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Diabetic limb salvage

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https://www.readbyqxmd.com/read/29733065/impacto-de-la-revascularizaci%C3%A3-n-y-factores-asociados-en-el-salvamento-de-la-extremidad-en-pacientes-con-pie-diab%C3%A3-tico
#1
Carlos A Hinojosa, Estefanía Boyer-Duck, Javier E Anaya-Ayala, Ana E Núñez-Salgado, Hugo Laparra-Escareno, René Lizola
Introducción: El pie diabético es causa frecuente de hospitalización. Objetivo: Examinar el impacto de la revascularización en la preservación de los miembros inferiores. Método: Estudio retrospectivo de pacientes diabéticos con úlceras en el pie. Se evaluó extensión del tejido perdido conforme las clasificaciones PEDIS y de Wagner, así como indicaciones y técnicas de revascularización. Los factores involucrados en la amputación mayor y el salvamento de la extremidad fueron evaluados por pruebas Fisher y chi cuadrado...
2018: Gaceta Médica de México
https://www.readbyqxmd.com/read/29701340/comparaison-between-endovascular-approach-and-aorto-bifemoral-bypass-for-tasc-d-aorto-iliac-disease-patients-treated-between-2011-2017
#2
Joel Sousa, João Neves, André Ferreira, José Vidoedo, José Teixeira
INTRODUCTION: In the last few years, endovascular approaches have been demonstrating remarkable results on the treatment of aortoiliac TASC D lesions. However, the results remain conflictuous and proper evidence regarding the best treatment option for this group of patients is still lacking. Through this work, we aim to compare patency, cost-effectiveness and quality of life in patients successfully treated by these two approaches. METHODS: Patients with TASC D aorto-iliac disease, from two independent Vascular Surgery Centers, treated either by open surgery and endovascular intervention between 2011- 2017, were retrospectively analyzed and consecutively included (n=59)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29686969/impact-of-heart-failure-and-dialysis-in-the-prognosis-of-diabetic-patients-with-ischemic-foot-ulcers
#3
Marco Meloni, Valentina Izzo, Laura Giurato, Valerio Cervelli, Roberto Gandini, Luigi Uccioli
Aim: To establish the role of heart failure (HF) and dialysis (D) in the prognosis of diabetic patients with critical limb ischemia and foot ulcers (FUs). Methods: Consecutive diabetic patients with ischemic FUs who referred to our Diabetic Foot Centre were prospectively included. All patients underwent a preset limb salvage protocol including peripheral revascularization. According to the presence of HF and D, they were divided in four groups: group 1 without HF and without D defined as ischemic foot (IF); group 2 with HF and without D defined as heart ischemic foot (H-IF); group 3 without HF and with D defined as renal ischemic foot (R-IF); group 4 with HF and with dialysis defined as heart-renal foot (HR-IF)...
March 2018: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29600673/-clinical-efficacy-analysis-of-transverse-tibial-bone-transport-combined-with-vacuum-drainage-for-the-treatment-of-diabetic-foot-ulcer
#4
Zhong-Wei Jia, Jian-Ping Yu, Yun-Xing Su, Xiu-Sheng Guo, Jin-Bin Yu, Zhi-Jun Yang, Jia-Wei Niu, Jie Wei
OBJECTIVE: To investigate clinical effect of transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage in treating diabetic foot ulcer. METHODS: From November 2015 and December 2016, clinical data of 19 diabetic foot ulcer patients treated with transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage were retrospective analyzed, including 15 males and 4 females aged from 42 to 82 years old with an average of (64...
March 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29595900/a-perioperative-approach-to-increase-limb-salvage-when-treating-foot-ulcers-in-patients-with-diabetes
#5
Raelina S Howell, Theresa Criscitelli, Jon S Woods, Brian M Gillette, Harold Brem, Scott Gorenstein
Foot ulceration in patients with diabetes increases the risk of lower extremity amputation. Major amputations produce substantial adverse consequences, increase length of hospital stay, diminish quality of life, and increase mortality. In this article, we describe approaches that decrease amputations and improve the quality of life for patients with diabetes and foot ulcers. We highlight the role of the perioperative nurse, who is essential to providing optimal patient care in the perioperative period. Perioperative care of patients with diabetes involves providing optimal surveillance for a break in the skin of the foot, screening for neuropathy, following guidelines for foot ulcer infections, preparing for pathophysiology-based debridement, using adjuvant therapies, and offloading the patient's affected foot...
April 2018: AORN Journal
https://www.readbyqxmd.com/read/29574036/prognostic-scoring-system-for-patients-undergoing-reconstructive-foot-and-ankle-surgery-for-charcot-neuroarthropathy-the-charcot-reconstruction-preoperative-prognostic-score
#6
David Rettedal, Alissa Parker, Adam Popchak, Patrick R Burns
Charcot neuroarthropathy is a destructive process that occurs in patients with peripheral neuropathy, often due to poorly controlled diabetes mellitus. Surgical reconstruction can be necessary to provide a plantigrade foot that is wound free. A risk of major amputation exists after a Charcot event and after attempted reconstruction. We retrospectively reviewed the data from 34 patients (36 reconstructions) who had undergone reconstructive surgery for Charcot neuroarthropathy. The mean patient age was 56.44 years...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29501595/heel-wounds-predict-mortality-but-not-amputation-after-infrapopliteal-revascularization
#7
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Rabih A Chaer, Steven A Leers, Aureline Boitet, Michael J Singh, Eric S Hager
BACKGROUND: Ischemic heel ulcerations are generally thought to carry a poor prognosis for limb salvage. We hypothesized that patients undergoing infrapopliteal revascularization for heel wounds, either bypass or endovascular intervention, would have lower wound healing rates and amputation-free survival (AFS) than patients with forefoot wounds. METHODS: A retrospective chart review was performed on patients who presented between 2006 and 2013 to our institution with ischemic foot wounds and infrapopliteal arterial disease and underwent either pedal bypass or endovascular tibial artery intervention...
March 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29428535/diabetic-foot-limb-salvage-a-series-of-809-attempts-and-predictors-for-endovascular-limb-salvage-failure
#8
Zhiwen Joseph Lo, Zhimin Lin, Uei Pua, Lawrence Han Hwee Quek, Bien Ping Tan, Sundeep Punamiya, Glenn Wei Leong Tan, Sriram Narayanan, Sadhana Chandrasekar
BACKGROUND: To review patient characteristics and outcomes of in-patient diabetic foot limb salvage and identify risk factors predicting for endovascular limb salvage failure. METHODS: Retrospective study of limb salvage attempts in 809 patients between August 2013 and July 2015. RESULTS: Sixty-eight percent of our study population were male with mean age at 65 years and 73% presented with Rutherford grade 6 critical limb ischemia, with the remaining 27% Rutherford grade 5...
February 9, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29421564/high-density-lipoprotein-mimicking-nanodiscs-carrying-peptide-for-enhanced-therapeutic-angiogenesis-in-diabetic-hindlimb-ischemia
#9
Hyun-Ji Park, Rui Kuai, Eun Je Jeon, Yoojin Seo, Youngmee Jung, James J Moon, Anna Schwendeman, Seung-Woo Cho
Therapeutic strategies using endogenous stem cell mobilizer can provide effective cell-free therapy for addressing various ischemic diseases. In particular, substance P (SP) exhibited therapeutic regeneration by facilitating mobilization of endogenous stem cells from bone marrow to the injured sites. However, its therapeutic effect has been limited due to short half-life and rapid degradation of administered SP peptides in vivo. Here we sought to develop high-density lipoprotein (HDL)-mimicking nanodiscs conjugated with SP (HDL-SP) in order to increase the in vivo half-life, bone marrow targeting, and therapeutic efficacy of SP for the treatment of diabetic peripheral ischemia...
April 2018: Biomaterials
https://www.readbyqxmd.com/read/29409267/uncontrolled-diabetes-as-a-potential-risk-factor-in-tibiotalocalcaneal-fusion-using-a-retrograde-intramedullary-nail
#10
Moses Lee, Woo Jin Choi, Seung Hwan Han, Jinyoung Jang, Jin Woo Lee
BACKGROUND: Tibiotalocalcaneal (TTC) fusion using a retrograde intramedullary (IM) nail is an effective salvage option for terminal-stage hindfoot problems. However, as many patients who receive TTC fusion bear unfavorable medical comorbidities, the risk of nonunion, infection and other complications increases. This study was performed to identify the factors influencing outcomes after TTC fusion using a retrograde IM nail. METHODS: Between September 2008 and February 2012, 34 consecutive patients received TTC fusion using a retrograde IM nail for limb salvage...
July 22, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29404750/acute-limb-ischemia-secondary-to-native-artery-occlusion-results-of-a-contemporary-case-series
#11
Nuria Seguí, Carlos Ruiz-Carmona, Alina Velescu, Eduardo Mateos, Roberto Elosua, Albert Clará
BACKGROUND: The treatment of acute limb ischemia (ALI) has barely changed over the last years. However, the progressive implementation of anticoagulants, antiplatelet agents or statins within the population might have modified the profile and prognosis of patients suffering an ALI. The aim of this study was to evaluate the current results of the management of ALI secondary to a native artery occlusion. METHODS: Retrospective study of 220 consecutive patients (mean age 78 years; 49% male) was conducted between 2007 and 2015...
February 5, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29353999/impact-of-pedal-arch-patency-on-tissue-loss-and-time-to-healing-in-diabetic-patients-with-foot-wounds-undergoing-infrainguinal-endovascular-revascularization
#12
Nicola Troisi, Filippo Turini, Emiliano Chisci, Leonardo Ercolini, Pierfrancesco Frosini, Renzo Lombardi, Francesca Falciani, Cristiana Baggiore, Roberto Anichini, Stefano Michelagnoli
Objective: To retrospectively evaluate the impact of pedal arch quality on tissue loss and time to healing in diabetic patients with foot wounds undergoing infrainguinal endovascular revascularization. Materials and Methods: Between January 2014 and June 2015, 137 consecutive diabetic patients with foot wounds underwent infrainguinal endovascular revascularization (femoro-popliteal or below-the-knee, arteries). Postprocedural angiography of the foot was used to divide the patients into the following three groups according to the pedal arch status: complete pedal arch (CPA), incomplete pedal arch (IPA), and absent pedal arch (APA)...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29288558/aggressive-infrainguinal-revascularization-in-renal-transplant-patients-is-justifiable
#13
Rebecca Craig-Schapiro, Besma Nejim, Isibor Arhuidese, Mahmoud B Malas
While studies demonstrate poor outcomes of lower extremity revascularization in patients with end-stage renal disease, little is known about results in renal transplant patients. We analyzed 2-year primary patency and limb salvage outcomes and associated risk factors of transplant (n = 202) and nontransplant patients (n = 25 274) in the Vascular Quality Initiative database undergoing infrainguinal bypass from 2003 to 2016. Multivariable Cox regression analysis and coarsened exact matching with many-to-one were used...
December 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29248237/the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-correlates-with-cost-of-care-for-diabetic-foot-ulcers-treated-in-a-multidisciplinary-setting
#14
Caitlin W Hicks, Joseph K Canner, Hikmet Karagozlu, Nestoras Mathioudakis, Ronald L Sherman, James H Black, Christopher J Abularrage
OBJECTIVE: We have previously demonstrated that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing time in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. Our aim was to assess whether the charges and costs associated with DFU care increase with higher WIfI stages. METHODS: All patients presenting to our multidisciplinary diabetic limb preservation service from June 2012 to June 2016 were enrolled in a prospective database...
December 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29240587/reclaiming-autologous-amputated-tissue-for-limb-salvage-of-a-diabetic-foot-burn-with-underlying-critical-limb-ischemia
#15
Catherine N Tchanque-Fossuo, Andrew M Wishy, Kaitlyn I M West, David L Dawson, Sara E Dahle, John G Carson
BACKGROUND: Diabetes mellitus is a worldwide pandemic that impacts more than 387 million people, with 29 million individuals affected in the United States alone. Diabetic patients have a 25% lifetime risk of developing a diabetic foot ulcer (DFU). Having a DFU is associated with a risk of recurrence approaching 70%. In addition, 1 in 6 patients with DFU will have a lower-limb amputation, with an associated increase in mortality ranging from 47% to 70%. Therefore, limb salvage is critical in patients with DFU...
January 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29220878/a-qualitative-study-of-the-experience-of-lower-extremity-wounds-and-amputations-among-people-with-diabetes-in-philadelphia
#16
Frances K Barg, Peter F Cronholm, Ebony E Easley, Trocon Davis, Michelle Hampton, D Scot Malay, Cornelius Donohue, Jinsup Song, Stephen R Thom, David J Margolis
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open-ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer (n = 19) or a lower extremity amputation (n = 20). Interviews were audio-recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts...
September 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29156168/new-fixation-methods-for-the-treatment-of-the-diabetic-foot-beaming-external-fixation-and-beyond
#17
REVIEW
Roberto A Brandão, Jeffrey S Weber, David Larson, Mark A Prissel, Patrick E Bull, Gregory C Berlet, Christopher F Hyer
Surgical correction of complex foot and ankle deformities secondary to Charcot neuroarthropathy remains a significant surgical challenge. New technological advancements in hardware have allowed for the use of augmented fixation techniques in midfoot deformity correction, including the use of indication-specific locking plates and beaming techniques that offer enhanced stability. Severe hindfoot deformity management can employ the use of internal fixation, including intramedullary hindfoot nails and circular external fixation frames for limb salvage...
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29153533/outcomes-at-a-single-center-after-subintimal-arterial-flossing-with-antegrade-retrograde-intervention-for-critical-limb-ischemia
#18
Anish Kaushal, Graham Roche-Nagle, Kong T Tan, Elizabeth Liao, Naomi Eisenberg, George D Oreopoulos, Dheeraj K Rajan
OBJECTIVE: The subintimal arterial flossing with antegrade-retrograde intervention technique has been used to overcome antegrade recanalization failures for peripheral lower limb arterial occlusive disease. There are few outcomes published for this technique and we sought to evaluate outcomes at our institution over a 7-year period. METHODS: A retrospective review was performed of all subintimal arterial flossing with antegrade-retrograde intervention procedures of infrainguinal occlusive disease from 2009 to 2016...
May 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29126421/peroneal-artery-perforator-flap-for-the-treatment-of-chronic-lower-extremity-wounds
#19
Liang Cheng, Xiaqing Yang, Tingxiang Chen, Zhijie Li
BACKGROUND: Reconstruction of chronic lower extremity wounds remains challenging. These wounds are mainly associated with diabetes mellitus, infections, and osteomyelitis. Although several reconstructive techniques are available, the peroneal artery perforator flap has unique advantages. METHODS: In this study, we discuss our experiences with peroneal artery perforator flaps in 55 patients who had suffered from chronic lower limb wounds. The size of the defect, comorbidities, etiology, flap size, and complications were recorded and analyzed based on a retrospective chart review...
November 10, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29107761/improved-limb-salvage-for-patients-with-vascular-disease-and-tissue-loss-associated-with-new-model-of-provision-targeted-at-the-diabetic-foot
#20
Dean T Williams, Anna Powell-Chandler, Quratulain Qureshi, Aeliya Zaidi, Christopher J Whitaker
AIMS: The establishment of a vascular surgeon-led emergency diabetic foot service in 2006 has evolved to provide lower limb wound care for patients with and without diabetes. We aimed to determine whether the service was associated with sustained, improved limb salvage rates for the whole population, analyse key aspects of service provision and compare outcomes against published studies. METHODS: The vascular unit serves a largely rural population of approximately 240,000...
January 2018: Diabetes Research and Clinical Practice
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