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The vascular causes of lower‐extremity ulcers cannot be neglected because they can directly affect treatment methods. No detailed epidemiological statistics have described vascular etiological diagnosis in China. This study aimed to explore the prevalence of clinical vascular etiological examination of lower‐extremity ulcers and improve the diagnosis and treatment effectiveness of lower‐extremity ulcers. Data were collected from the WoundCareLog database, which includes 2413 cases of lower‐extremity ulcers from 478 hospitals nationwide. Data analysis revealed that 1698 (70.4%) lower‐extremity blood flow examinations (including physical examination [PE] and assistant examinations [AE]) were performed, of which 61.7% were PE, 10.4% were AE only, and 27.9% were the combined PE and AE[PAE]. The proportion of nonexaminations was higher in the nondiabetic group than in the diabetic group (χ2 = 34.5; P <.01). The positive rates of vascular etiological examination in the diabetic and nondiabetic groups were 69.7% and 70.7%, respectively. Among the four economic regions of China, there were statistically significant differences in the use of the different examination methods. The examination of vascular diseases in lower‐extremity ulcers in China has not been fully popularized and requires improvement; there was no statistically significant difference between examination rates by doctors and nurses, which is mainly based on PE. However, PE has certain rates of misdiagnosis and missed diagnosis. The false‐positive and false‐negative rates were 25.7% and 57.6%, respectively. The use of an AE can compensate for this deficiency by making diagnosis more precise, while the quantitative diagnostic criteria allow disease diagnosis to transcend geographical and operator differences and maximize uniformity. The vascular B‐ultrasound examination is more suitable for the medical environment in China because of its mature technology, high hospital penetration rate, and low cost. [ABSTRACT FROM AUTHOR]

The aim of the study was to compare two systems of classification in a consecutive population with diabetic foot ulcers: the Wagner grade and the Saint Elian Wound Score System (SEWSS). Sociodemographic information, patient-related and ulcer-related data at first presentation was recorded, and the patients were followed up until wound healing or accepting major amputation or for 24 weeks. One hundred eighty-six patients were included in the study, of which 172 patients were completely followed up. Among the remaining 172 patients, 53.5% (n = 92) were healed without minor amputation, 32% (n = 55) were healed with minor amputation, 9.3% (n = 16) were not healed at study termination, 3.5% (n = 6) died and 1.7% (n = 3) underwent major amputation. The median healing time for Wagner 1, Wagner 2, Wagner 3, and Wagner 4 were 23, 50, 54, 119 days, respectively. The log-rank test showed significant differences in healing time for Wagner 1, Wagner 2, Wagner 3, and Wagner 4; The median healing time for SEWSS I, SEWSS II and SEWSS III were 12, 51, and 150 days, respectively. The log-rank test showed significant differences in healing time for SEWSS I, SEWSS II and SEWSS III. Cox regression analysis showed a decreasing probability of healing with or without minor amputation with a higher SEWSS value, an increase in the SEWSS by one score reduced the probability for healing by 24%. ROC analysis showed Wagner 3 and a cut-point 17 of SEWSS had the highest Youden's index. Both the Wagner grade and SEWSS system were associated with the ulcer healing time for the patients with active DFUs. The SEWSS score makes it a better prediction tool of DFU outcome synthetically., (© 2015 by the Wound Healing Society.)

The tissue accumulation of advanced glycation end products (AGEs) can be noninvasively assessed as skin autofluorescence (SAF) by the AGE Reader(TM) device. We aimed to detect the association between SAF and diabetes-associated vascular complications in diabetic foot ulcer (DFU) patients engaged in this study. This cross-sectional survey consisted of 118 consecutive hospitalized diabetic foot patients. The diabetic microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular referring to coronary heart disease (CHD), cerebrovascular disease (CVD), or peripheral artery disease (PAD) complications were evaluated, and then they were divided into different subgroups based on the assessment of vascular complications. As seen from the results, the mean SAF value was 2.8 ± 0.2 AU. SAF was significantly associated with diabetes duration and blood urea nitrogen (R(2) = 62.8%; P < .01). Moreover, in logistic regression analysis, SAF was significantly associated with retinopathy (odds ratio [OR] = 40.11), nephropathy (OR = 8.44), CHD (OR = 44.31), CVD (OR = 80.73), and PAD (OR = 5.98 × 10(9)). In conclusion, SAF, reflecting tissue accumulation of AGEs, is independently associated with the presence of vascular complications in DFU patients., (© The Author(s) 2015.)

The objectives of the study were to translate the Cardiff Wound Impact Schedule (CWIS), a disease-specific quality-of-life measure, into Chinese, and to evaluate its psychometric properties. The CWIS went through the full linguistic translation process and was evaluated in patients with current diabetic foot ulcers (DFU). Patients were categorized using the Wagner grade. Mean CWIS scores were compared between categories to evaluate the scale's ability to differentiate ulcer severity (Wagner grade). There were a total of 131 consecutive patients included in the study. Except item A22 (I am confident that the wound I have will heal), the results of item-domain correlation (r ranged from .391 to .827) and small-group analysis (critical ratio, P < .05) were satisfactory. Furthermore, the Chinese CWIS also demonstrated good criterion validity when correlated with the Short Form-36 (r = .79, P < .01). After deleting item 22, exploratory factor analysis of the items confirmed the existence of 3 hypothesized domains, physical symptoms and daily living (12 items), social life (7 items), and well-being (6 items), and totally explained 57.194% of the variance. The internal consistency of all scales of the Chinese CWIS was consistently high (Cronbach's α ranged from .789 to .929). Split-half reliability was 0.748. Sensitivity was demonstrated between patients with different etiologies of diabetic foot ulcer and those with different ulcer severity (Wagner grade). From the authors' view, the lately validated Chinese CWIS has good psychometric performance and may be appropriately used to assess the health-related quality of life of Chinese patients with DFUs.