2006 Volume 49 Issue 3 Pages 189-195
In order to clarify the usefulness of Semmes-Weinstein monofilaments (SWMs) as a screening test for risk of diabetic foot ulcer and amputation, we compared the sensitivity and specificity of using 4 sizes of SWM (3.61/0.4 g, 4.31/2 g, 4.56/4 g, 5.07/10 g) at 7 sites on the plantar surface of the foot of 59 type 2 diabetes patients with (n=19) and without of (n=40) foot ulcers or gangrene. The sensitivity of the 4.56/4 g SWM test for high-risk patients with foot ulcer or gangrene was significantly higher than that of 5.07/10 g SWM test, but there was no significant difference between the specificity of the 4.56/4 g and 5.07/10 g SWMs. The 4.56/4 g SWM test was less sensitive (90%) but more specific (78.9%) at the great toe plus plantar aspect of the first metatarsal head than at the great toe (100% and 73.6%, respectively), and had the highest SWM sensitivity and specificity at one site.
Based on these results, we concluded that using 4.56/4 g SWMs on the great toe plus plantar aspect of the first metatarsal head may be useful for screening diabetic patients for high risk of diabetic foot ulcer and gangrene.
