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Management diabetic foot ulcer

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https://www.readbyqxmd.com/read/28105902/cost-effectiveness-of-using-adjunctive-porcine-small-intestine-submucosa-tri-layer-matrix-compared-with-standard-care-in-managing-diabetic-foot-ulcers-in-the-us
#1
J F Guest, D Weidlich, H Singh, J La Fontaine, A Garrett, C J Abularrage, C R Waycaster
OBJECTIVE: To estimate the cost-effectiveness of using tri-layer porcine small intestine submucosa (SIS; Oasis Ultra) as an adjunct to standard care compared with standard care alone in managing diabetic foot ulcers (DFUs) in the US, from the perspective of Medicare. METHOD: A Markov model was constructed to simulate the management of diabetic neuropathic lower extremity ulcers over a period of one year in the US. The model was used to estimate the cost-effectiveness of initially using adjunctive SIS compared with standard care alone to treat a DFU in the US at 2016 prices...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28101794/diabetic-foot-infections-an-update-in-diagnosis-and-management
#2
REVIEW
Pinelopi Grigoropoulou, Ioanna Eleftheriadou, Edward B Jude, Nikolaos Tentolouris
Foot infections are a common problem in patients with diabetes and a risk factor for limb amputation. They occur as a result of skin ulceration, which facilitates penetration of pathogens to deeper tissues. The diagnosis of infection is clinical. Aerobic gram-positive cocci are the most common pathogens. Ulcers which are chronic, preceded by administration of antibiotics and hospitalization or complicated by severe infection are polymicrobial. Antibiotic therapy is initially empiric based on the severity of the infection...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28100957/conditions-for-success-in-introducing-telemedicine-in-diabetes-foot-care-a-qualitative-inquiry
#3
Beate-Christin Hope Kolltveit, Eva Gjengedal, Marit Graue, Marjolein M Iversen, Sally Thorne, Marit Kirkevold
BACKGROUND: The uptake of various telehealth technologies to deliver health care services at a distance is expanding; however more knowledge is needed to help understand vital components for success in using telehealth in different work settings. This study was part of a larger trial designed to investigate the effect of an interactive telemedicine platform. The platform consisted of a web based ulcer record linked to a mobile phone to provide care for people with diabetic foot ulcers in outpatient clinics in specialist hospital care in collaboration with primary health care...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#4
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28029181/new-horizons-in-the-understanding-of-the-causes-and-management-of-diabetic-foot-disease-report-from-the-2017-diabetes-uk-annual-professional-conference-symposium
#5
M Clokie, A L Greenway, K Harding, N J Jones, K Vedhara, F Game, K K Dhatariya
Diabetes-related foot disease remains a common problem. For wounds, classic teaching recommends the treatment of any infection, offloading the wound and ensuring a good blood supply, as well as ensuring that the other modifiable risk factors are addressed and optimized. There remain, however, several questions about these and other aspects of the care of diabetes-related foot disease. Some of these questions are addressed in the present report; in particular, the impact of newer technologies in the identification of any organisms present in a wound, as well as the use of novel approaches to treat infections...
December 28, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28012341/walking-cadence-affects-rate-of-plantar-foot-temperature-change-but-not-final-temperature-in-younger-and-older-adults
#6
Prabhav Nadipi Reddy, Glen Cooper, Andrew Weightman, Emma Hodson-Tole, Neil D Reeves
This study examined the relationship between (1) foot temperature in healthy individuals and walking cadence, (2) temperature change at different locations of the foot, and (3) temperature change and its relationship with vertical pressures exerted on the foot. Eighteen healthy adult volunteers (10 between 30 and 40 years - Age: 33.4±2.4years; 8 above 40 years - Age: 54.1±7.7years) were recruited. A custom-made insole with temperature sensors was placed directly onto the plantar surface of the foot and held in position using a sock...
December 6, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27977535/the-ideal-dual-isotope-imaging-combination-in-evaluating-patients-with-suspected-infection-of-pelvic-pressure-ulcers
#7
Sherif Heiba, Lewen Stempler, Timothy Sullivan, Dov Kolker, Lale Kostakoglu
INTRODUCTION: The successful management of infected pelvic pressure ulcer patients (PPUP) depends on the distinction between infections limited to soft tissue (STI) and those with underlying osteomyelitis (OM), which can be difficult to determine clinically. Dual-isotope (DI) comprehensive imaging has excellent accuracy in localizing diabetic foot infection and differentiating OM from STI with SPECT/CT utilization. In this study, we assess the accuracy and confidence of the different DI SPECT/CT imaging steps in PPUP with confirmed diagnoses...
December 13, 2016: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/27974006/safety-and-effectiveness-of-therapeutic-magnetic-resonance-in-diabetic-foot-ulcers-a-prospective-randomised-controlled-trial
#8
A Piaggesi, M Sambataro, C Nicoletti, C Goretti, E Lacopi, A Coppelli
OBJECTIVE: To test the efficacy and safety of therapeutic magnetic resonance (TMR) in the management of diabetic foot ulcers (DFU), the authors designed a prospective randomised controlled trial in three highly specialised diabetic foot clinics. METHOD: All the patients consecutively visited in a period of 18 months were screened according to the inclusion (presence of an ulcer >1 cm(2) in the foot lasting at least 6 weeks; ABPI>0.6; consent to participate in the study) and exclusion (Charcot's foot; local or systemic infections; chronic renal failure; any wearable electrically-driven life-supporting device) criteria...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27973235/development-of-antibiogram-for-management-of-aerobic-bacterial-infection-in-diabetic-foot-ulcer
#9
S S Miraj, U Mk, G S Rodrigues
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27871769/effect-of-mechanical-vibration-on-transcutaneous-oxygen-levels-in-the-feet-of-type-2-diabetes-mellitus-patients
#10
Gerardo Rodríguez Reyes, Lidia Núñez Carrera, Aldo Alessi Montero, Adriana Solís Vivanco, Ivett Quiñones Uriostegui, Alberto Isaac Pérez Sanpablo
BACKGROUND AND OBJECTIVE: Foot conditions in patients with diabetes mellitus (DM) are major causes of morbidity and disability. Whole body vibration may promote blood circulation in the lower limbs, hence facilitating perfusion and promoting the supply of nutrients and oxygen to comprised tissues. Transcutaneous oxygen levels (TcPO2)>40mmHg in cases of diabetic foot syndrome are associated with a good prognosis in the resolution of ulcers. The objective of this study was to determine whether whole body vibration favors some parameters of interest related to complications associated with the diabetic foot syndrome...
January 6, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#11
REVIEW
Daniel J Short, Thomas Zgonis
Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865312/an-overview-of-internal-and-external-fixation-methods-for-the-diabetic-charcot-foot-and-ankle
#12
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) of the foot and ankle is a challenging disease with regard to clinical presentation, pathogenesis, and prognosis. Its surgical management is equally difficult to interpret based on the wide array of options available. In the presence of an ulceration or concomitant osteomyelitis, internal fixation by means of screws, plates, or intramedullary nailing needs to be avoided when feasible. External fixation becomes a great surgical tool when managing DCN with concomitant osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27831638/aescin-based-topical-formulation-to-prevent-foot-wounds-and-ulcerations-in-diabetic-microangiopathy
#13
S Hu, G Belcaro, M Dugall, M Hosoi, S Togni, G Maramaldi, L Giacomelli
OBJECTIVE: Impairment of the peripheral microcirculation in diabetic patients often leads to severe complications in the lower extremities, such as foot infections and ulcerations. In this study, a novel aescin-based formulation has been evaluated as a potential approach to prevent skin breaks and ulcerations by improving the peripheral microcirculation and skin hydration. PATIENTS AND METHODS: In this registry study, 63 patients with moderate diabetic microangiopathy were recruited...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27723012/poorly-designed-research-does-not-help-clarify-the-role-of-hyperbaric-oxygen-in-the-treatment-of-chronic-diabetic-foot-ulcers
#14
EDITORIAL
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27720361/link-between-nasal-carriage-of-staphylococcus%C3%A2-aureus-and-infected-diabetic-foot-ulcers
#15
C Dunyach-Remy, C Courtais-Coulon, C DeMattei, N Jourdan, S Schuldiner, A Sultan, C Carrière, S Alonso, A Sotto, J-P Lavigne
AIMS: Nasal carriage of Staphylococcus aureus in diabetic patients may be a risk factor for diabetic foot lesion infections. The aims of this study were to compare the genotypic profiles of S. aureus strains isolated from nares and diabetic foot ulcers (DFUs) using microarray technology. METHODS: Patients were included if they were admitted for diabetic foot infection (DFI) at any of three diabetology departments of Montpellier and Nîmes University Hospitals between 1 September 2010 to 30 June 2012...
October 5, 2016: Diabetes & Metabolism
https://www.readbyqxmd.com/read/27697131/clinical-management-of-acute-diabetic-charcot-foot-in-denmark
#16
Rasmus Bo Jansen, Ole Lander Svendsen, Klaus Kirketerp-Møller
INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS: This study is based on a questionnaire survey sent out to healthcare professionals, primarily doctors, working with diabetic foot ulcers and Charcot feet in the public sector of the Danish healthcare system...
October 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27696694/the-care-of-transmetatarsal-amputation-in-diabetic-foot-gangrene
#17
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27694302/combination-of-open-subtotal-calcanectomy-and-stabilization-with-external-fixation-as-limb-salvage-procedure-in-hindfoot-infected-diabetic-foot-ulcers
#18
Luca Dalla Paola, Anna Carone, Giulio Boscarino, Giuseppe Scavone, Lucian Vasilache
Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator...
September 29, 2016: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/27681811/a-comparative-analysis-of-skin-substitutes-used-in-the-management-of-diabetic-foot-ulcers
#19
M Martinson, N Martinson
OBJECTIVE: To compare the relative product cost and clinical outcomes of four skin substitutes used as adjunctive treatments for diabetic foot ulcers (DFUs). METHOD: Medicare claims data from 2011 to 2014 were used to identify beneficiaries with diabetes and foot ulcers. Patients treated with one of four types of skin substitute (Apligraf, Dermagraft, OASIS, and MatriStem) were identified. The skin substitutes were compared on episode length; amputation rate; skin substitute utilisation; and skin substitute costs...
October 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27662892/single-stage-bipedicle-local-tissue-transfer-and-skin-graft-for-achilles-tendon-surgery-wound-complications
#20
Travis J Dekker, Yash Avashia, Suhail K Mithani, Andrew P Matson, Alexander J Lampley, Samuel B Adams
: Introduction Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support...
September 23, 2016: Foot & Ankle Specialist
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