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Diabetic Foot & Ankle

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https://www.readbyqxmd.com/read/29963295/cost-effectiveness-analysis-of-the-human-recombinant-epidermal-growth-factor-in-the-management-of-patients-with-diabetic-foot-ulcers
#1
Martin Romero Prada, Carolina Roa, Pamela Alfonso, German Acero, Lina Huérfano, David Vivas-Consuelo
Introduction : Diabetic foot ulcers are one of the most frequent complications of diabetes; such ulcers cause an increase in the costs of the health care of the diabetic patient and can even cause disability due to amputation in the patient. Although a proportion of patients achieve a spontaneous closure of ulcers, others require medical or surgical treatment. Objective : To determine the cost-effectiveness of the intra- and perilesional application of recombinant human epidermal growth factor (rhEGF), as opposed to conventional therapy for the management of patients diagnosed with Wagner's 3 or 4 diabetic foot ulcer in Colombia...
2018: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29868165/diabetic-foot-ulcer-outcomes-from-a-podiatry-led-tertiary-service-in-kuwait
#2
Grace Messenger, Richard Masoetsa, Imtiaz Hussain, Sriraman Devarajan, Mohamed Jahromi
Objective : This single-centred study aims to evaluate the incidence, risk factors and treatment outcomes of a podiatry led, evidence-based diabetic foot ulcer (DFU) clinic. Research design and methods : Data from the DFU database and patient electronic health records were retrospectively collected from patients with new DFUs who were referred for treatment to the Department of Podiatry, Dasman Diabetes Institute, Kuwait, from 1 October 2014, to 31 December 2016. Patients were followed-up until healing occurred or until 6 months after the study end date, whichever came first...
2018: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29713425/follow-up-of-mri-bone-marrow-edema-in-the-treated-diabetic-charcot-foot-a-review-of-patient-charts
#3
Ernst-A Chantelau, Sofia Antoniou, Brigitte Zweck, Patrick Haage
Background : Ill-defined areas of water-like signal on bone magnetic resonance imaging (MRI), characterized as bone marrow edema or edema-equivalent signal-changes (EESC), is a hallmark of active-stage pedal neuro-osteoarthropathy (Charcot foot) in painless diabetic neuropathy, and is accompanied by local soft-tissue edema and hyperthermia. The longitudinal effects on EESC of treating the foot in a walking cast were elucidated by reviewing consecutive cases of a diabetic foot clinic. Study design : Retrospective observational study, chart review Material and methods : Cases with active-stage Charcot foot were considered, in whom written reports on baseline and follow-up MRI studies were available for assessment...
2018: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29696071/building-a-scalable-diabetic-limb-preservation-program-four-steps-to-success
#4
Tanzim Khan, Laura Shin, Stephanie Woelfel, Vincent Rowe, Brittany L Wilson, David G Armstrong
Over the past generation, limb preservation programs and diabetic foot services have begun to proliferate within academic health science centers as well as within health-care systems in general. We describe four key components for a successful program that, developed sequentially with temporal overlap, can allow the program to scale. The first component includes establishment of a 'hot foot line' for urgent emergency department/inpatient referral. The second includes development of a wound-healing clinic to address outpatient care through to remission...
2018: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29410772/the-abrupt-temperature-changes-in-the-plantar-skin-thermogram-of-the-diabetic-patient-looking-in-to-prevent-the-insidious-ulcers
#5
REVIEW
Francisco-J Renero-C
Background: One of the complications of the diabetes mellitus is the amputation of the lower limbs. This complication may be developed after an insidious ulcer, that may be raised by the peripheral neuropathy or the ischaemic limb, and that the ulcer get infected. That is, to develop an ulcer, in the diabetic patient, three factors should be taken into the account, the autonomic nervous system, the blood supply and the inmune system. Methods: In this work, the thermogram is used to identify regions on the plantar skin with blood supply deficiencies and the behaviour of the thermoregulation process...
2018: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29057064/beyond-dichotomous-thinking-a-process-perspective-on-diabetic-foot-disease
#6
Gustav Jarl, Lars-Olov Lundqvist
Background : Diabetic foot (DF) disease causes severe suffering around the world, and appropriate self-care activities are needed to prevent and treat this condition. However, all too often, self-care activities are less than optimal and clinicians find themselves unable to influence them in a positive direction. Clinicians' and researchers' mental models of the DF tend to be dichotomous: either the patient has or does not have an active ulcer or other DF disease. This mode of thinking hides the long-term perspective of DF disease, where patients' previous experiences and expectations for the future influence their current behavior...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29057063/is-surgical-debridement-necessary-in-the-diabetic-foot-treated-with-photodynamic-therapy
#7
João Paulo Tardivo, Rodrigo Serrano, Lívia Maria Zimmermann, Leandro Luongo Matos, Mauricio S Baptista, Maria Aparecida Silva Pinhal, Álvaro N Atallah
Background : Diabetic patients are susceptible to developing foot ulcers with serious complications such as osteomyelitis and amputations. Treatment approaches are still empirical and the benefit of usual procedures such as surgical debridement has not been properly evaluated. Photodynamic Therapy (PDT) is a non-invasive and highly efficient method for the treatment of the diabetic foot, being able to eradicate the infection and to stimulate healing, decreasing considerably the amputation risk. In the day-to-day practice of our service, we have been faced with the question whether debridement is necessary before PDT...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28959382/nerve-decompression-and-neuropathy-complications-in-diabetes-are-attitudes-discordant-with-evidence
#8
REVIEW
D Scott Nickerson
External neurolysis of the nerve at fibro-osseous tunnels has been proprosed to treat or prevent signs, symptoms, and complications in the lower extremity of diabetes patients with sensorimotor polyneuropathy. Nerve decompression is justified in the presence of symptomatic compressed nerves in the several fibro-osseous tunnels of the extremities, which are known to be frequent in diabetes. Quite a body of literature has accumulated reporting results after such nerve decompression in the leg, describing pain relief and sensibility improvement, as well as balance recovery, diabetic foot ulcer prevention, curtailed ulcer recurrence risk, and amputation avoidance...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28904744/clinical-and-surgical-characteristics-of-infected-diabetic-foot-ulcers-in-a-tertiary-hospital-of-mexico
#9
Estrella Cervantes-García, Paz María Salazar-Schettino
Background: The objective of this study was to determine the clinical and surgical characteristics of diabetic foot ulcers in a tertiary level hospital in Mexico. Methods: We performed a longitudinal, descriptive study from July, 2012 to August, 2015 on a sample composed of 100 patients with type 2 diabetes mellitus and infected diabetic foot ulcers. We analyzed socio-demographic variables, comorbidities, characteristics of ulcers, and the applied treatment. Results: We found that the most affected areas were the forefoot (48%) and the plantar region (55%) of the foot...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28839522/the-thermoregulation-of-healthy-individuals-overweight-obese-and-diabetic-from-the-plantar-skin-thermogram-a-clue-to-predict-the-diabetic-foot
#10
REVIEW
Francisco-J Renero-C
Background : Thermoregulation is a complex autonomic process to keep or to dissipate heat in the human body. Methods : In this work, by means of the thermogram of the plantar skin, the thermoregulation of healthy individuals, overweight-obese, and diabetic is discussed. Results : The thermograms of the plantar skin, for the healthy individuals, are: (1) symmetrical, the temperature distribution of the right foot being a mirror image of that of the left foot ; (2) the thermograms of women, on average, are 3°C colder than those of the men; and (3) the temperature distributions decrease distally from the medial longitudinal arch...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28804593/an-innovative-sealed-shoe-to-off-load-and-heal-diabetic-forefoot-ulcers-a-feasibility-study
#11
Gustav Jarl, Roy Tranberg
Background : Non-removable knee-high devices are the gold standard to treat diabetic foot ulcers located on the plantar forefoot, but they immobilize the ankle, which restricts daily life activities and has negative effects on joint functioning. Objective : To investigate the feasibility of sealing a therapeutic shoe to off-load and heal diabetic forefoot ulcers. Design : A case series of seven men with type 2 diabetes and a metatarsal head ulcer were prescribed therapeutic shoes and custom-made insoles. The shoe was sealed with a plastic band...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28649296/clinical-profile-and-outcome-of-diabetic-foot-ulcer-a-view-from-tertiary-care-hospital-in-semarang-indonesia
#12
Tjokorda Gde Dalem Pemayun, Ridho M Naibaho
Background: This study attempted to determine the disease burden in terms of clinical profile and outcome of diabetic foot ulcer (DFU) admissions at a tertiary care hospital in a developing country. Methods: In this descriptive study, the data were collected from the medical record of diabetic patients with foot ulcer who were treated in Dr. Kariadi General Hospital during a 3-year period. The demographic characteristic, type of foot lesion, etiology, isolated microorganism, treatment, and outcome were reviewed...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28326159/effects-of-weight-bearing-exercise-on-a-mini-trampoline-on-foot-mobility-plantar-pressure-and-sensation-of-diabetic-neuropathic-feet-a-preliminary-study
#13
Wararom Kanchanasamut, Praneet Pensri
Objective: Foot and ankle exercise has been advocated as a preventative approach in reducing the risk of foot ulceration. However, knowledge about the appropriate types and intensity of exercise program for diabetic foot ulcer prevention is still limited. The current study aimed to examine the effects of an eight-week mini-trampoline exercise on improving foot mobility, plantar pressure and sensation of diabetic neuropathic feet. Methods: Twenty-one people with diabetic peripheral neuropathy who had impaired sensation perception were divided into two groups...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28326158/diabetic-limb-salvage-procedure-with-bone-allograft-and-free-flap-transfer-a-case-report
#14
Alexandre L Godoy-Santos, Daniel T Amodio, André Pires, Ana L M Lima, Teng H Wei, Cesar de Cesar-Netto, David G Armstrong
The aim of this case report was to describe a successful diabetic limb salvage procedure in the treatment of an infected diabetic foot ulcer through a multidisciplinary team approach and complex surgical reconstruction involving a femoral head bone allograft and musculocutaneous latissimus dorsi free flap. The decision to proceed with aggressive staged efforts at diabetic limb salvage should be made only after careful consultation with the patient, his or her family, and the rest of the multidisciplinary healthcare team...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#15
Mehmet Orçun Akkurt, Ismail Demirkale, Ali Öznur
Objective : The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/27829487/clinical-effectiveness-of-hemoglobin-spray-granulox-%C3%A2-as-adjunctive-therapy-in-the-treatment-of-chronic-diabetic-foot-ulcers
#16
Sharon D Hunt, Fredrik Elg
INTRODUCTION: Hemoglobin spray (Granulox® ) comprises purified hemoglobin and is a novel approach for increasing oxygen availability in the wound bed in diabetic foot ulcer patients. Its mode of action is to bind oxygen from the atmosphere and diffuse it into the wound bed to accelerate wound healing in slow-healing wounds. PATIENTS AND METHODS: Wound healing outcomes, that is, wound size, pain, percentage of slough, and exudate levels, were compared retrospectively to a similar cohort of patients treated over the same period the previous year...
2016: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/27702429/conventional-deep-pressure-algometry-is-not-suitable-for-clinical-assessment-of-nociception-in-painless-diabetic-neuropathy
#17
Ernst A Chantelau
BACKGROUND: In diabetic persons with painless neuropathic foot ulceration, foot skin was found to be insensate to noxious pinprick stimulation (stimulation area less than 0.05 mm(2)), while compression of deep subcutaneous foot tissues by Algometer II(®) (stimulation area 1 cm(2)) could evoke a deep dull aching. To elucidate this discrepancy, the Algometer II stimulation technique was critically reviewed by varying probe sizes and anatomical sites in the same study population 3 years later...
2016: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/27414481/consensus-on-surgical-aspects-of-managing-osteomyelitis-in-the-diabetic-foot
#18
Sachin Allahabadi, Kareem B Haroun, Daniel M Musher, Benjamin A Lipsky, Neal R Barshes
BACKGROUND: The aim of this study was to develop consensus statements that may help share or even establish 'best practices' in the surgical aspects of managing diabetic foot osteomyelitis (DFO) that can be applied in appropriate clinical situations pending the publication of more high-quality data. METHODS: We asked 14 panelists with expertise in DFO management to participate. Delphi methodology was used to develop consensus statements. First, a questionnaire elicited practices and beliefs concerning various aspects of the surgical management of DFO...
2016: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/27316920/does-obtaining-an-initial-magnetic-resonance-imaging-decrease-the-reamputation-rates-in-the-diabetic-foot
#19
Marlena Jbara, Ami Gokli, Sally Beshai, Martin L Lesser, Shirley Hanna, Cheryl Lin, Annie Zeb
OBJECTIVE: Diabetes mellitus (DM) through its over glycosylation of neurovascular structures and resultant peripheral neuropathy continues to be the major risk factor for pedal amputation. Repetitive trauma to the insensate foot results in diabetic foot ulcers, which are at high risk to develop osteomyelitis. Many patients who present with diabetic foot complications will undergo one or more pedal amputations during the course of their disease. The purpose of this study was to determine if obtaining an initial magnetic resonance imaging (MRI), prior to the first amputation, is associated with a decreased rate of reamputation in the diabetic foot...
2016: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/27283728/stepwise-surgical-approach-to-diabetic-partial-foot-amputations-with-autogenous-split-thickness-skin-grafting
#20
Crystal L Ramanujam, Thomas Zgonis
In the surgical treatment of severe diabetic foot infections, substantial soft tissue loss often accompanies partial foot amputations. These sizeable soft tissue defects require extensive care with the goal of expedited closure to inhibit further infection and to provide resilient surfaces capable of withstanding long-term ambulation. Definitive wound closure management in the diabetic population is dependent on multiple factors and can have a major impact on the risk of future diabetic foot complications. In this article, the authors provide an overview of autogenous skin grafting, including anatomical considerations, clinical conditions, surgical approach, and adjunctive treatments, for diabetic partial foot amputations...
2016: Diabetic Foot & Ankle
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