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International Journal of Lower Extremity Wounds

Harikrishna K R Nair
No abstract text is available yet for this article.
July 1, 2018: International Journal of Lower Extremity Wounds
Alfred Gatt, Owen Falzon, Kevin Cassar, Kenneth P Camilleri, Jean Gauci, Christian Ellul, Stephen Mizzi, Anabelle Mizzi, Nikolaos Papanas, Cassandra Sturgeon, Nachiappan Chockalingam, Cynthia Formosa
This study aimed to determine whether thermal imaging can detect temperature differences between healthy feet, nonulcerated neuroischemic feet, and neuroischemic feet with toe ulcers in patients with type 2 diabetes mellitus (T2DM). Participants were prospectively divided into 3 groups: T2DM without foot problems; a healthy, nonulcerated neuroischemic group, and an ulcerated neuroischemic group. Thermal images of the feet were obtained with automated segmentation of regions of interest. Thermographic images from 43 neuroischemic feet, 21 healthy feet, and 12 neuroischemic feet with active ulcer in one of the toes were analyzed...
June 1, 2018: International Journal of Lower Extremity Wounds
Álvaro Iglesias-Puzas, Beatriz González-Sixto, J Carlos Feal-Cortizas, M Teresa Abalde-Pintos, Ángeles Flórez
Acral lentiginous melanoma is the most common subtype among melanomas on the foot. Reconstruction of a wide surgical defect once it is excised may result in a challenge that requires replacing the lost tissue with another tissue having similarly unique physical characteristics. Although reconstructive options such as skin grafts and either local or distant flaps offer adequate coverage, they often are subject of contraction, muscle atrophy, and contour abnormalities. Dermal substitutes provide support and structure and recreates the dermal layer to ensure a durable reconstruction...
June 1, 2018: International Journal of Lower Extremity Wounds
Michael A Del Core, Junho Ahn, Dane K Wukich, George T Liu, Trapper Lalli, Michael D VanPelt, Katherine M Raspovic
The primary aim of this study was to evaluate the impact of gender on health-related quality of life (HRQOL) using a generic (Short Form-36 [SF-36]) and region-specific (Foot and Ankle Ability Measure [FAAM]) health measurement tool among a matched cohort of male and female patients with diabetes-related foot complications. The HRQOL of 240 patients with diabetic foot disease was measured using the SF-36 and the FAAM surveys. A total of 120 male patients were matched with 120 female patients with the same primary diagnosis, age, type, and duration of diabetes and insulin use...
June 1, 2018: International Journal of Lower Extremity Wounds
Sun-June Park, Kyeong-Tae Lee, Byung-Joon Jeon, Kyong-Je Woo
Pedicled perforator flaps (PPFs) have been widely used to treat pressure sores in the gluteal region. Selection of a reliable perforator is crucial for successful surgical treatment of pressure sores using PPFs. In this study, we evaluate the role of magnetic resonance imaging (MRI) in planning PPF reconstruction of pressure sores in the gluteal region. A retrospective chart review was performed in patients who had undergone these PPF reconstructions and who had received preoperative MRI. Preoperatively, the extent of infection and necrotic tissue was evaluated using MRI, and a reliable perforator was identified, considering the perforator location in relation to the defect, perforator size, and perforator courses...
April 1, 2018: International Journal of Lower Extremity Wounds
Kittipan Rerkasem, Raj Mani
No abstract text is available yet for this article.
March 2018: International Journal of Lower Extremity Wounds
Zhiqiang Zhang, Hao Li, Hai Li, Xuan Yang, Zhenkai Wu, Ziming Zhang
A 2-year-old girl who was badly injured by a forklift, was presented to the emergency department with open and comminuted pelvic fracture, dislocation of right sacroiliac jointand femoral neck fracture on the left side. An urgent debridement was performed. However, postoperatively, the girl had apparent abdominal distension. The results of contrast-enhanced CT implied that the intestineherniated through the fissure formed by dislocation of the sacroiliac joint, which was confirmed during the operation. Therefore, hernia repair and reduction of the sacroiliac joint were performed by a Multidisciplinary team...
March 1, 2018: International Journal of Lower Extremity Wounds
Christos D Karkos, Ioakeim Papoutsis, Ioakeim T Giagtzidis, Ioannis Pliatsios, Maria-Aphroditi Mitka, Konstantinos O Papazoglou, Apostolos G Kambaroudis
Management of large postfasciotomy wounds and/or skin and soft tissue defects after major vascular trauma to the extremities can be challenging. The External Tissue Extender (Blomqvist; ETE), a skin-stretching device, which consists of silicone tapes and plastic stoppers, approximates wound margins and facilitates delayed primary closure. We describe our experience with the use of ETE in 5 patients (4 males) with a total of 8 wounds (7 postfasciotomy, 1 soft tissue defect) over the past 12 years. The mean patient age was 32 (range 17-61) years...
March 1, 2018: International Journal of Lower Extremity Wounds
Harikrishna K R Nair
The management of chronic nonhealing ulcers pose a great challenge because they are associated with morbidity and increased costs. This report presents the observations of standard management along with application of modified collagen with glycerin (MCG) in the periwound area for management of nonhealing wounds. This observational report included 50 patients (33 male, 17 female) aged 24 to 94 years having nonhealing wounds. All wounds were treated using standard treatment protocols (TIME concept), whereas the periwound severity was assessed using the Harikrishna Periwound Skin Classification (HPSC)...
March 2018: International Journal of Lower Extremity Wounds
Maxime Tindong, John N Palle, Daniel Nebongo, Leopold Ndemnge Aminde, Yannick Mboue-Djieka, Nicole T Fouda Mbarga, Mesmin Y Dehayem, Siméon-Pierre Choukem
This study aimed to determine the prevalence of diabetic foot ulcer and high risk for ulceration, describe the clinical presentation, and identify factors associated with diabetic foot ulcer in the Southwest regional hospitals of Cameroon. In this cross-sectional study, data were collected using a structured questionnaire administered to consecutive patients with diabetes. Findings from detailed foot examination were recorded. Diabetic foot ulcer was diagnosed according to the International Working Group on Diabetic Foot (IWGDF) definition...
March 2018: International Journal of Lower Extremity Wounds
Gerardo Víquez-Molina, Javier Aragón-Sánchez, Cristian Pérez-Corrales, Christian Murillo-Vargas, María Eugenia López-Valverde, Benjamin A Lipsky
The aim of this study is to describe the presence of genes encoding for 4 virulence factors (pvl, eta, etb, and tsst), as well as the mecA gene conferring resistance to beta-lactam antibiotics, in patients with diabetes and a staphylococcal foot infection. We have also analyzed whether isolates of Staphylococcus aureus from bone infections have a different profile for these genes compared with those from exclusively soft tissue infections. In this cross-sectional study of a prospectively recruited series of patients admitted to the Diabetic Foot Unit, San Juan de Dios Hospital, San José, Costa Rica with a moderate or severe diabetic foot infection (DFI), we collected samples from infected soft tissue and from bone during debridement...
March 2018: International Journal of Lower Extremity Wounds
Junho Ahn, Michael A Del Core, Dane K Wukich, George T Liu, Trapper Lalli, Michael D VanPelt, Javier La Fontaine, Lawrence A Lavery, Katherine M Raspovic
The aim of this study was to examine if using orthogonal and oblique factor analysis detect changes in health-related quality of life differently in diabetic patients on the Short Form-36 (SF-36) survey. A total of 155 patients had diabetic foot complications (DFC), and 145 patients had no DFCs. The SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were calculated using scoring coefficients determined by orthogonal and oblique rotation principle component analyses of the subscales...
March 2018: International Journal of Lower Extremity Wounds
Philipp Jansen, Ingo Stoffels, Joachim Klode, Finja Jockenhöfer, Matthias Augustin, Dirk Schadendorf, Joachim Dissemond
The surgical removal of split skin grafts (SSGs) leads to superficial wounds that can be covered with different wound dressings. Currently, international guidelines that recommend a standard treatment of the donor sites are not yet established. We developed a questionnaire to evaluate the treatment of SSG donor sites and sent it to all dermatological departments in Germany. Altogether 78 of the 115 contacted departments in Germany participated in our cross-sectional trial. Our analysis reveals that multiple wound dressings with different frequencies of replacement are used...
March 2018: International Journal of Lower Extremity Wounds
Konstantinos Markakis, Alan Robert Faris, Hamed Sharaf, Barzo Faris, Sharon Rees, Frank L Bowling
Foot infections are common among diabetic patients with peripheral neuropathy and/or peripheral arterial disease, and it can be the pivotal event leading to a minor or major amputation of the lower extremity. Treatment of diabetic foot infections, especially deep-seated ones, remains challenging, in part because impaired blood perfusion and the presence of biofilms can impair the effectiveness of systemic antibiotics. The local application of antibiotics is an emerging field in the treatment of diabetic foot infections, with demonstrable advantages...
March 2018: International Journal of Lower Extremity Wounds
Prashanth R J Vas, Michael Edmonds, Venu Kavarthapu, Hisham Rashid, Raju Ahluwalia, Christian Pankhurst, Nikolaos Papanas
The "diabetic foot attack" is one of the most devastating presentations of diabetic foot disease, typically presenting as an acutely inflamed foot with rapidly progressive skin and tissue necrosis, at times associated with significant systemic symptoms. Without intervention, it may escalate over hours to limb-threatening proportions and poses a high amputation risk. There are only best practice approaches but no international protocols to guide management. Immediate recognition of a typical infected diabetic foot attack, predominated by severe infection, with prompt surgical intervention to debride all infected tissue alongside broad-spectrum antibiotic therapy is vital to ensure both limb and patient survival...
March 2018: International Journal of Lower Extremity Wounds
Hanlei Zhou, Huawei Shao, Jon Kee Ho, Xingang Wang, Chunmao Han, Guoxian Chen
Chronic or nonhealing wounds is a complex disease influenced by a multitude of factors, such as infection, ischemia, malnutrition, and diabetes and infrequently relates to retroperitoneal carcinoma. We present a case of an adenocarcinoma of ascending colon in a 68-year-old male who had lumbago and waist fistulas with retroperitoneal abscesses preceding other signs or symptoms of colonic malignancy. Supplemental information regarding the diagnosis and treatment of nonhealing wounds and colon carcinoma has also been included in the report...
March 2018: International Journal of Lower Extremity Wounds
Prashant R J Vas, Michael E Edmonds, Nikolaos Papanas
Diabetic foot ulcers remain difficult to heal and nutritional supplementation may be an important complementary therapeutic measure. However, we need to clarify many issues before such supplementation is more widely used. Indeed, improvements are needed in the following areas: evaluation of nutritional inadequacy, completion of randomized controlled trials, understanding of patient and ulcer characteristics that favor response to nutritional supplementation, optimal duration of supplementation therapy, and evaluation of patient adherence...
December 2017: International Journal of Lower Extremity Wounds
Javier Aragón-Sánchez, Yurena Quintana-Marrero, Cristina Aragón-Hernández, María José Hernández-Herero
Wound measurement to document the healing course of chronic leg ulcers has an important role in the management of these patients. Digital cameras in smartphones are readily available and easy to use, and taking pictures of wounds is becoming a routine in specialized departments. Analyzing digital pictures with appropriate software provides clinicians a quick, clean, and easy-to-use tool for measuring wound area. A set of 25 digital pictures of plain foot and leg ulcers was the basis of this study. Photographs were taken placing a ruler next to the wound in parallel with the healthy skin with the iPhone 6S (Apple Inc, Cupertino, CA), which has a camera of 12 megapixels using the flash...
December 2017: International Journal of Lower Extremity Wounds
Kittipan Rerkasem, Rajgopal Mani
No abstract text is available yet for this article.
December 2017: International Journal of Lower Extremity Wounds
Chi Sun Yoon, Sang Il Kim, Hoon Kim, Kyu Nam Kim
Reconstruction of pretibial skin and soft-tissue defects remains a challenge because this area has less underlying tissues and limited tissue mobility. Here, we present a retrospective review of our experience with pretibial reconstruction using the keystone-designed perforator island flap (KDPIF) in patients with comorbidities. All defects resulted from nononcological causes. We describe the expanding versatility of KDPIF reconstruction for pretibial defects and suggest a simple algorithmic approach. The medical records of 9 patients who underwent reconstruction with a KDPIF to cover a pretibial defect between May 2016 and June 2017 were reviewed...
December 2017: International Journal of Lower Extremity Wounds
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