The Semmes Weinstein monofilament examination is a significant predictor of the risk of foot ulceration and amputation in patients with diabetes mellitus.
Summary of "The Semmes Weinstein monofilament examination is a significant predictor of the risk of foot ulceration and amputation in patients with diabetes mellitus."
OBJECTIVE:
Diabetic peripheral neuropathy is a major complication of diabetes mellitus (DM) and is the leading cause of foot ulceration and lower extremity amputations (LEAs). The purpose of this systematic review is to evaluate current evidence regarding the prognostic value of the Semmes Weinstein monofilament examination (SWME) in predicting foot ulceration and LEA in patients with DM.
METHODS:
The MEDLINE/PubMed database was searched through November 2009 for articles pertaining to diabetic foot and SWME with no language or publication date restrictions. Prognostic studies with original data assessing the predictive value of SWME for foot ulceration or LEA in patients with DM were included in the selection. Data were systematically extracted and analyzed by two independent investigators. Absolute risks and relative risks were determined for each study.
RESULTS:
Of the 863 studies identified, nine articles were relevant, involving 11,007 patients with DM. Six studies were identified that assessed the prognostic value of SWME regarding diabetic foot ulceration. The relative risk for patients with a positive SWME result versus those with a negative result ranged from 2.5 (95% confidence interval [CI], 2.0 to 3.2) to 7.9 (95% CI, 4.4 to 14.3) in the identified studies with follow up between 1 and 4 years. Three of the studies assessed the risk of LEA with a positive SWME result. The relative risk for LEA ranged from 1.7 (95% CI, 1.1 to 2.6) to 15.1 (95% CI, 4.3 to 52.6) with follow-up between 1.5 and 3.3 years.
CONCLUSIONS:
All nine studies found SWME to be a significant and independent predictor of future foot ulceration or likely of future LEA as well in patients with DM. Therefore, SWME is an important evidence-based tool for predicting the prognosis of patients with diabetic foot, thus enabling improved patient selection for early intervention and management. More research should be conducted to elucidate the relationship between SWME and LEA.
Affiliation
Section of Vascular Surgery, Yale University School of Medicine.
Journal Details
This article was published in the following journal.
Name: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascu
ISSN: 1097-6809
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20692793
- DOI: http://dx.doi.org/10.1016/j.jvs.2010.06.100
Medical and Biotech [MESH] Definitions
Tarsal Tunnel Syndrome
Entrapment of the distal branches of the posterior TIBIAL NERVE (which divides into the medial plantar, lateral plantar, and calcanial nerves) in the tarsal tunnel, which lies posterior to the internal malleolus and beneath the retinaculum of the flexor muscles of the foot. Symptoms include ankle pain radiating into the foot which tends to be aggravated by walking. Examination may reveal Tinel's sign (radiating pain following nerve percussion) over the tibial nerve at the ankle, weakness and atrophy of the small foot muscles, or loss of sensation in the foot. (From Foot Ankle 1990;11(1):47-52)
Foot Deformities, Acquired
Distortion or disfigurement of the foot, or a part of the foot, acquired through disease or injury after birth.
Self-examination
The inspection of one's own body, usually for signs of disease (e.g., BREAST SELF-EXAMINATION, testicular self-examination).
Diabetic Foot
Common foot problems in persons with DIABETES MELLITUS, caused by any combination of factors such as DIABETIC NEUROPATHIES; PERIPHERAL VASCULAR DISEASES; and INFECTION. With the loss of sensation and poor circulation, injuries and infections often lead to severe foot ulceration, GANGRENE and AMPUTATION.
Risk Reduction Behavior
Reduction of high-risk choices and adoption of low-risk quantity and frequency alternatives.
PubMed Articles
Study design:Prospective experimental.Objectives:To compare the reliability and repeatability of the electrical perceptual threshold (EPT) and Semmes-Weinstein monofilament (SWM) tests for cutaneous s...
BACKGROUND: The 10-g Semmes-Weinstein monofilament and 128-Hz tuning fork examinations are considered simple and effective screening instruments for diabetic peripheral neuropathy. This study investig...
Nasal tactile sensitivity in elderly.
Abstract Conclusion: Although older people varied widely in tactile sensitivity, our results show that tactile thresholds increased with age. Objectives: The aim of this study was to evaluate the effe...
Peripheral neuropathy: a complication of systemic sclerosis.
We performed bedside testing for peripheral neuropathy in our systemic sclerosis (SSc) population to determine whether foot care guidelines should be developed for SSc. Twenty consecutive SSc patients...
Nasal tactile sensitivity in allergic rhinitis.
Abstract Conclusion: These preliminary data show a decrease in nasal tactile sensitivity and point out interesting aspects of the nasal chronic inflammatory condition in allergic rhinitis. Objectives:...
Clinical Trials
Risk Factors for Foot Ulceration in the Chronic Kidney Disease (CKD) Population
Foot ulceration is a risk factor that has been associated with early death in patients with chronic kidney disease. Little is known about the relationship between these risk factors that d...
Improving Diabetic Foot Ulcers With Atorvastatin
Lower limb complications are a substantial matter in the diabetic population and studies show that the annual incidence of foot ulcers ranges from 1.0-4.1% while the cumulative lifetime in...
A Comparison of Monosyn and Monocryl Sutures in Surgical Wounds
To better understand surgeon preference when using synthetic, absorbable, monofilament suture by comparing two similar appearing FDA-approved sutures, Monosyn (Aesculap) and Monocryl (Eth...
BST-DERMON Versus Standard of Care in the Treatment of Diabetic Foot Ulcers
This trial is designed to investigate the therapeutic benefits of using BST-DermOn for the wound repair of diabetic neuropathic foot ulcers. The objective of this study is to evaluate the...
Ischemic Foot Ulcers: Is Intervention Better Than Wound Care Alone
You are being asked to take part in this study because your doctor has determined that you have an ischemic foot ulcer. This research study will compare two approved standard of care trea...
