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Clinical Efficacy of Different Revision Times in the Reulceration Rate in Persons with Diabetes and Remission

Not Applicable
Completed
Conditions
Diabetic Foot
Interventions
Behavioral: 2 weeks revision
Registration Number
NCT06143215
Lead Sponsor
Universidad Complutense de Madrid
Brief Summary

The goal of this three arms randomized clinical trial is to compare different revision times in persons with diabetes at high risk of suffering a diabetic foot reulceration (patients in remission). The literature suggests to clinically check the patients in a 4-12 weeks basis, despite this, this recommendation is based in expert opinions.

The main question it aims to answer is:

- Does different revision times could affect the reulceration rate in persons with diabetes in remission. Different revision time will be 2 weeks, 4 weeks and 6 weeks.

Detailed Description

The planned RCT try to elucidate if there exist any difference in ulcer recurrence between different revisions times in persons with a previous healed diabetic foot ulcer and currently under remission.

There will exist three different groups for analyses after randomization:

* Group 1: patients revised every fourweeks.

* Group 2: patients revised every eightweeks.

* Group 3: patients revised every twelveweeks.

Main outcome measure will include:

- Recurrence: the outcome measure was based on recurrent events in the foot in a binary basis (patient with a recurrent event or patient without a recurrent event), as defined according to the IWGDF guidelines. Recurrent events were considered as breaks in the foot skin at the epidermis and part of the dermis level.

Secondary outcome measure will include:

* Minor lesions: defined as non ulcerative lesions of the skin on the plantar aspect of the foot and included abundant callus, hemorrhage, or a blister.

* Minor amputations: evaluated in a monthly basis during the 1-year prospective period

Follow-up period: all the sample will be followed-up depending on the randomization group up to a 1-year prospective period. In every visit de principal investigator will perform debridement of high-risk points, such as minor lesions or calluses.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
148
Inclusion Criteria
  • Patients aged 18 years or older.
  • Type 1 or type 2 diabetes.
  • Presence of diabetic polyneuropathy (diagnosed as an inability to sense the pressure of a 10-g Semmes-Weinstein monofilament at three plantar foot sites and/or a vibration perception threshold >25 V, as assessed using a bio-tensiometer.
  • Patients classified as high-risk patients (risk 3 patients according to the IWGDF guidance). Previous healed diabetic foot ulcer.
Exclusion Criteria
  • Active diabetic foot ulcers during inclusion.
  • Active Charcot foot process.
  • Conditions other than diabetes also associated with foot ulcers were excluded from the study as well.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Two weeks revision group2 weeks revisionPatients will be clinically revised in a 2-weeks basis
Four weeks revision group2 weeks revisionPatients will be clinically revised in a 4-weeks basis
Six weeks revision group2 weeks revisionPatients will be clinically revised in a 6-weeks basis
Primary Outcome Measures
NameTimeMethod
Recurrence rateFrom randomization to first documented diabetic foot ulcer appearance, assessed up to 48 weeks.

Defined as as break in the foot skin at the epidermis and part of the dermis level.

Secondary Outcome Measures
NameTimeMethod
Minor amputation rateFrom randomization to first documented diabetic foot ulcer appearance, assessed up to 48 weeks.

Need for minor amputation secondary to ulcer recurrence

Minor lesion rateFrom randomization to first documented diabetic foot ulcer appearance, assessed up to 48 weeks.

Defined as non ulcerative lesions of the skin on the plantar aspect of the foot and included abundant callus, hemorrhage, or a blister.

Trial Locations

Locations (1)

Clínica Universitaria de Podología de la Universidad Complutense de Madrid

🇪🇸

Madrid, Spain

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