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Neuropathic ulcer

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https://www.readbyqxmd.com/read/29346148/vertical-profunda-artery-perforator-flap-for-plantar-foot-wound-closure-a-new-application
#1
Allyson R Alfonso, James L Mayo, Vishal K Sharma, Robert J Allen, Ernest S Chiu
BACKGROUND: Plantar foot reconstruction requires special consideration of both form and function. There are several fasciocutaneous flap options, each with indications and reservations. CASE STUDY: This case presents a new application of the vertical profunda artery perforator flap for definitive closure of a neuropathic foot ulcer in a young woman with spina bifida. The postoperative course was uneventful, and the flap survived completely. The surgical and donor sites were without wound recurrence at 5-month follow-up...
February 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29344337/financial-burden-of-diabetic-foot-ulcers-to-world-a-progressive-topic-to-discuss-always
#2
REVIEW
Alok Raghav, Zeeshan Ahmad Khan, Rajendra Kumar Labala, Jamal Ahmad, Saba Noor, Brijesh Kumar Mishra
Diabetic foot complications are the most common occurring problems throughout the globe, resulting in devastating economic crises for the patients, families and society. Diabetic foot ulcers (DFUs) have a neuropathic origin with a progressive prevalence rate in developing countries compared with developed countries among diabetes mellitus patients. Diabetic patients that are of greatest risk of ulcers may easily be diagnosed with foot examination. Economic burden may be carefully examined. The budget costing must include both the clinical and social impact of the patients...
January 2018: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29337168/aggressive-resection-of-congenital-lumbosacral-lipomas-in-adults-indications-techniques-and-outcomes-in-122-patients
#3
S C Bai, B Z Tao, L K Wang, X G Yu, B N Xu, A J Shang
OBJECTIVE: The authors reviewed the treatment of adult patients with congenital intraspinal lipomas with total/near-total resection and discussed their preoperative characteristics, prognostic factors and surgical outcomes. METHODS: Medical records of 122 adult patients with congenital lumbosacral lipomas undergoing total/near-total resection were systematically analyzed. The cohort was subdivided into three groups depending on symptom onset age: Group 1 (≤5 years, n = 40), Group 2 (>5 years but <18 years, n = 33), and Group 3 (>18 years, n = 49)...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29273187/distal-syme-hallux-amputation-for-tip-of-toe-wounds-and-gangrene-complicated-by-osteomyelitis-of-the-distal-phalanx-surgical-technique-and-outcome-in-consecutive-cases
#4
Troy J Boffeli, Mark S Goss
Distal hallux gangrene and neuropathic ulceration associated with digit deformity frequently result in osteomyelitis of the distal phalanx. Ideal treatment would involve limited resection to preserve function. We describe our surgical technique and retrospective results for distal Syme hallux amputation with plantar flap closure. An institutional review board-approved review was conducted on cases performed over 8 years. A total of 15 consecutive patients (16 digits) with hallux soft tissue loss who had undergone distal Syme hallux amputation were included...
December 19, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29240741/a-retrospective-audit-of-the-characteristics-and-treatment-outcomes-in-patients-with-diabetes-related-charcot-neuropathic-osteoarthropathy
#5
Joanne Dixon, Joshua Coulter, Michele Garrett, Rick Cutfield
AIMS: To review the characteristics, management and outcomes one year after diagnosis in patients with diabetes related charcot neuropathic osteoarthropathy (CN) treated at the Diabetes Podiatry service, Waitemata District Health Board (WDHB) between 2000-2014. METHODS: Patients with diabetes and recorded diagnosis of CN were identified from the podiatry service records. Clinical details were retrospectively obtained from WDHB databases and patient medical records...
December 15, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29184753/tissue-augmentation-with-allograft-adipose-matrix-for-the-diabetic-foot-in-remission
#6
Tala B Shahin, Kairavi V Vaishnav, Marcy Watchman, Vignesh Subbian, Ethan Larson, Evangelia Chnari, David G Armstrong
Background: Repetitive stress on the neuropathic plantar foot is the primary cause of diabetic foot ulcers. After healing, recurrence is common. Modulating plantar pressure has been associated with extension of ulcer free days. Therefore, the goal of this study was to determine the effects of an injectable allograft adipose matrix in providing a protective padding and reducing the pressure in the plantar foot. Methods: After healing his recurrent ulcer using total contact casting, a 71-year-old man with a 9-year history of recurrent diabetic foot ulcers was treated with injection of allograft adipose matrix, procured from donated human tissue...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29166500/final-diagnosis-of-86-cases-included-in-differential-diagnosis-of-american-tegumentary-leishmaniasis-in-a-brazilian-sample-a-retrospective-cross-sectional-study
#7
Fernanda Tirelli, Sebastian Vernal, Ana Maria Roselino
BACKGROUND: Cutaneous leishmaniasis is distributed worldwide, including Brazil. Its several clinical forms need to be distinguished from other dermatoses. Clinical similarities and lack of a gold standard diagnostic tool make leishmaniasis-like lesions a challenging diagnosis. OBJECTIVES.: To report the final diagnosis of patients primarily suspected of having American tegumentary leishmaniasis (ATL). METHODS.: A retrospective cross-sectional study was conducted on the basis of medical records of 437 patients with clinical suspicion of ATL, registered in electronic hospital system between 1980 and 2013...
September 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/29158852/curative-metatarsal-bone-surgery-combined-with-intralesional-administration-of-recombinant-human-epidermal-growth-factor-in-diabetic-neuropathic-ulceration-of-the-forefoot-a-prospective-open-uncontrolled-nonrandomized-observational-study
#8
Aristides L Garcia Herrera, Ridel de Jesús Febles Sanabria, Liliana de Los Ángeles Acosta Cabadilla, Miriam Moliner Cartaya
Background: Curative surgery is performed for a foot with ulcers and loss of protective sensation to heal the wound and prevent amputation. Evidence supports that patients with diabetes have decreased concentrations of growth factors in their tissues, notably epidermal growth factor (EGF). Injecting EGF deep into the bottom of the wound and its contours encourages a more effective response in terms of granulation tissue growth and wound closure. Objective: To assess the effectiveness and safety of curative metatarsal bone surgery combined with intralesional administration of human recombitant EGF in neuropathic diabetic forefoot ulceration...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29109666/prevalence-of-pressure-ulcer-and-nutritional-factors-affecting-wound-closure-success-in-thailand
#9
Supakrit Auiwattanakul, Winai Ungpinitpong, Surakrant Yutthakasemsunt, Supawan Buranapin, Kaweesak Chittawatanarat
Introduction: The authors aimed to estimate the prevalence of pressure ulcers and to explore the nutritional effects of the prognostic factors on successful pressure ulcer closure in a public tertiary care hospital in Thailand. Patients and Methods: The study was a retrospective cohort analysis of seven-year census (2008 - 2014) at Surin hospital in Thailand. There were 424 of total 240,826 patients aged over than 15 years admitted to surgery, orthopedics and medicine wards during the study period with documented pressure ulcers (ICD 10TM)...
September 2017: Materia Socio-medica
https://www.readbyqxmd.com/read/29058098/osteomyelitis-of-the-lower-extremity-pathophysiology-imaging-and-classification-with-an-emphasis-on-diabetic-foot-infection
#10
Jacob C Mandell, Bharti Khurana, Jeremy T Smith, Gregory J Czuczman, Varand Ghazikhanian, Stacy E Smith
Osteomyelitis is inflammation of the bone caused by an infectious organism, and is a difficult clinical problem. The pathophysiology, imaging, and classification of osteomyelitis are challenging, varying with the age of the patient (child versus adult), the chronicity of the infection (acute versus chronic), and the route of spread (hematogenous versus contiguous focus), as well as the immune and vascular status of the patient and affected region. The two most common classification schemes are those of Lew and Waldvogel, and Cierny and Mader...
October 20, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29057609/the-efficacy-of-removable-devices-to-offload-and-heal-neuropathic-plantar-forefoot-ulcers-in-people-with-diabetes-a-single-blinded-multicentre-randomised-controlled-trial
#11
Sicco A Bus, Jaap J van Netten, Anke Ir Kottink, Erik A Manning, Maximilian Spraul, Arend-Jan Woittiez, Jeff G van Baal
Non-removable offloading is the 'gold standard' treatment for neuropathic diabetic plantar forefoot ulcers. However, removable offloading is the common 'standard of care'. We compared three removable offloading devices for ulcer healing efficacy. In this multicentre, randomised controlled trial, 60 persons with neuropathic diabetic plantar forefoot ulcers were randomly assigned to wear a custom-made knee-high cast [BTCC (bivalved TCC)], custom-made ankle-high cast shoe or a prefabricated ankle-high forefoot-offloading shoe (FOS)...
October 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28989556/fibreglass-total-contact-casting-removable-cast-walkers-and-irremovable-cast-walkers-to-treat-diabetic-neuropathic-foot-ulcers-a-health-technology-assessment
#12
(no author information available yet)
BACKGROUND: Diabetic neuropathic foot ulcers are a risk factor for lower leg amputation. Many experts recommend offloading with fibreglass total contact casting, removable cast walkers, and irremovable cast walkers as a way to treat these ulcers. METHODS: We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences for offloading devices. We performed a systematic literature search on August 17, 2016, to identify randomized controlled trials that compared fibreglass total contact casting, removable cast walkers, and irremovable cast walkers with other treatments (offloading or non-offloading) in patients with diabetic neuropathic foot ulcers...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28985487/lower-extremity-dynamics-of-walking-in-neuropathic-diabetic-patients-who-wear-a-forefoot-offloading-shoe
#13
Sicco A Bus, Josina C Maas, Nicoline M Otterman
BACKGROUND: A forefoot-offloading shoes has a negative-heel rocker outsole and is used to treat diabetic plantar forefoot ulcers, but its mechanisms of action and their association with offloading and gait stability are not sufficiently clear. METHODS: Ten neuropathic diabetic patients were tested in a forefoot-offloading shoe and subsequently in a control shoe with no specific offloading construction, both worn on the right foot (control shoe on left), while walking at 1...
October 2, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28964719/relationship-of-planter-pressure-and-glycemic-control-in-type-2-diabetic-patients-with-and-without-neuropathy
#14
Mohammed R Halawa, Yara M Eid, Rana A El-Hilaly, Mona M Abdelsalam, Amr H Amer
INTRODUCTION: Foot disease is a common complication of type 2 diabetes that can have tragic consequences. Abnormal plantar pressures are considered to play a major role in the pathologies of neuropathic ulcers in the diabetic foot. AIM: To examine Relationship of Planter Pressure and Glycemic Control in Type 2 Diabetic Patients with and without Neuropathy. MATERIALS AND METHODS: The study was conducted on 50 type 2 diabetic patients and 30 healthy volunteers...
September 23, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28959382/nerve-decompression-and-neuropathy-complications-in-diabetes-are-attitudes-discordant-with-evidence
#15
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/28949996/the-impact-of-team-based-interprofessional-comprehensive-assessments-on-the-diagnosis-and-management-of-diabetic-foot-ulcers-a-retrospective-cohort-study
#16
Ranjani Somayaji, James A Elliott, Reneeka Persaud, Morgan Lim, Laurie Goodman, R Gary Sibbald
BACKGROUND: Diabetic foot ulcers (DFU) are increasingly prevalent, and associated with significant morbidity, mortality, and cost. An interprofessional approach to DFU management is critical given the etiological complexity involved. This study aimed to assess the impact of an interprofessional team approach on DFU diagnosis and management for a cohort of patients receiving treatment in an Ontario Canada home care setting. METHODS: A retrospective cohort study of patients attending a large regional Community Care Access Centre (CCAC) between February 11, 2013-September 30, 2014 was conducted...
2017: PloS One
https://www.readbyqxmd.com/read/28942488/psychological-and-biomechanical-aspects-of-patient-adaptation-to-diabetic-neuropathy-and-foot-ulceration
#17
REVIEW
Loretta Vileikyte, Ryan T Crews, Neil D Reeves
PURPOSE OF REVIEW: The purpose of this review was to elucidate how psychological and biomechanical factors interrelate in shaping patients' experience with diabetic symmetric polyneuropathy (DSPN) and its sequela-diabetic foot ulceration (DFU). RECENT FINDINGS: Recent findings emphasize the importance not only of neuropathic pain but also of other DSPN symptoms, such as unsteadiness. We highlight the negative spiral between unsteadiness, falls, and psychological distress...
September 23, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28942120/immobilization-induced-osteolysis-and-recovery-in-neuropathic-foot-impairments
#18
David R Sinacore, Mary K Hastings, Kathryn L Bohnert, Michael J Strube, David J Gutekunst, Jeffrey E Johnson
BACKGROUND: Neuropathic foot impairments treated with immobilization and off-loading result in osteolysis. In order to prescribe and optimize rehabilitation programs after immobilization we need to understand the magnitude of pedal osteolysis after immobilization and the time course for recovery. OBJECTIVE: To determine differences in a) foot skin temperature; b) calcaneal bone mineral density (BMD) after immobilization; c) calcaneal BMD after 33-53weeks of recovery; and d) percent of feet classified as osteopenic or osteoporotic after recovery in participants with neuropathic plantar ulcers (NPU) compared to Charcot neuroarthropathy (CNA)...
December 2017: Bone
https://www.readbyqxmd.com/read/28817962/patients-with-diabetic-foot-disease-fear-major-lower-extremity-amputation-more-than-death
#19
Dane K Wukich, Katherine M Raspovic, Natalie C Suder
BACKGROUND: The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. METHODS: We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations...
February 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28802220/comparison-of-lower-limb-muscle-strength-between-diabetic-neuropathic-and-healthy-subjects-using-opensim
#20
Alessandra Scarton, Ilse Jonkers, Annamaria Guiotto, Fabiola Spolaor, Gabriella Guarneri, Angelo Avogaro, Claudio Cobelli, Zimi Sawacha
Diabetes neuropathy and vasculopathy are the two major complications of diabetes mellitus, leading to diabetic foot disease, of which the worst consequences are plantar ulcers and amputations. Motor impairments like joint stiffness and loss of balance are distinctive effects of diabetes and they have been extensively explored. However, while altered muscle function has been also assessed through experimentally measured surface electromyography, little is known about muscle forces. The objective of this study was to estimate muscle forces in subjects with diabetes and to use these data to identify differences with respect to a population of healthy subjects matched for age and BMI...
October 2017: Gait & Posture
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