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Hinchliffe RJ, Forsythe RO, Apelqvist J, Boyko EJ, Fitridge R, Hong JP, Katsanos K, Mills JL, Nikol S, Reekers J, Venermo M, Zierler RE, Schaper NC, International Working Group on the Diabetic Foot (IWGDF)., et al.
Diabetes/metabolism research and reviews. Date of publication 2020 Mar 1;volume 36 Suppl 1():e3276.
1. Diabetes Metab Res Rev. 2020 Mar;36 Suppl 1:e3276. doi: 10.1002/dmrr.3276. Epub 2020 Jan 20. Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update). Hinchliffe RJ(1), Forsythe RO(2), Apelqvist J(3), Boyko EJ(4), Fitridge R(5), Hong JP(6), Katsanos K(7), Mills JL(8), Nikol S(9), Reekers J(10), Venermo M(11), Zierler RE(12), Schaper NC(13); International Working Group on the Diabetic Foot (IWGDF). Author information: (1)Bristol Centre for Surgical Research, University of Bristol, Bristol, UK. (2)British Heart Foundation/Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. (3)Department of Endocrinology, University Hospital of Malmö, Malmö, Sweden. (4)Seattle Epidemiologic Research and Information Centre, Department of Veterans Affairs Puget Sound Health Care System and the University of Washington, Seattle, WA. (5)Vascular Surgery, The University of Adelaide, Adelaide, South Australia, Australia. (6)Asan Medical Center University of Ulsan, Seoul, South Korea. (7)School of Medicine, Patras University Hospital, Patras, Greece. (8)SALSA (Southern Arizona Limb Salvage Alliance), University of Arizona Health Sciences Center, Tucson, AZ. (9)Department of Interventional Angiology, Asklepios Klinik St. Georg, Hamburg, Germany. (10)Department of Vascular Radiology, Amsterdam Medical Centre, Amsterdam, The Netherlands. (11)Helsinki University Hospital, University of Helsinki, Helsinki, Finland. (12)Department of Surgery, University of Washington, Seattle, WA. (13)Division of Endocrinology, MUMC+, CARIM and CAPHRI Institute, Maastricht, The Netherlands. The International Working Group on the Diabetic Foot (IWGDF) has published evidence-based guidelines on the prevention and management of diabetic foot disease since 1999. This guideline is on the diagnosis, prognosis, and management of peripheral artery disease (PAD) in patients with foot ulcers and diabetes and updates the previous IWGDF Guideline. Up to 50% of patients with diabetes and foot ulceration have concurrent PAD, which confers a significantly elevated risk of adverse limb events and cardiovascular disease. We know that the diagnosis, prognosis, and treatment of these patients are markedly different to patients with diabetes who do not have PAD and yet there are few good quality studies addressing this important subset of patients. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to devise clinical questions and critically important outcomes in the patient-intervention-comparison-outcome (PICO) format, to conduct a systematic review of the medical-scientific literature, and to write recommendations and their rationale. The recommendations are based on the quality of evidence found in the systematic review, expert opinion where evidence was not available, and a weighing of the benefits and harms, patient preferences, feasibility and applicability, and costs related to the intervention. We here present the updated 2019 guidelines on diagnosis, prognosis, and management of PAD in patients with a foot ulcer and diabetes, and we suggest some key future topics of particular research interest. © 2020 John Wiley & Sons Ltd. DOI: 10.1002/dmrr.3276 PMID: 31958217
Appears in following Topics:
Arterial Ulcer - Treatment
Wound Infection - Overview