Home monitoring of foot skin temperatures to-prevent ulceration
Home monitoring of foot skin temperatures to-prevent ulceration
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DOI：
10.2337/diacare.27.11.2642
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发表时间：
2004-11-01
期刊：
影响因子：
16.2
通讯作者：
Agrawal, CM
中科院分区：
文献类型：
--
作者：
Lavery, LA;Higgins, KR;Agrawal, CM
目的-评估家庭红外温度监测作为糖尿病相关下肢溃疡和截肢高危人群预防工具的有效性。研究设计和方法-85例符合糖尿病足风险类别2或3的患者（神经病变和足部畸形或既往溃疡史或部分足部截肢）随机分为标准治疗组（n = 41）强化治疗组（n = 44）。标准治疗包括治疗鞋，糖尿病足教育，并定期足部评估足科医生。强化治疗包括增加手持红外皮肤温度计，以测量温度的脚底在早上和晚上。温度升高（与对侧脚相比> 4华氏度）被认为是由于测量部位的炎症而导致溃疡的“风险”。当足部温度升高时，指导受试者减少活动并联系研究护士。研究对象随访6个月。结果-增强治疗组糖尿病足并发症明显较少（增强治疗组2% vs.标准治疗组20%，P = 0.01，odds ratio 10.3，95%CI 1.2-85.3）。有七个溃疡和两个夏科骨折标准治疗的患者和一个溃疡在增强therapy.CONCLUSIONS-这些结果表明，在家里的患者自我监测与每日足部温度可能是一个有效的预防工具，以防止足部并发症的个人在高风险的下肢溃疡和截肢。
OBJECTIVE- To evaluate the effectiveness of at-home infrared temperature monitoring as a preventative tool in individuals at high risk for diabetes-related lower-extremity ulceration and amputation.RESEARCH DESIGN AND METHODS- Eighty-five patients who fit diabetic foot risk category 2 or 3 (neuropathy and foot deformity or previous history of ulceration or partial foot amputation) were randomized into a standard therapy group (n = 41) or an enhanced therapy group (n = 44). Standard therapy consisted of therapeutic footwear, diabetic foot education, and regular foot evaluation by a podiatrist. Enhanced therapy included the addition of a handheld infrared skin thermometer to measure temperatures on the sole of the foot in the morning and evening. Elevated temperatures (>4degreesF compared with the opposite foot) were considered to be "at risk" of ulceration due to inflammation at the site of measurement. When foot temperatures were elevated, subjects were instructed to reduce their activity and contact the study nurse. Study subjects were followed for 6 months.RESULTS- The enhanced therapy group had significantly fewer diabetic foot complications (enhanced therapy group 2% vs. standard therapy group 20%, P = 0.01, odds ratio 10.3, 95% CI 1.2-85.3). There were seven ulcers and two Charcot fractures among standard therapy patients and one ulcer in the enhanced therapy group.CONCLUSIONS- These results suggest that at-home patient self-monitoring with daily foot temperatures may be an effective adjunctive tool to prevent foot complications in individuals at high risk for lower-extremity ulceration and amputation.