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Cited by 12Diabetic Foot Ulcer Assessment and ManagementPeripheral Artery Disease ManagementWound Healing and Treatments

Do toe blood pressures predict healing after minor lower limb amputation in people with diabetes? a systematic review and meta-analysis.

Open access
Linton, Clare, Searle, Angela, Hawke, Fiona, Tehan, Peta Ellen, Sebastian, Mathew, Chuter, Vivienne·2020·Diabetes and Vascular Disease Research
DOI 10.1177/1479164120928868PMC PMC7607408
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Abstract

PURPOSE OF STUDY: To investigate toe systolic blood pressure and/or toe-brachial pressure index in predicting healing post minor diabetic foot amputations. KEY METHODS: A systematic search of EMBASE and PubMed (including Medline and The Cochrane Library) was conducted from database inception to 9 March 2020. Two authors independently reviewed and selected relevant studies. Quality was assessed with a modified Critical Appraisal Skill Programme checklist. MAIN RESULTS: = 0.001). Two studies investigating toe-brachial pressure index report successful healing where toe-brachial pressure index >0.2, with one study reporting a higher value of 0.8. MAIN CONCLUSIONS: Successful post-amputation healing outcomes were reported at mean toe systolic blood pressure ⩾30 mmHg, and the results varied considerably between the studies. Further research should identify whether variables, including amputation level, method of wound closure and length of post-operative follow-up periods, affect the values of toe systolic blood pressure and toe-brachial pressure index observed in this review.

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Crossref · 10.1177/1479164120928868

Cites

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  • Particularly among hospitalized patients, the combination of a positive probe-to-bone test and plain film radiography can be sufficient to diagnose osteomyelitis (likelihood ratio, 14) without the need for other, more expensive radiological studies.

    “Particularly among hospitalized patients, for whom the pretest probability of osteomyelitis is high, the combination of a positive probe-to-bone test and plain film radiography can be sufficient to diagnose osteomyelitis (likelihood ratio, 14) without the need for other, more expensive radiological studies.41,42”

    From Diabetic Foot Ulcers (2023) · cites this paper as [41]

    The Discussion and Conclusion (pages unavailable) address toe-pressure thresholds for healing after minor foot amputation, not diagnosis of osteomyelitis. Searches for the probe-to-bone test, plain-film radiography, hospitalized patients, and a likelihood ratio of 14 found no passage addressing the claimed diagnostic approach. (LLM, conf=0.77)

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  • In the absence of other associated diagnoses, an erythrocyte sedimentation rate greater than 70 mm/h can be helpful in improving diagnostic accuracy for osteomyelitis (likelihood ratio, 11).

    “In the absence of other associated diagnoses, an erythrocyte sedimentation rate greater than 70 mm/h can be helpful in improving diagnostic accuracy for osteomyelitis (likelihood ratio, 11).40,41”

    From Diabetic Foot Ulcers (2023) · cites this paper as [41]

    The Discussion (page unavailable) addresses toe blood pressure and healing after minor amputation, mentioning osteomyelitis only as a possible impediment to healing. Searches for erythrocyte sedimentation rate, ESR, and the claimed threshold and likelihood ratio found no passage about using ESR to diagnose osteomyelitis. (LLM, conf=0.78)

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Cites

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Research works printed but not linked: 4

  1. [14]Tawfik M Peripheral arterial disease and the diabetic foot. Diabet Foot Canada 2017; 5: 10– 12.
  2. [16]Sonter J Ho A Chuter V The predictive capacity of toe blood pressure and the toe brachial index for foot wound healing and amputation: a systematic review and meta-analysis. Wound Pract Res 2014; 22: 208– 220.
  3. [45]Jouhar L Wehbe MR Najjar O, et al Predictors of further intervention after toe amputation in people with diabetes. Diabet Foot J 2018; 21: 45– 52.
  4. [50]Bates-Jensen B Wethe J Acute surgical wound management. Wound Care 2007; 2: 310– 324.

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Authors
Linton, C., Searle, A., Hawke, F., Tehan, P. E., Sebastian, M., & Chuter, V.
Affiliations
  • University of Newcastle Australia (AU)
  • John Hunter Hospital (AU)
Corresponding author
Linton, Clare
ORCID
Venue
Diabetes and Vascular Disease Research
Publisher
SAGE Publications
Published
2020-03
Volume
17
Issue
3
Pages
147916412092886
ISSN
  • 1479-1641 (ISSN-L)
  • 1752-8984
DOI
10.1177/1479164120928868
PMC
PMC7607408
OpenAlex
W3035571605
Cited by
12
References
49
Citations by year
2026: 1 · 2025: 1 · 2024: 6 · 2023: 3 · 2021: 1
FWCI
0.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes and Vascular Disease Research (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by-nc)
  • NOVA (University of Newcastle Australia) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
  • Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
  • Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
Keywords
diabetic foot amputation, wound healing, diabetes mellitus, peripheral perfusion, amputation level
MeSH terms
Aged, Aged, 80 and over, Amputation, Surgical, Blood Pressure, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Regional Blood Flow, Risk Factors, Toes, Wound Healing, Treatment Outcome, Diabetic Foot, Ankle Brachial Index

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