The efficacy of temperature-guided preventive care in reducing diabetic foot ulcer incidence and prolonging ulcer-free survival: a systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION

Recurrence of diabetic foot ulcers (DFU) is a major clinical challenge, often leading to amputation. Temperature-guided preventive care based on skin temperature monitoring has been proposed as an early warning tool that can trigger preventive actions before overt ulceration develops. We conducted a systematic review and meta-analysis to evaluate its efficacy in preventing DFU recurrence in high-risk individuals.

METHODS

We systematically searched PubMed, Embase, the Wiley Online Library, and Web of Science for randomized controlled trials comparing temperature-guided preventive care based on skin temperature monitoring with standard care. The primary outcome was time to first ulcer recurrence, with the hazard ratio (HR) as the effect measure. The secondary outcome was overall recurrence incidence, measured by the risk ratio (RR).

RESULTS

Six randomized controlled trials involving a total of 917 participants were included. The meta-analysis demonstrated a significant protective effect for temperature-guided preventive care. The intervention group had a significantly lower hazard of ulcer recurrence compared with the control group (HR 0.63; 95% CI: 0.49-0.82; p = 0.001). Similarly, the overall risk of recurrence was significantly reduced in the intervention group (RR 0.64; 95% CI: 0.52-0.80; p = 0.001).

CONCLUSION

Temperature-guided preventive care appears to be an effective, patient-driven intervention that may reduce the risk and incidence of DFU recurrence in high-risk individuals. These findings support the potential integration of this simple, proactive tool into standard preventive care protocols to mitigate the severe consequences of this complication.