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Diabetic foot ulcer care

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https://www.readbyqxmd.com/read/28101794/diabetic-foot-infections-an-update-in-diagnosis-and-management
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
Graham Machin, Aaron Whittam, Suhail Ainarkar, John Allen, John Bevans, Michael Edmonds, Ben Kluwe, Audrey Macdonald, Nina Petrova, Peter Plassmann, Francis Ring, Leon Rogers, Rob 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
#8
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/28018920/delay-between-onset-of-symptoms-and-seeking-physician-intervention-increases-risk-of-diabetic-foot-complications-results-of-a-cross-sectional-population-based-survey
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27942260/effect-of-infrared-radiation-on-the-healing-of-diabetic-foot-ulcer
#13
Ashrafalsadat Hakim, Ali Sadeghi Moghadam, Abdalali Shariati, Hamid Karimi, Mohamad Hossien Haghighizadeh
BACKGROUND: Diabetic foot ulcer is a worldwide health care concern affecting tens of thousands of patients. If these ulcers left untreated, they can create severe complications. OBJECTIVES: This study was designed to examine the effect of infrared radiation on the healing of diabetic foot ulcer. PATIENTS AND METHODS: This clinical trial was performed on 50 patients referred to Dr. Ganjavian hospital in Dezful city, Iran, with diabetic foot ulcer degree 1 and 2 (based on Wegener Scale)...
July 2016: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27896528/low-level-laser-therapy-as-an-adjunct-to-conventional-therapy-in-the-treatment-of-diabetic-foot-ulcers
#14
R K Mathur, Khageswar Sahu, Siddharth Saraf, Pooja Patheja, Fareed Khan, P K Gupta
Foot ulcers are serious complications of diabetes mellitus (DM) and are known to be resistant to conventional treatment. This study was conducted to evaluate the efficacy of low-level laser therapy (LLLT) for the treatment of diabetic foot ulcers in a tertiary care centre (Department of Surgery, Mahatma Gandhi Memorial Medical College and Maharaja Yashwantrao Hospital, A.B. Road, Indore). A total of 30 patients with type 2 DM having Meggitt-Wagner grade I foot ulcers of more than 6 weeks duration with negative culture were studied...
November 29, 2016: Lasers in Medical Science
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#15
REVIEW
Claire M Capobianco, Thomas Zgonis
Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population...
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
#16
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/27843849/a-study-of-risk-factors-and-foot-care-behavior-among-diabetics
#17
Mackson Nongmaithem, Arjinder Pal Singh Bawa, Abhilash Kumar Pithwa, Simran Kaur Bhatia, Gurjit Singh, Somnath Gooptu
BACKGROUND: Diabetic foot results in considerable morbidity and mortality in developing countries and the prevalence of diabetes is expected to increase further in the next decades in these countries. Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27829487/clinical-effectiveness-of-hemoglobin-spray-granulox-%C3%A2-as-adjunctive-therapy-in-the-treatment-of-chronic-diabetic-foot-ulcers
#18
Sharon D Hunt, Fredrik Elg
INTRODUCTION: Hemoglobin spray (Granulox(®)) comprises purified hemoglobin and is a novel approach for increasing oxygen availability in the wound bed in diabetic foot ulcer patients. Its mode of action is to bind oxygen from the atmosphere and diffuse it into the wound bed to accelerate wound healing in slow-healing wounds. PATIENTS AND METHODS: Wound healing outcomes, that is, wound size, pain, percentage of slough, and exudate levels, were compared retrospectively to a similar cohort of patients treated over the same period the previous year...
2016: Diabetic Foot & Ankle
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
#19
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/27827284/extracorporeal-shockwave-therapy-in-the-treatment-of-chronic-diabetic-foot-ulcers-a-prospective-randomised-trial
#20
S M Jeppesen, K B Yderstraede, B S B Rasmussen, M Hanna, L Lund
OBJECTIVE: To investigate the efficacy of extracorporeal shockwave therapy (ESWT) on healing chronic diabetic foot ulcers (DFU). METHOD: Patients with chronic DFUs were randomised (1:1) to receive a series of six ESWT treatments over 3 weeks in combination with standard care or standard care alone. ESWT was performed on DFUs using 250 shocks/cm(2) and 500 shocks on arterial beds supplying the ulcer location. RESULTS: We recruited 23 patients, 11 in the intervention group and 12 in the control...
November 2, 2016: Journal of Wound Care
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