Offloading devices for neuropathic foot ulcers in adult persons with type 1 or type 2 diabetes: a rapid review with meta-analysis and trial sequential analysis of randomized controlled trials Article Swipe
George N. Okoli
,
Rasheda Rabbani
,
Olt Lam
,
Nicole Askin
,
Tanya Horsley
,
Lorraine Bayliss
,
Ildiko Tiszovszky
,
John M. Embil
,
Ahmed M Abou-Setta
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1136/bmjdrc-2022-002822
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1136/bmjdrc-2022-002822
Introduction Healing time for neuropathic planter foot ulcers (NPFUs) in persons with diabetes may be reduced through use of non-removable fiberglass total contact casting (F-TCC) compared with removable cast walkers (RCWs), although the evidence base is still growing. Research design and methods We conducted a rapid review and systematically searched for, and critically assessed, randomized controlled trials (RCTs) that compared the efficacy of F-TCC versus RCW, focusing on the time to ulcer healing in adult persons (18+ years) with NPFUs and type 1 or type 2 diabetes. We meta-analysed the mean differences and associated 95% CIs using an inverse variance, random-effects model. We also conducted a trial sequential analysis (TSA) to assess if the available evidence is up to the required information size for a robust conclusion. We assessed and quantified statistical heterogeneity between the included studies using the I 2 statistic. Results Out of 102 retrieved citations, five RCTs met the eligibility criteria. Participants’ inclusion in relation to stage of ulcer was highly variable as was peripheral neuropathy complicating comparisons. F-TCC appeared to present a shorter ulcer healing time (−5.42 days, 95% CI −9.66 days to −1.17 days; I 2 9.9%; 5 RCTs; 169 participants) compared with RCW. This finding was supported by the TSA. Conclusions There is limited evidence from RCTs to suggest that F-TCC has a shorter ulcer healing time compared with RCW among adults with diabetic NPFUs. Properly designed and conducted RCTs are still required for a stronger evidence base.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjdrc-2022-002822
- https://drc.bmj.com/content/bmjdrc/10/3/e002822.full.pdf
- OA Status
- gold
- Cited By
- 6
- References
- 23
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4280530878
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4280530878Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1136/bmjdrc-2022-002822Digital Object Identifier
- Title
-
Offloading devices for neuropathic foot ulcers in adult persons with type 1 or type 2 diabetes: a rapid review with meta-analysis and trial sequential analysis of randomized controlled trialsWork title
- Type
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reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-05-01Full publication date if available
- Authors
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George N. Okoli, Rasheda Rabbani, Olt Lam, Nicole Askin, Tanya Horsley, Lorraine Bayliss, Ildiko Tiszovszky, John M. Embil, Ahmed M Abou-SettaList of authors in order
- Landing page
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https://doi.org/10.1136/bmjdrc-2022-002822Publisher landing page
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https://drc.bmj.com/content/bmjdrc/10/3/e002822.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://drc.bmj.com/content/bmjdrc/10/3/e002822.full.pdfDirect OA link when available
- Concepts
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Medicine, Randomized controlled trial, Meta-analysis, Type 2 diabetes, Diabetic foot, Diabetes mellitus, Randomization, Internal medicine, Surgery, EndocrinologyTop concepts (fields/topics) attached by OpenAlex
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6Total citation count in OpenAlex
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2025: 1, 2024: 2, 2023: 3Per-year citation counts (last 5 years)
- References (count)
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23Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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