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Neuropathic ulcer

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https://www.readbyqxmd.com/read/27875539/secular-trends-in-admissions-and-mortality-rates-from-diabetes-mellitus-in-the-central-belt-of-ghana-a-31-year-review
#1
Osei Sarfo-Kantanka, Fred Stephen Sarfo, Eunice Oparebea Ansah, Benjamin Eghan, Nana Kwame Ayisi-Boateng, Emmanuel Acheamfour-Akowuah
INTRODUCTION: Diabetes Mellitus is currently a leading cause of morbidity and mortality throughout the world, particularly in sub-Saharan Africa where a significant proportion of diabetes cases are now found. Longitudinal profiling of in-patient admissions and mortality trends from diabetes provide useful insights into the magnitude of the burden of diabetes, serve as a sentinel on the state of out-patient diabetes care and provide effective tools for planning, delivering and evaluating the health care needs relating to the disease in sub-Saharan Africa...
2016: PloS One
https://www.readbyqxmd.com/read/27865313/surgical-equinus-correction-for-the-diabetic-charcot-foot-what-the-evidence-reveals
#2
REVIEW
Claire M Capobianco
Triceps surae contracture, or equinus, is a known deforming force in the foot and ankle. Biomechanical studies have shown that ankle equinus significantly alters gait and plantar pressures, and in the diabetic neuropathic patient population, this can propagate plantar ulceration and/or Charcot neuroarthropathy (CN). Surgical correction of equinus is globally and frequently used to aid in plantar wound healing in the neuropathic diabetic patient, with and without CN. Treatment guidelines for equinus correction in this medically complex population are undefined and lack evidence from high-quality published peer-reviewed studies...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27849290/the-prevention-of-diabetic-foot-ulceration-how-biomechanical-research-informs-clinical-practice
#3
Frank E DiLiberto, Judith F Baumhauer, Deborah A Nawoczenski
Background: Implementation of interprofessional clinical guidelines for the prevention of neuropathic diabetic foot ulceration has demonstrated positive effects regarding ulceration and amputation rates. Current foot care recommendations are primarily based on research regarding the prevention of ulcer recurrence and focused on reducing the magnitude of plantar stress (pressure overload). Yet, foot ulceration remains to be a prevalent and debilitating consequence of Diabetes Mellitus...
November 16, 2016: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/27834436/secondary-health-conditions-and-quality-of-life-in-persons-living-with-spinal-cord-injury-for-at-least-ten-years
#4
Jacinthe J E Adriaansen, Laura E M Ruijs, Casper F van Koppenhagen, Floris W A van Asbeck, Govert J Snoek, Dirk van Kuppevelt, Johanna M A Visser-Meily, Marcel W M Post
OBJECTIVES: To describe the prevalence of secondary health conditions among persons with long-term spinal cord injury, and the relationship between these secondary health conditions and quality of life. DESIGN: Multicentre, cross-sectional study. SUBJECTS: Individuals (n = 282) with traumatic or non-traumatic spinal cord injury for ≥ 10 years, age at injury 18-35 years, current age 28-65 years, and using a wheelchair. METHODS: Occurrence of 13 secondary health conditions was assessed during a consultation with a rehabilitation physician...
November 11, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27827300/concordance-in-diabetic-foot-ulceration-a-cross-sectional-study-of-agreement-between-wound-swabbing-and-tissue-sampling-in-infected-ulcers
#5
E Andrea Nelson, Alexandra Wright-Hughes, Sarah Brown, Benjamin A Lipsky, Michael Backhouse, Moninder Bhogal, Mwidimi Ndosi, Catherine Reynolds, Gill Sykes, Christopher Dowson, Michael Edmonds, Peter Vowden, Edward B Jude, Tom Dickie, Jane Nixon
BACKGROUND: There is inadequate evidence to advise clinicians on the relative merits of swabbing versus tissue sampling of infected diabetic foot ulcers (DFUs). OBJECTIVES: To determine (1) concordance between culture results from wound swabs and tissue samples from the same ulcer; (2) whether or not differences in bacterial profiles from swabs and tissue samples are clinically relevant; (3) concordance between results from conventional culture versus polymerase chain reaction (PCR); and (4) prognosis for patients with an infected DFU at 12 months' follow-up...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27827282/primary-wound-closure-of-diabetic-foot-ulcers-by-debridement-and-stitching
#6
M E Ahmed, M S Mohammed, S I Mahadi
OBJECTIVE: The role of stitching in healing diabetic foot ulcers (DFUs) has little attention, with few reports published on the technique. This study aimed to report on the role of stitching in healing of neuropathic DFUs. METHOD: This comparative study was between patients with diabetes with neuropathic foot ulcers who had undergone wound stitching and those on conventional wound care. The study was carried in Jabir Abu Eliz Diabetic Center Khartoum (JADC) during between January 1 2011 and January 1 2013...
November 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27771922/capsaicin-and-its-role-in-chronic-diseases
#7
E S Fernandes, A R A Cerqueira, A G Soares, Soraia K P Costa
A significant number of experimental and clinical studies published in peer-reviewed journals have demonstrated promising pharmacological properties of capsaicin in relieving signs and symptoms of non-communicable diseases (chronic diseases). This chapter provides an overview made from basic and clinical research studies of the potential therapeutic effects of capsaicin, loaded in different application forms, such as solution and cream, on chronic diseases (e.g. arthritis, chronic pain, functional gastrointestinal disorders and cancer)...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27763881/neuropathic-ulcers-among-children-with-neural-tube-defects-a-review-of-literature
#8
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
https://www.readbyqxmd.com/read/27757347/a-unique-case-of-allogeneic-fat-grafting-between-brothers
#9
Samuel Kim, Richard L Edelson, Brandon Sumpio, Stephanie Kwei, Deepak Narayan
We present a case of a 65-year-old man with cutaneous T-cell lymphoma treated with radiation therapy and an allogeneic hematopoietic stem cell transplant from his human leukocyte antigen-matched brother. Engraftment was successful, but the patient went on to develop painful, radiation-induced ulcers. The ulcers were fat-allografted using liposuctioned fat from his brother because of the patient's unique chimeric state. Postprocedure follow-up revealed epithelialization of the ulcer sites and significant improvement in neuropathic pain...
September 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27721122/the-effectiveness-of-felt-padding-for-offloading-diabetes-related-foot-ulcers-at-baseline-and-after-one-week-of-wear
#10
Anita Raspovic, Kate Waller, Wan Mun Wong
AIM: Felt padding is used to offload diabetes-related foot ulceration although limited quality data exists to support its use. This study aimed to quantify pressure offloading from neuropathic plantar foot ulcers in a clinical setting, when felt padding is first applied and after wear. METHODS: This study used a within-subjects, repeated measures design. Data was collected in a high-risk foot service. Peak plantar pressures, contact area and contact time were measured in 15 diabetes subjects with 16 non-complicated plantar neuropathic foot ulcers, with: no felt padding, newly applied felt padding and felt padding after one week of wear...
September 28, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27702429/conventional-deep-pressure-algometry-is-not-suitable-for-clinical-assessment-of-nociception-in-painless-diabetic-neuropathy
#11
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/27676750/programmed-amputation-on-a-teenager-what-kind-of-preparation-for-what-outcome
#12
Marion Prigent, Sylvain Brochard, Mathias Thepaut, Christian Lefèvre, Dominique Le Nen, Thierry Cornic, Marie-Thérèse Cariou, Catherine Le Rouzic, Phlippe Le Moine, Christelle Pons, Laetitia Houx
OBJECTIVE: Traumatic lower limb amputation is rare in pediatric population, and surgeons always try limb salvage. But rarely, later amputation occurred when the traumatic limb is painful. It is a difficult and irreversible decision needed a multidisciplinary approach. We report how we managed a programmed trans-tibial amputation on 13-years-old boy, 20 months after a foot trauma. OBSERVATIONS: Our patient is an adolescent victim of a left foot crash. The first checkup showed a degloving injury, dislocation of the interphalangeal joints and of all toes...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27627777/-charcot-arthropathy-and-diabetic-foot
#13
E López-Gavito, P Parra-Téllez, J Vázquez-Escamilla
Diabetes mellitus is a major chronic degenerative disease, which currently is taking on alarming proportions in the population of our country. Neuropathic arthropathy is one of the most interesting degenerative joint disorders and increasingly common within the orthopedic pathology. It is defined as a progressive degenerative arthropathy, chronic and affecting one or more peripheral joints, and develops as a result of the lack of sensory perception normal in the innervation of joints. As a result the joints of the feet are subjected to trauma and repetitive injury causing a neurotraumatic effect with progressive damage to the joints of the hindfoot, midfoot and forefoot...
January 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27594645/complete-fifth-ray-amputation-with-peroneal-tendon-transfer-to%C3%A2-the%C3%A2-cuboid-a-review-of-consecutive-cases-involving-lateral-column%C3%A2-neuropathic-foot-ulceration-and-osteomyelitis
#14
Troy J Boffeli, Steven R Smith, Kyle W Abben
Nonhealing wounds along the fifth metatarsal associated with neuropathy and bone deformity frequently become complicated with osteomyelitis. Our surgical technique for complete fifth ray amputation with peroneal tendon transfer has been previously published. The present study evaluated the outcomes regarding success with initial healing and intermediate-term limb survival after this procedure, which is intended to resolve infection, remove bone deformity, heal and prevent recurrence of lateral column wounds, and maintain functional stability of the foot...
September 1, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27594569/-how-can-leg-ulcer-pain-be-reduced
#15
A Stansal, I Lazareth, M D'Ussel, P Priollet
Chronic vascular wounds are often painful. Pain can develop whatever the cause of the ulceration. It is well known during wound care but can occur at any time. The pain is often a complex phenomenon involving nociceptive pain, neuropathic pain, anxiety and emotional suffering, all directly related to the chronic disease. Care for the patient suffering from pain must take into consideration all of these aspects of the disease. The therapeutic strategy should rely on the use of different pharmacological agents, well-adapted local care using the different available analgesic tools and include psycho-affective care...
September 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/27556758/the-role-of-pressure-offloading-on-diabetic-foot-ulcer-healing-and-prevention-of-recurrence
#16
Sicco A Bus
BACKGROUND: An increased plantar pressure is a causative factor in the development of plantar foot ulcers in people with diabetes mellitus, and ulcers are a precursor of lower extremity amputation. METHODS: In this article, the evidence is reviewed that relieving areas of increased plantar pressure (ie, offloading) can heal plantar foot ulcers and prevent their recurrence. RESULTS: Noninfected, nonischemic neuropathic plantar forefoot ulcers should heal in 6 to 8 weeks with adequate offloading...
September 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27555884/the-evaluation-of-off-loading-using-a-new-removable-orthosis-in-diabetic-foot-orthodiab-randomized-controlled-trial-study-design-and-rational
#17
Kamel Mohammedi, Louis Potier, Maud François, Dured Dardari, Marilyne Feron, Estelle Nobecourt-Dupuy, Manuel Dolz, Roxane Ducloux, Abdelkader Chibani, Dominique-François Eveno, Teresa Crea Avila, Ariane Sultan, Laurence Baillet-Blanco, Vincent Rigalleau, Gilberto Velho, Florence Tubach, Ronan Roussel, Jean-Claude Dupré, Dominique Malgrange, Michel Marre
BACKGROUND: Off-loading is essential for diabetic foot management, but remains understudied. The evaluation of Off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) trial aims to evaluate the efficacy of a new removable device "Orthèse Diabète" in the healing of diabetic foot. METHODS/DESIGN: ORTHODIAB is a French multi-centre randomized, open label trial, with a blinded end points evaluation by an adjudication committee according to the Prospective Randomized Open Blinded End-point...
2016: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/27524708/neuropathic-minimally-invasive-surgeries-nemesis-percutaneous-diabetic-foot-surgery-and-reconstruction
#18
REVIEW
Roslyn J Miller
Patients with peripheral neuropathy associated with ulceration are the nemesis of the orthopedic foot and ankle surgeon. Diabetic foot syndrome is the leading cause of peripheral neuropathy, and its prevalence continues to increase at an alarming rate. Poor wound healing, nonunion, infection, and risk of amputation contribute to the understandable caution toward this patient group. Significant metalwork is required to hold these technically challenging deformities. Neuropathic Minimally Invasive Surgeries is an addition to the toolbox of management of the diabetic foot...
September 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27459762/-multidisciplinary-team-approach-for-diabetic-foot-patients-in-an-out-patient-clinic
#19
E Yu Komelyagina, A K Volkovoy, N I Sanbanchieva, M Fe Zaichikova, N V Maksimov, M B Antsiferov
AIM: To assess the effectiveness of multidisciplinary team approach in daily practice of diabetic foot. MATERIALS AND METHODS: 376 diabetic patients (446 ulcers) treated in a diabetic foot department in 2014 were examined. All patients were screened for diabetic peripheral polyneuropathy and blood insufficiency of lower extremities in order to diagnose the type of diabetic foot ulcer: neuropathic or neuroischemic. Patients were treated by a multidisciplinary team...
2016: Klinicheskaia Meditsina
https://www.readbyqxmd.com/read/27456320/leprae-reaction-resembling-rheumatologic-disease-as-presenting-feature-of-leprosy
#20
Hazlyna Baharuddin, Tarita Taib, Mollyza Mohd Zain, Shereen Ch'ng
Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae with predominant involvement of skin and nerves. We present a 70-year-old man with leprosy whose initial presentation resembled rheumatologic disease, due to leprae reaction. He presented with an 8-week history of worsening neuropathic pain in the right forearm, associated with necrotic skin lesions on his fingers that had ulcerated. Physical examination revealed two tender necrotic ulcers at the tip of the right middle finger and the dorsal aspect of the left middle finger...
July 26, 2016: International Journal of Rheumatic Diseases
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