Cited by 143Diabetic Foot Ulcer Assessment and ManagementSkin Diseases and DiabetesUltrasound Imaging and Elastography

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Epidermal Thickness and Biomechanical Properties of Plantar Tissues in Diabetic Foot

Chao, Clare Y.L., Zheng, Yong-Ping, Cheing, Gladys L.Y.·2011·Ultrasound in Medicine & Biology

DOI 10.1016/j.ultrasmedbio.2011.04.004

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Abstract

Diabetic foot is a common complication for people with diabetes but it is unclear whether the change is initiated from the skin surface or underneath plantar tissues. This study compared the thickness of epidermis and the thickness and stiffness of the total plantar soft tissue among people with diabetes with or without complications. Seventy-two people with diabetes, including 22 people with neuropathies, 16 foot ulcerations, 34 pure diabetics without complications and 40 healthy controls participated in the study. The thickness of the epidermal layer of the plantar skin was examined using high-frequency ultrasonography; the thickness and stiffness of the total plantar soft tissue were measured by using tissue ultrasound palpation system at the big toe, the first, third and fifth metatarsal heads; and the heel pad. Compared with the control group, the average epidermal thickness of plantar skin was reduced by 15% in people with diabetic foot ulceration and 9% in people with neuropathy, but was increased by 6% in pure diabetics. There was an 8% increase in total thickness of plantar soft tissue in the 3 diabetic groups at all testing sites (all p < 0.05), except the first metatarsal head. The stiffness of plantar soft tissue was increased in all diabetic groups at all testing sites compared with the control (all p < 0.05). The epidermal plantar skin becomes thinner and plantar soft tissues stiffen in people with diabetes, particularly in persons who have neuropathy or ulceration, which increases the risk of tissue breakdown and ulceration formation.

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Authors: Chao, C. Y. L., Zheng, Y.-P., & Cheing, G. L. Y.
Affiliations: Hong Kong Polytechnic University (HK)
Corresponding author: Cheing, Gladys L.Y.
ORCID: Zheng, Yong-Ping
Cheing, Gladys L.Y.
Venue: Ultrasound in Medicine & Biology
Publisher: Elsevier BV
Published: 2011-07
Volume: 37
Issue: 7
Pages: 1029-1038
ISSN: 0301-5629 (ISSN-L)
DOI: 10.1016/j.ultrasmedbio.2011.04.004
OpenAlex: W2005413679
Cited by: 143
References: 43
Citations by year: 2026: 7 · 2025: 12 · 2024: 11 · 2023: 18 · 2022: 17 · 2021: 23 · 2020: 13 · 2019: 5 · 2018: 2 · 2017: 3 · 2016: 9 · 2015: 4 · 2014: 7 · 2013: 5 · 2012: 7
FWCI: 4.98
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Ultrasound in Medicine & Biology (publishedVersion)
PubMed (publishedVersion)
PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
Keywords: diabetic foot, epidermal thickness, plantar soft tissue, tissue stiffness, diabetic neuropathy, foot ulcer, high-frequency ultrasound, heel pad, metatarsal heads, skin biomechanics
MeSH terms: Aged, Analysis of Variance, Biomechanical Phenomena, Female, Humans, Male, Middle Aged, Signal Processing, Computer-Assisted, Software, Ultrasonography, User-Computer Interface, Case-Control Studies, Diabetic Foot

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Epidermal Thickness and Biomechanical Properties of Plantar Tissues in Diabetic Foot

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