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Management diabetic foot ulcer

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https://www.readbyqxmd.com/read/28627227/smarter-sole-survival
#1
Bijan Najafi, Eyal Ron, Ana Enriquez, Ivan Marin, Javad Razjouyan, David G Armstrong
OBJECTIVE: This study examined adherence to alert-based cues for plantar pressure offloading in patients with diabetic foot disease. METHOD AND DESIGN: Participants (n = 17) with in diabetic foot remission (history of neuropathic ulceration) were instructed to wear a smart insole system (the SurroSense Rx, Orpyx Medical Technologies Inc, Calgary, Canada) over a three-month period. This device is designed to cue offloading to manage unprotected sustained plantar pressures in an effort to prevent foot ulceration...
January 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28616361/hyperbaric-oxygen-therapy-side-effects-defined-and-quantified
#2
REVIEW
Marvin Heyboer, Deepali Sharma, William Santiago, Norman McCulloch
Significance: Hyperbaric oxygen therapy (HBOT) is an important advanced therapy in the treatment of problem wounds, including diabetic foot ulcers and late effect radiation injury. HBOT remains among the safest therapies used today. Nonetheless, there are side effects associated with HBOT. It is important for providers to be able to identify, understand, and quantify these side effects for prevention, management, and informed consent. Recent Advances: The past two decades have seen significant advancements in our understanding of the underlying mechanisms of HBOT...
June 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28616080/pedobarography-as-a-clinical-tool-in-the-management-of-diabetic-feet-in-new-zealand-a-feasibility-study
#3
Jason K Gurney, Uwe G Kersting, Dieter Rosenbaum, Ajith Dissanayake, Steve York, Roger Grech, Anthony Ng, Bobbie Milne, James Stanley, Diana Sarfati
BACKGROUND: The peripheral complications of diabetes mellitus remain a significant risk to lower-limb morbidity. In New Zealand, risk of diabetes, comorbidity and lower-limb amputation are highly-differential between demographic groups, particularly ethnicity. There is growing and convincing evidence that the use of pedobarography - or plantar pressure measurement - can usefully inform diabetic foot care, particularly with respect to the prevention of re-ulceration among high-risk patients...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28606045/patient-impressions-of-possible-catastrophic-outcomes-after-diabetic-foot-ulceration
#4
Benjamin Vickers, Javier La Fontaine, Naohiro Shibuya, Daniel C Jupiter, Zachary Ashmore
BACKGROUND: Diabetes mellitus (DM) and its complications are well studied; patients with diabetes may suffer from neuropathy and vascular issues, and associated with these, lower extremity ulceration. Ulcers are often refractory to treatment, and can be difficult for both patients and clinicians to manage. Such complications may lead to amputations, which in turn are a risk factor for death. However, in certain situations amputation may be the only option available, and may be used as reconstructive surgery, restoring function...
June 12, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28598756/the-impact-of-the-multidisciplinary-team-in-the-management-of-individuals-with-diabetic-foot-ulcers-a-systematic-review
#5
A Buggy, Z Moore
OBJECTIVE: To assess the impact of the multidisciplinary team in the management of the diabetic foot compared with those who did not receive multidisciplinary care. METHOD: A systematic review of the literature was conducted using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase and Cochrane Library. The following search terms were used: diabetic foot, multidisciplinary team, patient care team, multidisciplinary care team...
June 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28594320/silver-containing-foam-dressings-with-safetac-a-review-of-the-scientific-and-clinical-data
#6
Phil Davies, Sara McCarty, Kristina Hamberg
Background Topical antimicrobials, such as silver dressings, are progressively being used alongside systemic antibiotics to provide adjunctive, antimicrobial therapy to wounds that are clinically infected or at risk of infection. To help improve wound management, dressings that use Safetac soft silicone technology in combination with a silver-impregnated foam dressing material were developed by Mölnlycke Health Care (Gothenburg, Sweden). The range comprises Mepilex Ag, Mepilex Border Ag and Mepilex Transfer Ag...
June 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28576257/management-of-the-chronic-burn-wound
#7
REVIEW
Stephen Tyler Elkins-Williams, William A Marston, Charles Scott Hultman
This article reviews the current evidence in using hyperbaric oxygen therapy (HBOT) in burn wounds. There is also separate consideration of diabetic foot burns and a protocol for use of HBOT in a specific case. The challenges of using HBOT in an acute burn care setting are reviewed. Next the pathophysiology of Marjolin ulcers is reviewed. The current thinking in diagnosis, treatment, and prevention of Marjolin ulcers is discussed. Finally, a background in using topical growth factors (tGF) is provided, followed by a summary of the current evidence of tGF in burn wounds...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576196/management-of-osteomyelitis-and-bone-loss-in-the-diabetic-charcot-foot-and-ankle
#8
REVIEW
Daniel J Short, Thomas Zgonis
Bone loss and destruction due to diabetic Charcot neuroarthropathy (CN) and osteomyelitis of the foot and ankle is a challenging clinical condition when lower extremity preservation is considered. Resection and excision of osteomyelitis and associated nonviable soft tissue can lead into large osseous and soft tissue defects that will most likely need the utilization of bone grafting and subsequent arthrodesis for stability and anatomic alignment. In the diabetic population with peripheral neuropathy, osseous instability can lead to subsequent lower extremity deformity, ulceration, infection and/or amputation...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28532226/novel-biological-therapies-for-the-treatment-of-diabetic-foot-ulcers
#9
Jennifer Adeghate, Syed Nurulain, Kornélia Tekes, Erzsébet Fehér, Huba Kalász, Ernest Adeghate
The number of people with diabetes mellitus (DM) is estimated to exceed 640 million by the year 2040. Diabetic foot ulcer (DFU) is a debilitating illness that affects more than 2% of DM patients. DFU is caused by DM-induced neural and vascular lesions leading to a reduced sensation and microcirculation. The increase in the prevalence of DFU has prompted researchers to find new therapies for the management of DFU. Areas covered: This review presents the current status of novel biological therapies used in the treatment of DFU...
June 1, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28524000/the-effect-of-a-common-antibiotics-doxycycline-on-non-healing-chronic-wound
#10
Dixon H Xu, Ziwen Zhu, Yujiang Fang
Up to 25% of diabetic patients will develop a diabetic foot ulcer. Chronic wounds such as diabetic foot ulcers often fail to heal with conventional therapies. In recent years, it has been identified that chronic wounds are usually associated with elevated level of matrix metalloproteinases (MMPs). Doxycycline, a cheap tetracycline antibiotic, has been shown to inhibit MMPs both in vitro and in vivo independent of its antimicrobial property. In this review, we provide an overview of the roles of MMPs in the pathogenesis of chronic wounds and explore the potential application of doxycycline as a treatment option in managing chronic wounds such as diabetic foot ulcers...
May 18, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28513212/an-optical-fiber-based-smart-textile-smart-socks-to-manage-biomechanical-risk-factors-associated-with-diabetic-foot-amputation
#11
Bijan Najafi, Hooman Mohseni, Gurtej S Grewal, Talal K Talal, Robert A Menzies, David G Armstrong
OBJECTIVE: This study aimed to validate a smart-textile based on fiber-optics for simultaneous measurement of plantar temperature, pressure, and joint angles in patients with diabetic peripheral neuropathy (DPN). METHODS: After in-vitro validation in the laboratory, 33 eligible subjects with DPN were recruited (age: 58 ± 8 years, BMI: 31.5 ± 8 kg/m(2)) for assessing plantar pressure and temperature during habitual gait-speed in a clinical-setting. All participants were asked to walk at their habitual speed while wearing a pair of sensorized socks made from highly flexible fiber optics (SmartSox)...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28497218/to-evaluate-the-efficacy-of-an-acellular-flowable-matrix-in-comparison-with-a-wet-dressing-for-the-treatment-of-patients-with-diabetic-foot-ulcers-a-randomized-clinical-trial
#12
F Campitiello, M Mancone, A Della Corte, R Guerniero, S Canonico
The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra LifeScience Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in patients with diabetic foot ulcers. Sixty patients with diabetic foot ulcers (Grades 3 Wagner) were included in this randomized clinical trial. The study was conducted in the General Surgery Unit and Geriatric of the Second University of Naples, Italy, in the last 12 months. Forty-six cases of diabetic foot ulcers were equally and randomly divided into control and test groups...
May 11, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28485879/evidence-for-silver-in-wound-care-meta-analysis-of-clinical-studies-from-2000-2015
#13
Joachim Dissemond, Johannes Georg Böttrich, Horst Braunwarth, Jörg Hilt, Patricia Wilken, Karl-Christian Münter
BACKGROUND: Given that the scientific evidence for silver in wound care is generally considered insufficient, there is uncertainty among users regarding its clinical use. MATERIAL AND METHODS: A group of experts evaluated the clinical studies on silver in wound management published from 2000-2015. RESULTS: Overall, 851 articles were identified, 173 of which were included and categorized. There were 31 randomized controlled trials (RCTs) and eight cohort studies...
May 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28393586/evaluation-of-glycated-albumin-ga-and-ga-hba1c-ratio-for-diagnosis-of-diabetes-and-glycemic-control-a-comprehensive-review
#14
Sara Yazdanpanah, Mohammad Rabiee, Mohammadreza Tahriri, Mojgan Abdolrahim, Asadollah Rajab, Hossein E Jazayeri, Lobat Tayebi
Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose...
April 10, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28388680/association-between-diabetic-foot-ulcer-and-diabetic-retinopathy
#15
Duck Jin Hwang, Kyoung Min Lee, Moon Seok Park, Sung Hee Choi, Ji In Park, Joon Hee Cho, Kyu Hyung Park, Se Joon Woo
PURPOSE: We aimed to investigate the prevalence of diabetic retinopathy (DR) in patients with diabetic foot ulcer (DFU) and elucidate the association between DR and DFU severities and their shared risk factors. METHODS: A retrospective review was conducted on DFU patients who underwent ophthalmic and vascular examinations within 6 months; 100 type 2 diabetic patients with DFU were included. The medical records of 2496 type 2 diabetic patients without DFU served as control data...
2017: PloS One
https://www.readbyqxmd.com/read/28351488/investigating-the-effect-of-external-trauma-through-a-dynamic-system-modeling-approach-for-clustering-causality-in-diabetic-foot-ulcer-development
#16
Parisa Salimi, Mohsen Hamedi, Nima Jamshidi, Milad Vismeh
Diabetes and its associated complications are realized as one of the most challenging medical conditions threatening more than 29 million people only in the USA. The forecasts suggest a suffering of more than half a billion worldwide by 2030. Amid all diabetic complications, diabetic foot ulcer (DFU) has attracted much scientific investigations to lead to a better management of this disease. In this paper, a system thinking methodology is adopted to investigate the dynamic nature of the ulceration. The causal loop diagram as a tool is utilized to illustrate the well-researched relations and interrelations between causes of the DFU...
April 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28336046/charcot-arthropathy-versus-osteomyelitis-evaluation-and-management
#17
REVIEW
John Womack
Charcot arthropathy of the foot and ankle is a severe complication of peripheral neuropathy and is most commonly seen in the developed world in association with diabetes mellitus. Correct diagnosis and differentiation from osteomyelitis of the foot and ankle are critical to guide treatment. It can exist concomitantly with osteomyelitis, typically in the setting of an advanced midfoot ulcer. Simple plain radiographs and contrasted MRI studies often yield inconclusive or confusing data. Correct use of imaging studies and a clinical algorithm can be effective tools to help make accurate and early diagnoses and guide clinical interventions for these conditions...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28272013/when-traditional-offloading-is-not-an-option-could-an-external-fixator-be-a-solution-a-case-report
#18
Abdulaziz A Kimawi, Robert J Snyder, Mario A Cala, Cherison Cuffy
Offloading is a cornerstone in managing diabetic plantar foot ulcers; however, it often represents one of the most challenging aspects of treatment for clinician and patient alike. The authors present a case of a 61-year-old African American man with type 2 diabetes and a limb-threatening plantar foot ulcer that required aggressive wound and surgical management. Due to the heavy drainage and patient adherence issues, traditional offloading techniques such as total contact cast, DH Pressure Relief Walker (Össur, Foothill Ranch, CA), and wedge shoes, among others, were not viable options...
February 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28268140/comparison-of-metatarsal-head-resection-versus-conservative-care-in-treatment-of-neuropathic-diabetic-foot-ulcers
#19
Alireza Kalantar Motamedi, Mohammad Ansari
Complications from diabetic foot ulcers often lead to increased patient morbidity. Much debate still ensues concerning surgical versus conservative management of neuropathic diabetic foot ulcerations. The present study assessed and compared the efficacy of metatarsal head resection and medical approach in the treatment of neuropathic diabetic foot ulcers located at the plantar surface of metatarsal heads. In a retrospective cohort study, 24 consecutive neuropathic diabetic foot ulcers in the lower area of the metatarsal heads that had undergone metatarsal head resection were included as the operative group...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28257680/surgical-correction-of-the-achilles-tendon-for-diabetic-foot-ulcerations-and-charcot-neuroarthropathy
#20
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Achilles tendon pathologic conditions are implicated in contributing to the development of many diabetic foot complications including diabetic foot ulceration and Charcot neuroarthropathy. Surgical correction of the diabetic equinus deformity has been studied as an isolated or adjunctive treatment when dealing with difficult-to-close diabetic foot ulcerations or when surgically addressing the diabetic Charcot neuroarthropathy foot or ankle. This article reviews the most common indications, complications, and surgical procedures for equinus correction by either a tendo-Achilles lengthening or gastrocnemius recession for the management of diabetic foot conditions...
April 2017: Clinics in Podiatric Medicine and Surgery
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