{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:32:49Z","timestamp":1788978769624,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,8,4]],"date-time":"2016-08-04T00:00:00Z","timestamp":1470268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A heel ulcer is considered to be a serious complication in patients with diabetes, and there is limited information regarding outcome. In most of the literature, a poor prognosis is described. The aim of this study was to investigate a large cohort of ulcers located in the heel in patients with diabetes.<\/jats:p><jats:p>Seven hundred and sixty\u2010eight patients [median age 73 (17\u201398)], presenting with a heel ulcer at a multidisciplinary diabetes foot clinic, fulfilled the inclusion criteria and were followed\u2010up until final outcome.<\/jats:p><jats:p>Fifty\u2010eight per cent of the patients healed primarily; 7% healed after major debridement; 9% healed after amputation and 25% died unhealed. Median healing time was 17 weeks. Ulcer progression was seen in 19% of patients. Thirty\u2010one percent of patients had severe peripheral vascular disease. A creatinine level below 91 \u00b5mol\/l was related to a higher probability for healing without major debridement or amputation, whereas vascular surgery, nephropathy and oedema were related to a lower probability for healing without major debridement or amputation.<\/jats:p><jats:p>Two thirds of heel ulcers do heal in patients with diabetes despite patients being elderly and with extensive comorbidity. The extent of peripheral vascular disease, nephropathy, oedema and decreased renal function are important factors influencing outcome.<\/jats:p>","DOI":"10.1111\/iwj.12654","type":"journal-article","created":{"date-parts":[[2016,8,4]],"date-time":"2016-08-04T06:48:20Z","timestamp":1470293300000},"page":"629-635","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Heel ulcers do heal in patients with diabetes"],"prefix":"10.1111","volume":"14","author":[{"given":"Hedvig","family":"\u00d6rneholm","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Sk\u00e5ne University Hospital and Lund University  Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Apelqvist","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Sk\u00e5ne University Hospital and Lund University  Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Sk\u00e5ne University Hospital and Lund University  Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Eneroth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Sk\u00e5ne University Hospital and Lund University  Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,8,4]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"International Consensus on the Diabetic Foot and Guidance on the Management and Prevention of the Diabetic Foot. International Working Group on the Diabetic Foot2015. The Hague URLwww.iwgdf.org. [accessed on 1 September 2015]."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(96)00125-0"},{"key":"e_1_2_7_4_1","first-page":"50","article-title":"Diabetic heel ulcers: a major risk factor for lower extremity amputation","volume":"50","author":"Younes N","year":"2004","journal-title":"Ostomy Wound Manage"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2011.01.008"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2011.00869.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(99)80052-0"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2011.00878.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01665.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1994.tb01104.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453679408995476"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199805000-00021"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-1226-2"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8227(92)90054-U"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.12.6.373"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110078100200202"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(99)00065-3"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0491-1"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2000.106493"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2011.10.032"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12328"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2400"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.136.12.1531"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2431"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2001.00422.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0940-0"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fiwj.12654","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fiwj.12654","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.12654","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T11:52:49Z","timestamp":1696506769000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.12654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,4]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1111\/iwj.12654"],"URL":"https:\/\/doi.org\/10.1111\/iwj.12654","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,8,4]]},"assertion":[{"value":"2016-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}