• 1.

    Lippman HI , Perotto A & Ferrar R: The neuropathic foot of the diabetic. Bull NY Acad Med 52: 1159, 1976.

  • 2.

    Bus SA , Yang QX & Wang JH et al.: Intrinsic muscle atrophy and toe deformity in the diabetic neuropathic foot: a magnetic resonance imaging study. Diabetes Care 25: 1444, 2002.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Lavery LA , Barnes SA & Keith MS et al.: Prediction of healing for postoperative diabetic foot wounds based on early wound area progression. Diabetes Care 31: 26, 2008.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 4.

    Snyder RJ , Cardinal M & Dauphinée DM et al.: A post-hoc analysis of reduction in diabetic foot ulcer size at 4 weeks as a predictor of healing by 12 weeks. Ostomy Wound Manage 56: 44, 2010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Menke A , Casagrande S & Geiss L et al.: Prevalence of and trends in diabetes among adults in the United States, 1988-2012. JAMA 314: 1021, 2015.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 6.

    Boulton AJ: What you can't feel can hurt you. J Vasc Surg 52 (suppl) : 28S, 2010.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 7.

    Mayfield JA , Reiber GE & Sanders LJ et al.: Preventive foot care in people with diabetes. Diabetes Care 21: 2161, 1988.

  • 8.

    Gries FA , Ziegler D & Zimmet PZ et al.: “Costs of Foot Ulcer and Lower-Extremity Amputation,” in Textbook of Diabetic Neuropathy, edited by Gries, FA, Cameron, NE & Low, PA et al., p 64, Thieme, New York, 2003.

    • Search Google Scholar
    • Export Citation
  • 9.

    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.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Palumbo PJ & Melton LJ III: “Peripheral Vascular Disease and Diabetes,” in Diabetes in America: Diabetes Data Compiled 1984, XV1, US Government Printing Office, Washington, DC, August 1985, NIH publication no. 85-1468.

    • Search Google Scholar
    • Export Citation
  • 11.

    Sheehan P , Jones P & Caselli A et al.: Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial. Diabetes Care 26: 1879, 2003.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Barshes NR , Sigireddi M & Wrobel JS et al.: The system of care for diabetic foot: objectives, outcomes, opportunities. Diabet Foot Ankle 4: 10, 2013.

    • Search Google Scholar
    • Export Citation
  • 13.

    Alenzuela-Silva CM , Tuero-Iglesias ÁD & García-Iglesias E et al.: Granulation response and partial wound closure predict healing in clinical trials on advanced diabetes foot ulcers treated with recombinant human epidermal growth factor. Diabetes Care 36: 210, 2013.

    • Crossref
    • PubMed
    • Web of Science
    • Search Google Scholar
    • Export Citation
  • 14.

    Margolis DJ , Gelfand JM & Hoffstad O et al.: Surrogate end points for the treatment of diabetic neuropathic foot ulcers. Diabetes Care 26: 1696, 2003.

  • 15.

    Consensus Development Conference on diabetic foot wound care: 7–8 April 1999, Boston, Massachusetts. American Diabetes Association. Diabetes Care 22: 1354, 1999.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Laurens N , Koolwijk P & de Maat MPM. Fibrin structure and wound healing. J Thromb Haemost 4: 932, 2006.

Healing Rate of Diabetic Foot Wounds When Treated with Serial Debridement in the Presence of Antithrombotic Therapy

Jack Route
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Background

Previous study indicates that pharmacologic antithrombotic therapy may be an inhibitory factor for wound healing and should merit consideration among the other core factors in wound healing optimization.

Methods

This study provides a retrospective analysis of the effect of antithrombotic therapy on wound healing rates of uncomplicated diabetic foot ulcerations. Wounds treated with standard of care in the presence of clinical anticoagulation were compared to control wounds.

Results

The results indicate a statistically significant negative correlation between antithrombotic therapy and diabetic foot wound healing rate. This represents the first study focusing on this correlation in the uncomplicated diabetic foot wound.

Conclusions

This retrospective study demonstrates that antithrombotic therapy has a statistically significant negative effect on healing rates of uncomplicated diabetic foot ulcerations. Both wound area and depth improvement over 4 weeks was significantly better in treated patients who were not on antithrombotic therapy for comorbidity not associated with peripheral arterial disease.

Denver VA Hospital, 1700 N Wheeling St, Aurora, CO 80045. (E-mail: jackroute7@gmail.com)