Systematic review of methods to diagnose infection in foot ulcers in diabetes
UNSPECIFIED (2006) Systematic review of methods to diagnose infection in foot ulcers in diabetes. DIABETIC MEDICINE, 23 (4). pp. 341-347. ISSN 0742-3071Full text not available from this repository.
Aim To undertake a systematic review of the diagnostic performance of clinical examination, simple acquisition and sample analysis in infected foot ulcers in diabetes.
Methods Nineteen electronic databases plus other sources were searched. To be included, studies had to fulfil the following criteria: (i) compare a method of clinical assessment, sample collection or sample analysis with a reference standard; (ii) recruit diabetic individuals with foot ulcers; (ii) present 2 x 2 diagnostic data. Studies were critically appraised using a 12-item checklist.
Results Three eligible studies were identified, one each on clinical examination, sample collection and sample analysis. For all three, study groups were heterogeneous with respect to wound type and a small proportion of participants had foot ulcers due to diabetes. No studies identified an optimum reference standard. Other methodological problems included non-blind interpretation of tests and the time lag between index and reference tests. Individual signs or symptoms of infection did not prove to be Useful tests when assessed against punch biopsy as the reference standard. The wound swab did not perform well when assessed against tissue biopsy. Semiquantitative analysis of wound swab might be a useful alternative to quantitative analysis. The limitations of these findings and their impact on recommendations from relevant clinical guidelines are discussed.
Conclusion Given the importance of this topic, it is surprising that only three eligible studies were identified. It was not possible to describe the optimal methods of diagnosing infection in diabetic patients with foot ulceration from the evidence identified in this systematic review.
|Item Type:||Journal Item|
|Subjects:||R Medicine > RC Internal medicine|
|Journal or Publication Title:||DIABETIC MEDICINE|
|Official Date:||April 2006|
|Number of Pages:||7|
|Page Range:||pp. 341-347|
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