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Diabetic foot ulcer care

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https://www.readbyqxmd.com/read/28216809/healing-ulcers-and-preventing-their-recurrences-in-the-diabetic-foot
#1
S Raja Sabapathy, Madhu Periasamy
Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28182533/the-reality-of-routine-practice-a-pooled-data-analysis-on-chronic-wounds-treated-with-tlc-nosf-wound-dressings
#2
K C Münter, S Meaume, M Augustin, P Senet, J C Kérihuel
OBJECTIVE: A number of randomised controlled trials (RCT) have compared control groups with TLC-NOSF dressings (UrgoStart) on chronic wounds. Our aim was to determine whether the clinical trials' results translate into routine management of such wounds, by pooling the data from real-life observational studies. METHOD: Observational studies, conducted in France and Germany, evaluating current practices in patients suffering from non-selected chronic wounds treated with a TLC-NOSF dressing were identified...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28153676/a-model-to-estimate-cost-savings-in-diabetic-foot-ulcer-prevention-efforts
#3
Neal R Barshes, Samira Saedi, James Wrobel, Panos Kougias, O Erhun Kundakcioglu, David G Armstrong
BACKGROUND: Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. METHODS: A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes...
January 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28135201/use-of-a-dehydrated-amniotic-membrane-allograft-in-the-treatment-of-lower-extremity-wounds-a-retrospective-cohort-study
#4
Eric J Lullove
: Injuries to the skin are extensively costly to the health care system. When caused by metabolic and vascular compromise, these injuries are even more foreboding for patients. They can result in chronic inflammation, reduced mobility, and chronic pain. MATERIALS AND METHODS: Twenty patients were selected from the author's patient population at the West Boca Center for Wound Healing for a retrospective cohort study. Patients underwent a run-in period of 2 weeks, where standard of care was used to clear the wound of bioburden...
January 23, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28133924/safety-and-efficacy-of-intramuscular-human-placenta-derived-mesenchymal-stromal-like-cells-cenplacel-pda-002-in-patients-who-have-a-diabetic-foot-ulcer-with-peripheral-arterial-disease
#5
Stephanie C Wu, Richard Pollak, Robert G Frykberg, Wei Zhou, Maha Karnoub, Vladimir Jankovic, Steven A Fischkoff, Denesh Chitkara
The objective of this study was to examine the safety of cenplacel (PDA-002) in patients with peripheral arterial disease (PAD) and a diabetic foot ulcer (DFU). Cenplacel is a mesenchymal-like cell population derived from full-term human placenta. This phase 1, dose-escalation study investigated cenplacel in diabetic patients with chronic DFUs (Wagner grade 1 or grade 2) and PAD [ankle-brachial index (ABI) >0·5 and ≤0·9], enrolled sequentially into each of four dose cohorts (3 × 10(6) , 10 × 10(6) , 30 × 10(6) and 100 × 10(6) cells; administered intramuscularly on study days 1 and 8 in combination with standard of care)...
January 30, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28116957/prevention-and-treatment-of-diabetic-foot-ulcers
#6
Jonathan Zhang Ming Lim, Natasha Su Lynn Ng, Cecil Thomas
The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident...
January 1, 2017: Journal of the Royal Society of Medicine
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
#7
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/28105899/clinic-visit-frequency-in-wound-care-matters-data-from-the-us-wound-registry
#8
M J Carter, C E Fife
OBJECTIVE: A previous study suggested that the frequency with which patients visit wound care clinics influences the rate of chronic wound healing but high bias was present with regard to wound care centre selection. The objective of this retrospective cohort study was to confirm this finding by using a very large sample size of diabetic foot ulcers (DFUs) from the US Wound Registry. METHOD: Patients who visited the clinic more than once for a new DFU were eligible for study inclusion...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28101794/diabetic-foot-infections-an-update-in-diagnosis-and-management
#9
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
#10
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/28098565/bio-engineering-tissue-and-v-a-c-therapy-a-new-method-for-the-treatment-of-extensive-necrotizing-infection-in-the-diabetic-foot
#11
Andrea Armenio, Daniela Anna Cutrignelli, Maria Luisa Nardulli, Giulio Maggio, Giuseppe Memeo, Valerio De Santis, Giuseppe Giudice, Cosmo Maurizio Ressa
AIM: The aim of the study is to compare the standard care for progressive necrotizing infection in diabetic foot with a treatment protocol based on the association between autologous fibroblast grafts and vacuum-assisted closure therapy (V.A.C.). MATERIAL OF STUDY: A retrospective matched Case-Control study was carried out on 20 patients with diabetic foot infection, 10 treated with the standard care and 10 with our new protocol. Inclusion criteria were: acute diabetic foot necrosis (Wagner III and IV), ulcer size (30 to 80 cm2), tendon and bone exposure...
December 6, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28070472/utilizing-the-veraflo%C3%A2-instillation-negative-pressure-wound-therapy-system-with-advanced-care-for-a-case-study
#12
Rita K Driver
BACKGROUND:  Mankind has always suffered wounds throughout time due to trauma, disease, and lifestyles. Many wounds are non-healing and have continued to be challenging. However, utilizing advanced wound care treatments, such as negative pressure wound treatment with instillation and dwell time (NPWTi-d), has proven beneficial. NPWTi-d is indicated in a variety of wounds, such as trauma, surgical, acute, pressure injuries, diabetic foot ulcers, and venous leg ulcers. Bacteria and bioburden interrupts wound healing by increasing the metabolic needs, ingesting, and robbing the necessary nutrients and oxygen...
November 30, 2016: Curēus
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
#13
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/28054923/descriptive-longitudinal-study-results-applied-to-statistical-models-to-assess-the-impact-of-early-microbiological-cultures-on-the-economic-burden-of-treatment-for-infected-diabetic-foot-ulcers-at-a-mexican-public-health-facility
#14
Luz-Ma-Adriana Balderas-Peña, Daniel Sat-Muñoz, Rosa-Emilia Ramírez-Conchas, Moisés-Roberto Alvarado-Iñiguez, Javier-Eduardo García-de-Alba-García, Eduardo Cruz-Corona, José-Luis Chávez-Hurtado, José-Martín Chagollán-Ramírez
Infection plays a critical role in health care and impacts the cost of the treatment of diabetic foot ulcers (DFU). To examine the cost reduction associated with the multidisciplinary treatment of infected DFU (IDFU) by obtaining early (ie, within 48 hours of admission) microbiological culture results, a descriptive, longitudinal study was conducted. Data were collected prospectively from patient medical charts of a cohort of 67 patients (mean age, 56.14 ± 12.3 years; mean duration of diabetes, 14.95 ± 8 years) with IDFU treated at a Mexican public health facility from January 1 to April 30, 2010...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28053300/a-medical-thermal-imaging-device-for-the-prevention-of-diabetic-foot-ulceration
#15
G Machin, A Whittam, S Ainarkar, J Allen, J Bevans, M Edmonds, B Kluwe, A Macdonald, N Petrova, P Plassmann, F Ring, L Rogers, R Simpson
In this paper a description is given of the development, characterisation and first results of a thermal imaging device aimed at significantly reducing the incidence of diabetic foot ulceration (DFU). These devices will be used in three clinical centres and in two preliminary clinical trials. The first will be on healthy volunteers to set a robust baseline for the overall research aims and the second on  >100 patients at high risk of DFU. In the second phase of the project the objective is to demonstrate significant reduction in the incidence of DFU through a comparison of the results of standard care of high risk feet with standard care plus thermal imaging...
January 5, 2017: Physiological Measurement
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
#16
REVIEW
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...
March 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28018920/delay-between-onset-of-symptoms-and-seeking-physician-intervention-increases-risk-of-diabetic-foot-complications-results-of-a-cross-sectional-population-based-survey
#17
Norina A Gavan, Ioan A Veresiu, Etta J Vinik, Aaron I Vinik, Bogdan Florea, Cosmina I Bondor
We present a post hoc analysis of 17,530 questionnaires collected as part of the 2012 screening for neuropathy using Norfolk Quality of Life tool in patients with diabetes in Romania, to assess the impact on foot complications of time between the onset of symptoms of diabetes/its complications and the physician visit. Odds ratios (ORs) for self-reporting neuropathy increased from 1.16 (95% CI: 1.07-1.25) in those who sought medical care in 1-6 months from symptoms of diabetes/its complications onset to 2.27 in those who sought medical care >2 years after symptoms onset...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28013263/invasive-systemic-infection-after-hospital-treatment-for-diabetic-foot-ulcer-risk-of-occurrence-and-effect-on-survival
#18
Shey-Ying Chen, John M Giurini, Adolf W Karchmer
BACKGROUND: Diabetic foot ulcers (DFUs) threaten limbs and prompt hospitalization. After hospitalization, remote-site invasive systemic infection related to DFU (DFU-ISI) may occur. The characteristics of DFU-ISIs and their effect on mortality risk have not been defined. METHODS: We conducted a retrospective cohort study of 819 diabetic patients hospitalized for treatment of 1212 unique DFUs during a 9-year period. We defined the index ulcer as that present at the first (index) DFU admission to our hospital...
February 1, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28002690/diabsat-telemedicine-itinerant-screening-of-chronic-complications-of-diabetes-using-a-satellite
#19
Marie-Christine Turnin, Solène Schirr-Bonnans, Marie-Christine Chauchard, Patrice Deglise, Catherine Journot, Yann Lapeyre, Antonio Güell, Benoit Lepage, Helene Hanaire, Jacques Martini
BACKGROUND: Health authorities recommend regular screening for the chronic complications of diabetes. The ENTRED (*) survey results show that insufficient screening is undertaken. The DIABSAT (†) program aims to improve care for diabetes patients in rural areas of the Midi-Pyrénées region, telemonitoring complications of diabetes through an itinerant screening service. METHODS: A vehicle was equipped with a satellite dish and medical equipment for screening ophthalmological, renal, vascular, and neuropathic damage and assessing the level of risk of diabetic foot ulceration...
December 21, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27984272/association-of-sociodemographic-factors-with-spirituality-and-hope-in-patients-with-diabetic-foot-ulcers
#20
Geraldo Magela Salomé, Sergio Aguinaldo de Almeida, Bruno Mendes, Maiume Roana Ferreira de Carvalho, José Carlos Bueno, Marcelo Renato Massahud, Lydia Masako Ferreira
OBJECTIVE: To evaluate levels of spirituality and hope in patients with diabetic foot ulcers (DFUs) according to sociodemographic factors. DESIGN: This was a primary, prospective, descriptive, analytical, and clinical study. Questionnaires assessing sociodemographic and clinical characteristics of the patients, the Spirituality Self-rating Scale (SSRS), and the Herth Hope Index (HHI) were administered to all participants. SETTING: University-affiliated skilled nursing center and outpatient wound care clinic in Pouso Alegre, Brazil...
January 2017: Advances in Skin & Wound Care
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