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Base de datos de revistas de enfermería

Guía temática de podología

Herramienta de investigación que permite explorar las bases de datos de CAS que contienen literatura de Química y varias disciplinas relacionadas con ella.

DynaMed es la herramienta de apoyo a la decisión clínica a la que acuden los médicos para obtener respuestas a sus preguntas.

Guía del grado de Podología de la Facultad de Enfermería, Fisioterapia y Podología de la Universidad Complutense de Madrid

Con el objetivo de integrar de manera efectiva los entornos virtuales en las prácticas de Microbiología, se ha analizado la eficacia de las prácticas en formato virtual en comparación con el presencial en la asignatura de Microbiología del Grado de Podología. Tras elegir el formato práctico presencial o virtual, los alumnos realizaron voluntariamente cuestionarios de conocimientos previos y posteriores a las prácticas, con el fin de evaluar su rendimiento. Asimismo, se evaluó el compromiso y satisfacción de los estudiantes. La mayoría de los alumnos eligieron realizar las prácticas en formato presencial, mostrando un mayor compromiso y participación en los cuestionarios. Ambos grupos experimentaron una mejora en el rendimiento, sin diferencias significativas entre formatos. Los estudiantes que participaron en las prácticas expresaron un alto nivel de satisfacción en ambos formatos. Las prácticas virtuales suponen una alternativa adecuada a las prácticas presenciales en la enseñanza de Microbiología., With the aim of effectively integrating virtual environments in Microbiology practices, theeffectiveness of virtual versus face-to-face practices in the Microbiology course of the Degree inPodiatry was analysed. After choosing the face-to-face or virtual practical format, studentsvoluntarily completed pre- and post-practicum knowledge questionnaires to evaluate theirperformance. Students' commitment and satisfaction were also evaluated. Most students chose tocomplete the practices in the face-to-face format and showed a higher level of engagement andparticipation in the questionnaires. Both groups showed improved performance with no significantdifferences between the formats. Students who participated in the practices expressed an elevatedlevel of satisfaction in both formats. Virtual practices are a viable alternative to face-to-face practicesin Microbiology teaching, Depto. de Medicina, Fac. de Medicina, TRUE, pub

2023 Acuerdos transformativos CRUE, Cryotherapy is commonly regarded as the primary treatment method for plantar warts. A new medical device called nitric–zinc complex solution (NZCS) has also emerged as a potential alternative for wart treatment. The main aim of this study was to analyze and compare the effectiveness of cryotherapy using liquid nitrogen and NZCS in treating plantar warts. We conducted a randomized and controlled clinical trial involving patients with plantar warts. A total of 62 patients were enrolled in the study and monitored for 12 weeks or until their warts were completely resolved. The patients received either cryotherapy or NZCS, with a maximum of six treatment applications. The cure rate was 65.5% in the group treated with cryotherapy and 56.6% in the group treated with NZCS. The average number of treatment applications required for curing warts was significantly lower in the cured group (3.28 ± 1.63) than in the group with unresolved warts (5.5 ± 1.27) (p < 0.01). Moreover, the average number of applications was lower in the cryotherapy group (3.6 ± 1.8) than in the NZCS group (4.8 ± 1.8) (p < 0.01). Based on the findings, NZCS could be considered a favorable first-line treatment option for plantar warts., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub, APC financiada por la UCM

Depto. de Enfermería, Depto. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, Fac. de Medicina, TRUE, pub

2023 Acuerdos transformativos CRUE, Background A systematic review was conducted to investigate the prevalence of onychomycosis in patients with diabetes. The association of onychomycosis with risk factors in patients with diabetic foot syndrome was also examined. Methods The recommendations in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist were applied, and the included studies were assessed using the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) method. Searches were conducted in October 2022 using PubMed (Medline) and Scopus for clinical studies, clinical trials, comparative studies, observational studies, and randomised clinical trials or controlled clinical trials addressing the prevalence and consequences of onychomycosis in patients with diabetes, diagnoses or treatments. Two authors performed the study selection and data extraction, and any discrepancies between the two reviewers were resolved through discussion with a third reviewer. Results The systematic review included ten studies that met the inclusion criteria, and these studies enrolled 5664 patients with diabetes. Among these patients, 29.18% had onychomycosis that was mainly caused by Trichophyton rubrum. A significant association was found between the occurrence of onychomycosis and the presence of diabetic neuropathy (p = .012) and elevated glycosylated haemoglobin values (p = .039). There was no significant association between onychomycosis and ulceration (p = .185). Eight studies had a grade 4 level of evidence and a grade C recommendation, and one study had a grade 1b level of evidence and a grade A recommendation. Conclusion The information described in the literature is insufficient and heterogeneous regarding the association of risk factors and ulceration in patients with diabetic foot compared with developing onychomycosis. There is also a need to implement onychomycosis diagnostic testing instead of relying only on a clinical diagnosis. Additional pro, Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub, APC financiada por la UCM

Previous studies have reported the potential emission of nail dust to the indoor air of the podiatrist's workplace during nail drilling procedures. The main objective of this study was to analyse the fungal bioaerosol present in the indoor air of podiatry rooms, including during the nail drilling procedure. Seventeen private clinics were sampled in Madrid during spring and summer. The most prevalent filamentous fungi detected were Cladosporium spp. and Penicillium spp. in both seasons. The presence of Trichophyton rubrum and Trichophyton interdigitale was reported in samples during the drilling procedures, establishing a positive association with the clinical suspicion of onychomycosis (p = 0.002) and the utilization of aspiration systems (p=0.04). The present study concludes that airborne fungal concentrations in podiatrist's clinics are consistent with national and international guidance. Occupational exposure to dermatophytes may briefly occur during definite periods across the daily activity despite the use of dust aspiration systems., Depto. de Medicina, Fac. de Medicina, TRUE, pub

Las infecciones de piel y partes blandas (IPPB), y en particular las infecciones del pie de diabético (IPD), presentan complicaciones diagnósticas y terapéuticas, que a menudo desembocan en complicaciones graves. El objetivo de este estudio fue evaluar la eficacia in vitro de cefditoreno y amoxicilina/ ácido clavulánico frente a los microorganismos típicos de las IPD. Se analizaron muestras clínicas de 40 pacientes con IPPB leves mostrando un predominio de especies de Staphylococcus spp. y Streptococcus spp. Cefditoreno mostró frente al 90% de los aislados una potencia superior a la de la amoxicilina/ácido clavulánico. Estos resultados destacan la utilidad de cefditoreno en el tratamiento empírico de la IPD, aunque sería deseable disponer de un mayor tamaño muestral para una mejor validación., Skin and soft tissue infections (SSTIs), and particularly diabetic-related foot infections (DFI), present diagnostic and therapeutic complexities, often leading to severe complications. This study aims to evaluate the in vitro efficacy of cefditoren and amoxicillin/clavulanic acid against typical DFI pathogens. Clinical samples from 40 patients with mild SSTIs were analyzed, revealing a predominance of Staphylococcus spp. and Streptococcus spp. species. Cefditoren exhibited activity against 90% of isolates, with superior potency over amoxicillin/clavulanic acid. These findings underscore the utility of cefditoren in empirical treatment of DFI, although a larger sample size would be desirable for further validation., Meiji Pharma Spain, Depto. de Medicina, Fac. de Medicina, TRUE, pub

2023 Acuerdos transformativos CRUE, Background: Onychomycosis (ONM) is the most prevalent nail unit pathology, and its severity and monitoring are often based on the visual judgement of clinicians.Objective: The objective of this study is to assess the reliability of the Onychomycosis Severity Index (OSI) classification when utilized by three clinicians with varying lev-els of clinical experience: an experienced podiatrist (with 5 years of experience), a moderately experienced podiatrist (with 2 years of experience) and an inexperienced podiatrist (a recent graduate familiar with the OSI classification but lacking clinical experience). Additionally, we compared the severity assessments made through visual inspection with those determined using the OSI by different clinicians.Methods: We evaluated reliability using the intraclass correlation index (ICC), analys-ing 50 images of ONM.Results: The OSI demonstrated a very high level of reliability (ICC: 0.889) across cli-nicians, irrespective of their experience levels. Conversely, a statistically significant increase in severity was observed when comparing visual assessments with the OSI (p< .001) for ONM severity evaluation.Conclusion: The OSI proves to be a reproducible classification system, regardless of the clinical experience of the practitioner employing it., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub, APC financiada por la UCM

Background Nail disorders are frequent among the geriatric population and unfortunately, repeat avulsionprocedures often result in complications.Objective To utilize a phenol-based total matricectomy technique for permanent nail ablation and evaluate itseffectiveness.Methods We performed total nail ablation on 34 toenails of the hallux (30 patients) with a gauze–phenolapplication technique and evaluated the degree of pain reported by the patient 12 months postoperatively comparedwith the preoperative stage. Furthermore, we evaluated the patients’ satisfaction with the final cosmetic appearanceas well as their satisfaction with the overall procedure.Results All patients reported ‘too much’ or ‘severe’ pain prior to surgery and 94.11% reported ‘no pain’ 12 monthspost-surgery. A vast majority of the patients (82.35%) felt pleased with the cosmetic results and all patients reportedthat they were ‘very satisfied’ or ‘strongly satisfied’ with the procedure when interviewed at their 12 month follow-upexamination.Limitations There were a limited number of participants in this study across an extensive timeframe.Conclusion Phenol-based total nail ablation with specific gauze application is safe, inexpensive and has a highrate of patient satisfaction., Depto. de Enfermería, Depto. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, Fac. de Medicina, TRUE, pub

2023 Acuerdos transformativos CRUE, The current study aimed to evaluate the dispersal of solution and microbes (aerosol) in the clinical environment during treatment with Low-frequency contact ultrasonic debridement (LFCUD) with or without suction attachment in patients with diabetic foot ulcers (DFUs). We performed 20 treatments in 10 patients divided into two groups to receive the proposed LFCUD modalities. We measured the microbial load of the environment pre-treatment (sample M1), during treatment with each LFCUD modality (sample M2) and post-treatment (sample M3). The use of LFCUD debridement without a suction attachment results in significantly higher immediate contamination of the clinic environment than the suction attachment, particularly during the procedure (1.70 ± 0.98 log 10 CFU/mL versus 0.77 ± 0.85 log 10 CFU/mL, p = 0.035). When suction is not applied, there are statistically significant differences depending on whether the DFUs are neuropathic or neuroischemic, finding a greater number of microorganisms with high loads in neuropathic DFUs. We found a statistically significant positive correlation between wound area (r = 0.450, p = 0.047) and TBI (r = 0.651, p = 0.006) with the bacterial load during the LFCUD. Based on our results, we recommend using the personal protective equipment required to protect staff members and patients during treatment with LFCUD and using a suction attachment where clinically possible to reduce clinic environmental pollution, especially in neuropathic DFUs and those with larger areas., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub, APC financiada por la UCM

Objective: to explore attitudes towards patients' self-reported data about foot health-related beliefs from a behavioural and attitudinal perspective. Methods: a sample of 282 participants of a mean age of 39.46 ± 16.026 came to a health centre where self-reported demographic, clinical characteristics and beliefs relating to foot health data were registered, informants' completed all the stages of the research process. Results: the results of the analysis revealed an 8-factor factorial structure based on (1) podiatric behaviours, (2) the intention to carry out protective behaviour, (3) attitudinal beliefs, (4) normative beliefs, (5) needs, (6) apathy, (7) self-care, and (8) the general perception of foot health. They all explained 62.78% of the variance, and were considered as independent variables in a regression analysis to determine which provided the best explanations for the importance attributed to foot health. Conclusions: the participants in the study revealed a positive attitude in relation to foot health care and responsible behaviour., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Phenol matrixectomy is commonly used to treat onychocryptosis. The podiatric medical community has been progressively improving the technique of phenol application to avoid cases of burns. We describe a modification that uses gauze to provide a safe way for the phenol to be applied and prevents skin lesions due to phenol burns. (J Am Podiatr Med Assoc 98(5): 418–421, 2008), Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

The technological transformation and advertising utilized in the footwear industry significantly impact purchasing decisions. The gait properties, barefoot and with shoes, change depending on the footwear structure. The aim of this work is the biomechanical analysis of walking barefoot and with different sports shoes in a controlled group of 12 children between 4 and 6 years old. Kinematic and spatiotemporal variables were analyzed using a BTS motion capture analysis system with the Helen Hayes protocol. Previously, a survey was carried out with 262 families with children between 4 and 6 years old to justify the choice of footwear for this study. No significant differences were found between any of the measured conditions. The kinematic results showed significant differences in the ankle (right sagittal plane p = 0.04, left p < 0.01; right frontal plane p < 0.01, left p < 0.01), knee (right and left sagittal plane p < 0.01) and hip (right sagittal plane p < 0.01, left p = 0.04; right frontal plane p = 0.03). Additionally, the post hoc analysis revealed significant differences between barefoot gait and different footwear. The footwear used for this study and each one's various characteristics are not preponderant in the spatiotemporal and kinematic parameters of the children's gait. Thus, the footwear purchase may be conditioned by its design or composition and other properties may not be relevant., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

The aim of this study was to evaluate the recovery time and the development of complications in the dorsal and plantar approach to metatarsal head resections (MHR) in patients with diabetic foot ulcers complicated by osteomyelitis. A retrospective study was carried out involving 108 patients who underwent MHRs for the treatment of diabetic foot osteomyelitis. Two cohorts were defined: dorsal approach with incision closed with sutures and plantar approach with ulcer healed using conservative treatment. The main outcomes were the weeks until healing and complications related to the approaches. Fifty-three patients (49.1%) underwent a plantar approach and 55 (50.9%) a dorsal approach. Both approaches rendered similar healing times. However, the patients undergoing a dorsal approach developed more post-surgical complications than patients treated through a plantar approach. The dorsal approach intervention was performed on smaller and shallower ulcers; however, more complications developed at follow up using this approach than through a plantar approach for MHR complicated with osteomyelitis., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Carta al editor, ninguna, Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Background: A variety of treatment modalities have been described for cutaneous warts. We sought to determine the safety and efficacy of a topical formulation of cantharidin, podophyllotoxin, and salicylic acid in the treatment of plantar warts. This combination treatment is widely used in Europe and elsewhere but has not been described in the podiatric medical literature. Methods: A retrospective study was conducted of 144 patients with simple or mosaic plantar warts who were treated with a topical, pharmacy-compounded solution of cantharidin, 1%; podophyllotoxin, 5%; and salicylic acid, 30%. All of the patients, aged 8 to 52 years (mean ± SD, 20.9 ± 11.0 years), were treated according to the authors3 standard protocol. Of the 144 patients, 92 were being treated for the first time. None of the 52 previously treated patients had received more than one other type of treatment in the past. Results: After 6 months of follow-up, complete eradication of the plantar warts was noted in 138 of the 144 patients (95.8%). Of these patients, 125 (86.8%) required a single application of the solution, and 13 (9.0%) needed two or more applications. No significant adverse effects or complications were observed. Conclusion: A topical solution of cantharidin, podophyllotoxin, and salicylic acid was found to be safe and effective in the treatment of simple and mosaic plantar warts. This formulation is a promising alternative treatment modality for plantar warts. (J Am Podiatr Med Assoc 98(6): 445–450, 2008), Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

A systematic review and meta-analysis were undertaken in order to explore the influence of matrix metalloproteinases and their diagnostic methods in chronic and acute wounds. Searches were conducted in the PubMed (Medline) and Embase (Elsevier) databases from inception to late November 2017. We included clinical trials enrolling patients with cutaneous chronic and acute wounds where a validated diagnostic method was employed for metalloproteinases. We excluded in vitro, animal or preclinical studies, nonoriginal articles, and studies without available data for analysis. In addition, references of narrative and systematic reviews were scrutinized for additional articles. Eight studies met the inclusion criteria. Results revealed that the most frequently determined matrix metalloproteinases were MMP-2 and MMP-9, and were found in 54.5% of wounds. MMP-9 was present in more than 50% of the chronic wounds with a range from 37 to 78%. However, metalloproteinases were found in only 20% of acute wounds, and other types of metalloproteinases were also observed (MMP-2 and MMP-3). On the basis of the available evidence, high levels of metalloproteinases have been correlated with significantly delayed wound healing in wounds of a variety of etiologies., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Objective: To compare the potential healing prognosis of the different routine noninvasive techniques implemented in the International Working Group Diabetic Foot Guidelines with the novel use of hyperspectral imaging (HSI) in patients with diabetic foot ulcers (DFUs). Methods: Twenty-one patients with active DFUs participated in this 1-year prospective study in a specialized diabetic foot unit between December 2018 and January 2020. HSI was performed at baseline to quantify tissue oxygenation and should be presented on an anatomical map by analyzing the following parameters: (1) oxygen saturation of the hemoglobin, (2) tissue hemoglobin index, (3) the near-infrared perfusion index, and (4) tissue water index. In addition, transcutaneous oxygen pressure (TcpO2), systolic toe and ankle pressures, ankle-brachial index, and toe-brachial index values were calculated for the ulcerated limb. The primary outcome measure was wound healing, defined as complete epithelization without any drainage confirmed for at least 10 days after closure was first documented at 24 weeks. Results: During the follow-up period 14 patients (66.66 %) healed and 7 patients did not heal (33.3%) by 24 weeks. The TcpO2 optimal cut-off point as determined by a balance of sensitivity and specificity of 28.5 mm Hg that yielded a sensitivity of 91% and a specificity of 100%, and area under the curve of 0.989 (P = .005; 95% confidence interval [CI], 0.945-1.000). Followed by the oxygen saturation of the hemoglobin optimal cut-off point as determined by a balance of sensitivity and specificity of 48.5 mm Hg that yielded a sensitivity of 93% and a specificity of 0.71%, and area under the curve of 0.932 (P = .013; 95% CI, 0.787-1.000). The logistic regression analyses showed that TcpO2 was the only variable associated with wound healing at 24 weeks (P < .001; 95% CI, 0.046-0.642). Conclusions: The HSI was shown to be effective in the prognosis of DFU healing compared with other noninvasive test; only TcpO2, Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

The Edmonton Frail Scale (EFS) is an index employed to measure alterations related to frailty. The main objective in this research was to develop the EFS short-form (EFS-SF) and to evaluate its validity, reliability, and sensitivity to predict frailty disability outcomes in elderly patients with foot disabilities. Results: Exploratory factor analysis (EFA) of the EFS-SF revealed the presence of three components, as in the original EFA. There were significant differences (p < 0.05) in the study population for several of the EFS and 5-item FRAIL scale indicators. The highest correlation (Pearson R = 0.871; p < 0.001) was found for the first component of the EFS-SF. Finally, the Cronbach alpha was 0.864 which indicated a high level of internal consistency. Conclusion: The EFS-SF is a reliable and valid instrument to measure frailty in patients with and without foot disabilities. Method: A cross sectional descriptive study was carried out. The study population was aged over 60 years (n = 66) and comprised 29 men and 37 women. Frailty disorders were registered by using the EFS, 5-item FRAIL scale, and the Geriatricians’ Clinical Impression of Frailty (GCIF) scale. EFA was employed to locate potential constituents of the EFS, with scores ranging from 0.596 to 0.946 for each of the sub scales: (1) cognitive and general health status; (2) medication and nutrition status; and (3) functional and physiological status, thus revealing that the EFS-SF comprised three components, a reduction compared to the nine in the original EFS., Generalitat Valenciana, grant number GV/2020/061, Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Background: Therapeutic footwear becomes the first treatment line in the prevention of diabetic foot ulcer and future complications of diabetes. Previous studies and the International Working Group on the Diabetic Foot have described therapeutic footwear as a protective factor to reduce the risk of re-ulceration. In this study, we aimed to analyze the efficacy of a rigid rocker sole to reduce the recurrence rate of plantar ulcers in patients with diabetic foot. Methods: Between June 2016 and December 2017, we conducted a randomized controlled trial in a specialized diabetic foot unit. Participants and intervention: Fifty-one patients with diabetic neuropathy who had a recently healed plantar ulcer were randomized consecutively into the following two groups: therapeutic footwear with semi-rigid sole (control) or therapeutic footwear with a rigid rocker sole (experimental). All patients included in the study were followed up for 6 months (one visit each 30 ± 2 days) or until the development of a recurrence event. Main outcome and measure: Primary outcome measure was recurrence of ulcers in the plantar aspect of the foot. Findings: A total of 51 patients were randomized to the control and experimental groups. The median follow-up time was 26 [IQR-4.4-26.1] weeks for both groups. On an intention-to-treat basis, 16 (64%) and 6 (23%) patients in the control and experimental groups had ulcer recurrence, respectively. Among the group with >60% adherence to therapeutic footwear, multivariate analysis showed that the rigid rocker sole improved ulcer recurrence-free survival time in diabetes patients with polyneuropathy and DFU history (P = 0.019; 95% confidence interval, 0.086-0.807; hazard ratio, 0.263). Conclusions: We recommend the use of therapeutic footwear with a rigid rocker sole in patients with diabetes with polyneuropathy and history of diabetic foot ulcer to reduce the risk of plantar ulcer recurrence. Trial registration: ClinicalTrials.gov NCT02995863., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

The aim of this article was to assess the ability to predict reulceration in people with diabetes and a history of minor amputation according to the formula proposed by Miller et al. A retrospective study was performed on 156 consecutive records of patients with a recent history of simple or multiple forefoot amputation. The sample was divided according to Miller's formula into patients at low risk of reulceration and those at high risk; those were further divided into two subgroups according to whether or not the first segment of the forefoot had been amputated. Forty-eight (47·1%) individuals suffered forefoot reulceration, showing a median reulceration-free survival time of 8 months [interquartile range (IR) 3·6-14·8]. Nephropathy (P = 0.005) and Miller's formula (P = 0.028) were risk factors for reulceration-free survival time in the univariate analysis. The pattern relating to the first segment amputated [hazard ratio (HR) 2·853; P = 0·004; 95% confidence interval (CI) 1·391-5·849] and nephropathy (HR 2·468; P = 0.004; 95% CI 1.328-4.587) showed a significant hazard ratio in the multivariate Cox model. Participants with first segment amputation and one other amputation showed an association with the probability of reulceration in comparison with any other specific type of minor amputation., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Objective: To analyze the correlation between empirical antibiotic therapies prescribed in primary care centers by general practitioners and the microbiology results of bone culture in patients with diabetic foot-related osteomyelitis. Methods: This observational study involved 80 patients with diabetic foot ulcers and clinically suspected osteomyelitis. The patients were taking antibiotics prescribed by general practitioners to treat diabetic foot infections. Bone samples were taken from every patient for microbiology analysis in a specialized diabetic foot unit. Main outcome measure: The sensitivity of the bone cultures to antibiotics was compared with the patient's previous antibiotic therapy, and antibiotic and bacterial resistance were analyzed. Main results: The bone cultures from only 16 patients (22.3%) showed sensitivity to the antibiotics that the patient had been prescribed. Fifty-six patients (77.8%) displayed bacterial resistance to the antibiotic that they were taking. Conclusions: Awareness and implementation of international antibiotic stewardship guidelines are poor in primary care centers. It is important to establish strategies that foster a better understanding of treatment management standards and ensure the proper implementation of guidelines., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Aims: To evaluate the utility of the sudomotor function test (SFT) as a clinical tool in the Risk Stratification System of diabetic patients and to demonstrate the earlier detection of the risk of developing diabetic foot ulcers (DFU) compared to the standard clinical tests. Methods: Prospective follow-up study on 263 patients enrolled consecutively over 3.5 years. Diabetic patients without active DFU were classified according to the International Working Group Risk Stratification System (RSS) and categorized according to the results of the Semmes-Wenstein Monofilament (SWM) and biothesiometer measurements or the SFT. The main outcome evaluated was the development of DFU. Results: Median follow-up was 42 [38-44] months. Sixty patients (22.8%) developed DFU after a median of 6.2 [3-17] months. Ten patients that were included in the no-risk group (group 0) based on the SWM and biothesiometer results developed DFU. Thus the sensitivity of this approach was 83.33% and the specificity was 50.47%. Based on the SFT results, all patients that developed DFU were included in the correct risk group. This approach had 100% sensitivity and 31.53% specificity. Regarding the diagnostic accuracy of the two Methods, the respective AUC values were 0.776 (95% CI 0.702-0.849) and 0.816 (95% CI 0.757-0.874). Conclusions: SFT improved RSS in diabetic patients in a specialized diabetic foot unit. SFT categorized patients correctly according to the risk of developing DFU., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub