ,2002. .

  • 18

    Armstrong DG, Rosales MA, Gashi A: Efficacy of fifth metatarsal head resection for treatment of chronic diabetic foot ulceration.JAPMA 95::353. ,2005. .

    • Search Google Scholar
    • Export Citation
  • 19

    Plank J, Haas W, Rakovac I, et al: Evaluation of the impact of chiropodist care in the secondary prevention of foot ulcerations in diabetic subjects.Diabetes Care 26::1691. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Walsh CH: A healed ulcer: what now?Diabet Med 13::S58. ,1996. .

  • 21

    Lavery LA, Higgins KR, Lanctot DR, et al: Preventing diabetic foot ulcer recurrence in high-risk patients: use of temperature monitoring as a self-assessment tool.Diabetes Care 30::14. ,2007. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Meaume S: Chronic wound scars.Wound Repair Regen 10::103. ,2002. .

  • 23

    Sims DS, Cavanaugh PR, Ulbrecht JS: Risk factors in the diabetic foot: recognition and management.Phys Ther 68::1887. ,1988. .

  • 24

    Mustoe TA, Cooter RD, Gold MH, et al: International clinical recommendations on scar management.Plast Reconstr Surg 110::560. ,2002. .

  • 25

    Bressler RS, Bressler CH: Skin and superficial fascia of the foot.JAPMA 81::379. ,1991. .

  • 26

    Chang CC, Kuo YF, Chiu HC, et al: Hydration, not silicone, modulates the effects of keratinocytes on fibroblasts.J Surg Res 59::705. ,1995. .

  • 27

    Smith & Nephew Pty Ltd: Cica-Care™ Adhesive Gel Sheet for Scar Care [product information sheet], Smith & Nephew, Mount Waverley, Australia,2001. .

  • 28

    Brooks B, Dean R, Patel S, et al: TBI or not TBI: that is the question: is it better to measure toe pressure than ankle pressure in diabetic patients?Diabet Med 18::528. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Bonham PA: Get the LEAD out: noninvasive assessment for the lower extremity arterial disease using ankle brachial index and toe brachial index measurements.J Wound Ostomy Continence Nurses 33::30. ,2006. .

    • Search Google Scholar
    • Export Citation
  • 30

    Abbott CA, Carrington AL, Ashe H, et al: The North-West diabetes foot care study: incidence of, and risk factors for, new diabetic foot ulceration in a community-based patient cohort.Diabet Med 19::377. ,2002. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Young MJ, Boulton AJ, Macleod AF, et al: A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population.Diabetologia 36::150. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Armstrong DG, Lavery LA, Vela SA, et al: Choosing a practical screening instrument to identify patients at risk for diabetic foot ulceration.Arch Intern Med 158::289. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation

A Diabetic Foot Ulcer Pilot Study

Does Silicone Gel Sheeting Reduce the Incidence of Reulceration?

Cara Westphal Podiatry Department, Royal Perth Hospital, Perth, Australia.

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 BSc (Podiatry)
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Ingrid M. Neame Podiatry Department, Royal Perth Hospital, Perth, Australia.

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 BHlthSc (Podiatry)
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Jessica C. Harrison Podiatry Department, Royal Perth Hospital, Perth, Australia.

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Virginia M. Bower Podiatric Medicine Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Australia.

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 BAppSc (Podiatry), MPH
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Joel M. Gurr Podiatric Medicine Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Australia.

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Background: Silicone gel sheeting is an effective therapeutic intervention in the management of scar tissue. This pilot study was designed to examine the effect of silicone gel sheeting in preventing reulceration at former wound sites in diabetic patients.

Methods: Thirty patients with diabetes and a healed plantar neuropathic foot ulcer were enrolled and investigated in this randomized controlled trial. Participants with a newly healed ulcer were assigned to use either silicone gel sheeting or emollient cream daily for 3 months.

Results: Compared with emollient cream use, the use of silicone gel sheeting did not diminish and may have potentially increased the risk of reulceration.

Conclusions: Silicone gel sheeting does not seem to reduce the risk of reulceration in diabetic patients. The results of this trial should be viewed with caution given the small sample size. (J Am Podiatr Med Assoc 101(2): 116–123, 2011)

Corresponding author: Cara Westphal, BSc (Podiatry), Podiatry Department, Royal Perth Hospital, PO Box X2213 GPO, Perth WA 6847, Australia. (E-mail: cara.westphal@health.wa.gov.au)