Diabetic Foot
Conditions
Keywords
diabetic foot, diabetes, LSCI, thermography
Brief summary
Diabetic foot ulcers are one of the complications of diabetes mellitus. These wounds are often the result of diabetes-related neuropathy and/or an ischemic foot. Even with great care, recurrent ulcers are common. To mediate the damage and societal costs that come with DF there is a need for applications to detect ulcers before they come apparent. Two of these promising techniques are Laser Speckle Contrast imaging and thermography. This study is part of 4 specific clinical studies and is aimed at determining Laser Speckle Contrast imaging and thermography features, the provocations that are needed to optimize imaging and the correlation between these features and the IWGDF risk stratification category system for the diabetic foot.
Detailed description
Diabetic foot ulcers are one of the complications of diabetes mellitus. These wounds are often the result of diabetes-related neuropathy and/or an ischemic foot. Diabetic feet (DF) are ideally treated by a multidisciplinary wound care team. Patients at high risk and especially patients that suffer from DF before will have to be checked regularly for new wounds. Even with great care, recurrent ulcers are common. To mediate the damage and societal costs that come with DF there is a need for applications to detect ulcers before they come apparent. To improve care, an application to predict the healing status is desired. To this purpose, a set of four (4) specific clinical studies has been conceived to tackle the overall challenging objectives to characterise the risk of ulcers in different patients and through different measurement conditions, including conditions of how a tele-home care service can be deployed. This is clinical study A. This study investigates two techniques: Laser speckle contrast imaging (LSCI) is a promising non-invasive technique to assess microcirculation. LSCI, exploits the random speckle pattern that is generated when tissue is illuminated by laser light and changes when blood cells move in the sampled tissue. Thermography is used to measure temperature distribution on the foot. It is expected that soon-to-be affected regions will be warmer than other regions. Also, regions with impaired blood supply can be recognized. Clinical study A aims at determining Laser Speckle Contrast imaging and thermography features, the provocations that are needed to optimize imaging, and the correlation between these features and the IWGDF risk stratification category system for the diabetic foot.
Interventions
None listed
Sponsors
University of Twente
Ziekenhuisgroep Twente
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The sample will include all the people who sign the informed consent. * Patients above 18. Patients diagnosed with Diabetic feet. * Patients with Risk Level 0, 1, 2 and 3 according to the International Working Group on the Diabetic Foot - IWGDF).
Exclusion criteria
* People who do not give their consent to participate in the study. * Patients with active wounds on one or both feet.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Temperature at various regions of interest using thermography | During one outpatient visit (30 minutes) | Maps of perfusion units will be gathered for different risk groups. The Temperature will be used to create risk features together with perfusion units from LSCI . |
| The effect of provocations performed prior to measuring with thermography | During one outpatient visit (30 minutes) | For both LSCI and thermography the circulation in the leg will be provoked using the leg raise maneuver or a pressure cuff. The effect on both measurements with and without these provocations will be evaluated. |
| Correlation of the above features with the chance of developing ulcers (Risk 0, Risk 1, Risk 2 and Risk 3). | Year 4 | A first attempt will be made to find a correlation between perfusion and temperature and how these differ depending on the risk factor. |
| Perfusion units at various regions of interest using LSCI | During one outpatient visit (30 minutes) | Maps of perfusion units will be gathered for different risk groups. The perfusion units will be used to create risk features together with thermography . |
| The effect of provocations performed prior to measuring with LSCI | During one outpatient visit (30 minutes) | For both LSCI and thermography the circulation in the leg will be provoked using the leg raise maneuver or a pressure cuff. The effect on both measurements with and without these provocations will be evaluated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assessing the practical needs for transferring measurements to a different environment (e.g., home) by interviewing the clinicians involved in the consortium. | Year 3 | Other work packages in the greater MYFOOT consortium focus on transferring technologies from the hospital to the patient's home. Based on the workflow created in this study and the expert opinion of the clinicians involved in the consortium it will be decided if and how LSCI and thermography can be measured at a patient's home. |
| Gathering data for AI (artificial intelligence) risk factor analysis in MYFOOT study | Year 4 | Data will be gathered for other work packages in the consortium that focus on creating a model for clinical decision making. |
Contacts
Primary ContactKilian Kappert, PhD
Backup ContactWiendelt Steenbergen, PhD
Outcome results
None listed