What Researchers Did
Researchers conducted a narrative review, extending literature research from the 2014 German S3-PAD-guidelines to 2020, to evaluate alternative therapies for diabetic foot patients without revascularization options.
What They Found
The review found insufficient evidence to recommend gene and stem-cell therapy, hyperbaric oxygen, sympathectomy, spinal cord stimulation, or prostanoids for diabetic foot patients unable to undergo revascularization. Instead, risk factor management is recommended for all critical limb-threatening ischemia patients, and conservative treatment with proper wound care and offloading can be effective. Timely amputation was also identified as a beneficial alternative to improve mobilization and quality of life.
What This Means for Canadian Patients
For Canadian patients with diabetic foot wounds who cannot undergo revascularization, this review suggests that conservative treatment with diligent wound care and offloading remains a primary option. Additionally, timely amputation should be considered as a beneficial alternative to improve mobility and overall quality of life.
Canadian Relevance
This narrative review has no direct Canadian connection as it extended literature research for German guidelines.
Study Limitations
As a narrative review, this study may be subject to selection bias and lacks the systematic rigor of a comprehensive systematic review or meta-analysis.