Systematic ReviewResearchPatient EducationWorkflow

Custom orthoses reduced diabetic-foot ulcer recurrence inconsistently across 10 trials

Journal of Foot and Ankle Research (PubMed)Aug 1, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review of 10 randomized trials involving 1,686 participants found that custom orthoses reduced diabetic-foot ulcer recurrence in several studies, but differences in devices and follow-up prevented a pooled effectiveness estimate.

What NurseJet pulled from the source

The review narratively compared medical shoes and custom insoles with usual care. One cited trial reported recurrence of 9.9% versus 25%, but results were heterogeneous and should not be treated as a universal effect for every orthosis or patient.

Why this matters for nurses

Wound-care nurses assess skin integrity, pressure exposure, footwear use, and adherence between visits. The review supports including prescribed orthoses in a recurrence-prevention plan while emphasizing that fit, consistent use, surveillance, and multidisciplinary follow-up remain essential.

Bedside takeaway

Prescribed orthoses may reduce recurrent diabetic-foot ulcers when fit, adherence, skin checks, and follow-up are addressed together.

How This Applies in Practice

Use this when: Caring for a person with diabetes and a healed foot ulcer who has prescribed therapeutic footwear or a custom orthosis.

On your shift

Inspect the feet and orthosis for fit, pressure marks, moisture, debris, wear, and new skin or infection concerns.
Confirm the prescribed wearing schedule and podiatry, wound-care, diabetes, or orthotics follow-up plan.
Use teach-back for daily foot inspection and symptoms that require stopping device use and prompt clinical contact.

Keep in mind: Devices and outcomes varied across trials, and an orthosis does not replace glycemic, vascular, skin, and footwear management. Follow the wound-care protocol, facility policy, and provider orders.

Key takeaways

The review included 10 randomized trials and 1,686 participants at risk for recurrent diabetic-foot ulcers.
Several trials favored custom orthoses or therapeutic footwear over usual care.
Orthosis types, adherence, and follow-up periods varied across studies.
Heterogeneity prevented a single pooled estimate of recurrence reduction.

Practice implications

Inspect both feet and the device for pressure areas, skin damage, moisture, fit problems, and signs of infection. Confirm the prescribed wearing schedule and follow-up, reinforce daily self-inspection, and escalate new redness, blistering, drainage, odor, warmth, swelling, or breakdown.

Limitations & cautions

The review used narrative synthesis because devices, comparators, adherence, and follow-up varied. The abstract gives one trial-level recurrence example rather than a pooled effect, so the magnitude of benefit cannot be generalized to every orthosis.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Open source

Public citations are filtered to exact credible source pages. Homepage-only or invalid links stay in admin review and are not shown here.

Journal of Foot and Ankle Research (PubMed)

Journal of Foot and Ankle Research (PubMed). Comparing the Effectiveness of Different Types of Orthoses in Preventing Diabetic Foot Ulcer Recurrence: A Systematic Review of Randomized Clinical Trials.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42541747/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

Related briefs

More updates for this clinical area

Back to Discover

Renal failure (PubMed)Sep 7, 2026Research Article

A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

Med-SurgAI summaryReview source

Research ArticleResearchQuality ImprovementAI summary · original source linked below

Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

Telemetry Med-SurgAI summaryReview source

Research ArticleResearchMedication SafetyPatient EducationAI summary · original source linked below

Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

Key takeaways

At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Journal of the American Medical Directors Association (PubMed)Sep 5, 2026Research Article

A prospective Dutch nursing-home cohort found clinically important differences in illness burden across respiratory viruses, with influenza and human metapneumovirus standing out.

Geriatrics Med-SurgAI summaryReview source

Research ArticleResearchInfection ControlAI summary · original source linked below

Among 3,195 residents at 15 nursing homes, 526 suspected acute respiratory-infection episodes were recorded and a virus was identified in 291. Influenza A was associated with delayed recovery, oxygen use, and threefold secondary-bacterial-pneumonia risk; hMPV was linked to fourfold more time in bed.

Key takeaways

SARS-CoV-2, influenza A, rhinovirus or enterovirus, and RSV were the most frequently identified viruses.
hMPV and RSV tended to have higher odds of moderate or severe disease.
Virus-specific patterns were associations from a cohort, not randomized comparisons.

Why this matters on shift

Frailty can amplify respiratory-infection consequences, and the causative virus may help anticipate recovery, oxygen, mobility, and secondary-infection needs.

Bedside takeaway

Trend oxygen needs, mobility, recovery, and secondary-pneumonia signs during nursing-home respiratory infections.

Nursing implications

During outbreaks or suspected infection, trend oxygen needs, mobility and time in bed, recovery, and signs of bacterial pneumonia according to facility protocols.

Limitations & cautions

Abstract-only summary. Data came from 15 Dutch nursing homes, the overall suspected-infection risk estimate was imprecise, and virus-outcome comparisons may be affected by confounding and small subgroup counts.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of the American Medical Directors Association (PubMed). Clinical Impact of Acute Respiratory Virus Infections in Nursing Home Residents.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

One in four laboratory-defined AKI cases went undocumented on medicine wards

Targeted vitamin D did not significantly reduce major cardiovascular events after MI

Influenza and hMPV carried substantial illness burden in nursing home residents