Abstract
IntroductionThe aim of this systematic review was to evaluate the strength of the existing research to answer the question: Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabetes?MethodsThis study is a systematic review and meta-analysis of temperature-monitoring in the prediction and prevention of diabetic foot ulceration. Two investigators conducted a literature search for all relevant articles from 1960 until July 2011. During this process the following data bases were searched: MEDLINE, Science Direct, AMED, Australian Medical Index, APAIS-Health, ATSIhealth, EMBASE, Web of Science and OneSearch. Keywords used in this search included diabetes, foot complications, ulceration, temperature-monitoring, prediction and prevention.ResultsResults of the meta-analysis support the theory that an increase in skin temperature is predictive of foot ulceration when compared with the same site on the contralateral limb. The theory that there is a mean norm foot temperature which can be used as a benchmark to monitor pathological change was unsupported by this meta-analysis.ConclusionsThe conclusions derived from this review are based on the best available scientific evidence in this field. It is intended that the results of this study will improve clinical decision-making and encourage the appropriate measures used to predict and prevent ulceration in people with diabetes at high risk of foot complications. Based on quality studies in this area, the results of this review have indicated that the use of temperature-monitoring is an effective way to predict, and thus prevent, diabetic foot ulceration.
Highlights
The aim of this systematic review was to evaluate the strength of the existing research to answer the question: Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabetes?
In this same study it was predicted that, by the year 2030, this figure is likely to double [1]. Diabetic foot complications such as neuropathic ulceration are major contributors to morbidity and mortality and it is thought that 15% of people with diabetes will develop an ulcer at some point in their lives [2]
This review incorporates two subtopics: a study which assesses temperaturemonitoring as a predictive tool for diabetic ulceration; and a study that assesses temperature-monitoring as a tool aiding in the prevention of diabetic ulceration
Summary
The aim of this systematic review was to evaluate the strength of the existing research to answer the question: Is an increase in skin temperature predictive of neuropathic foot ulceration in people with diabetes?. 2000 it was estimated by the world health organisation that more than 171 million people in the world were suffering from diabetes mellitus In this same study it was predicted that, by the year 2030, this figure is likely to double [1]. Foot examination by a clinician, custom footwear and orthoses, debridement of hyperkeratosis and offloading are just some of the preventative measures described in the literature. In addition to these methods, handheld skin temperaturemonitoring has been found to be an effective monitoring instrument to reduce the incidence of foot complications, such as ulceration in people with diabetes [3,4,5]
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