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Foot amputation

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https://www.readbyqxmd.com/read/28820834/super-thin-scip-flap-for-reconstruction-of-subungual-melanoma-aesthetic-functional-surgery
#1
Kyeong-Tae Lee, Bo Young Park, Eun-Ji Kim, Jung-Han Kim, Kee-Taek Jang, Sang-Hee Choi, Dong-Youn Lee, Goo-Hyun Mun
BACKGROUND: This study aimed to use a super-thin, free superficial circumflex iliac artery perforator (SCIP) flap in the functional surgery for treating subungual melanoma and to evaluate its outcomes. METHODS: Forty-one patients with primary subungual melanoma of ≤ 2-mm thickness who were treated with functional surgery were prospectively enrolled. Following oncologic resection, a thin SCIP flap was harvested along the trans-superficial fat layer and transferred to the defect with further thinning by primary defatting...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28817962/patients-with-diabetic-foot-disease-fear-major-lower-extremity-amputation-more-than-death
#2
Dane K Wukich, Katherine M Raspovic, Natalie C Suder
BACKGROUND: The aim of this study was to identify the most-feared complications of diabetes mellitus (DM), comparing those with diabetic foot pathology with those without diabetic foot pathology. METHODS: We determined the frequency of patients ranking major lower-extremity amputation (LEA) as their greatest fear in comparison to blindness, death, diabetic foot infection (DFI), or end-stage renal disease (ESRD) requiring dialysis. We further categorized the study group patients (N = 207) by their pathology such as diabetic foot ulcer (DFU), Charcot neuroarthropathy, foot infection, or acute neuropathic fractures and dislocations...
February 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28817237/dysregulation-of-wound-healing-mechanisms-in-diabetes-and-the-importance-of-negative-pressure-wound-therapy-npwt
#3
Mogher Khamaisi, Sarit Balanson
Diabetes is a serious disease with severe side effects and comorbidities. Diabetic foot with its chronic non-healing ulcers, or diabetic food ulcers (DFU) as they are commonly called, can be devastating, even leading to amputation. Many therapies exist to assist and improve wound healing. One exciting discovery is the use of negative pressure wound therapy (NPWT) as an adjunct to standard treatment. Few studies have substantively explored the molecular mechanisms of NPWT and why we see improved wound healing, a concept that demands more research...
August 17, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28814050/segmental-contributions-to-sagittal-plane-whole-body-angular-momentum-when-using-powered-compared-to-passive-ankle-foot-prostheses-on-ramps
#4
Nathaniel T Pickle, Anne K Silverman, Jason M Wilken, Nicholas P Fey
Understanding the effects of an assistive device on dynamic balance is crucial, particularly for robotic leg prostheses. Analyses of dynamic balance commonly evaluate the range of whole-body angular momentum (H). However, the contributions of individual body segments to overall H throughout gait may yield futher insights, specifically for people with transtibial amputation using powered prostheses. We evaluated segment contributions to H using Statistical Parametric Mapping to assess the effects of prosthesis type (powered vs passive) and ramp angle on segmental coordination...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813975/a-lightweight-robotic-ankle-prosthesis-with-non-backdrivable-cam-based-transmission
#5
Tommaso Lenzi, Marco Cempini, Jeremy Newkirk, Levi J Hargrove, Todd A Kuiken
Below-knee level amputation significantly impacts the ability of an individual to ambulate. Transtibial amputees are typically prescribed energetically passive ankle-foot prostheses that behave as a spring or controlled damper, and therefore cannot fully replace the function of the missing limb. More recently, fully-powered devices have been proposed to more closely match the power generation ability of intact limbs. However, these fully-powered devices are significantly heavier than passive devices, thus increasing the stress on the socket-residual limb interface...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813971/feasibility-study-of-transtibial-amputee-walking-using-a-powered-prosthetic-foot
#6
Martin Grimmer, Matthew Holgate, Jeffrey Ward, Alexander Boehler, Andre Seyfarth
Passive prosthetic feet are not able to provide non-amputee kinematics and kinetics for the ankle joint. Persons with amputations show reduced interlimb symmetry, slower walking speeds, and increased walking effort. To improve ankle range of motion and push off, various powered prosthetic feet were introduced. This feasibility study analyzed if predefined motor reference trajectories can be used to achieve non-amputee ankle biomechanics during walking with the powered prosthetic foot, Walk-Run Ankle. Trajectories were calculated using the desired ankle angle and ankle moment based spring deflection at a given spring stiffness...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28802698/in-hospital-costs-of-diabetic-foot-disease-treated-by-a-multidisciplinary-foot-team
#7
Willem D Rinkel, Jacky Luiten, Jelle van Dongen, Bram Kuppens, Johan W Van Neck, Suzanne Polinder, Manuel Castro Cabezas, J Henk Coert
BACKGROUND: The diabetic foot imposes significant burden on healthcare systems. Obtaining knowledge on the extent of the costs of diabetic foot ulcers (DFUs) is of value to health care researchers investigating cost-effectiveness of interventions that prevent these costly complications. OBJECTIVES: To estimate the in-hospital costs associated with the treatment of DFUs by a multidisciplinary diabetic foot team. METHODS: Persons with DFUs presenting to our team in 2013 and 2014 were followed and use of care was estimated...
July 29, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28802220/comparison-of-lower-limb-muscle-strength-between-diabetic-neuropathic-and-healthy-subjects-using-opensim
#8
Alessandra Scarton, Ilse Jonkers, Annamaria Guiotto, Fabiola Spolaor, Gabriella Guarneri, Angelo Avogaro, Claudio Cobelli, Zimi Sawacha
Diabetes neuropathy and vasculopathy are the two major complications of diabetes mellitus, leading to diabetic foot disease, of which the worst consequences are plantar ulcers and amputations. Motor impairments like joint stiffness and loss of balance are distinctive effects of diabetes and they have been extensively explored. However, while altered muscle function has been also assessed through experimentally measured surface electromyography, little is known about muscle forces. The objective of this study was to estimate muscle forces in subjects with diabetes and to use these data to identify differences with respect to a population of healthy subjects matched for age and BMI...
July 31, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28800712/outcomes-achieved-with-use-of-a-prefabricated-roll-on-total-contact-cast
#9
Jonathan F Arnold, Valerie Marmolejo
BACKGROUND: The total contact cast (TCC) is considered the gold standard for offloading of plantar diabetic foot ulcerations, yet its use remains suboptimal for a variety of reasons. Prefabricated TCC systems have been developed to help enhance TCC use. The primary objective of this study was to determine if healing rates obtained with use of a prefabricated roll-on TCC were similar to those reported with conventional TCC use. Secondary outcomes measured were the incidence of iatrogenic ulceration, amputation, and recurrent ulceration, and patient tolerance of the device...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28795888/effective-wound-bed-preparation-using-maggot-debridement-therapy-for-patients-with-critical-limb-ischaemia
#10
A Nishijima, M Gosho, R Yoshida, S Yanagibayashi, M Takikawa, J Nishijima, M Sekido, N Yamamoto
OBJECTIVE: Patients with critical limb ischaemia (CLI) lack sufficient blood flow in to the limb, which leads to difficulties in the normal wound healing process. Therefore, maggot debridement therapy (MDT) has not generally been recommended for CLI patients. We evaluated the effectiveness of wound bed preparation by MDT in CLI patients who had undergone mid-foot amputation. METHODS: Patients who underwent mid-foot amputation after angioplasty between April 2014 and October 2016 were retrospectively investigated by classifying them into an MDT group or a conventional treatment group...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28777906/can-amputation-be-prevented-in-diabetic-foot-interdisciplinary-approach-to-diabetic-foot-a-case-report
#11
Ali Erdal Gunes, Maide Cimsit
Diabetic foot ulcers may result in loss of an extremity and may even lead to mortality. The use of comprehensive foot care programs which include early screening and evaluation of problems, foot care education, preventive therapy and referral to specialists has been shown to reduce amputation rates by 49-85 [percent]. A 51-year-old woman with Type 2 diabetes under surveillance for nine months was referred from the emergency department. She presented with an entirely inflamed right foot with ulcer covering two-thirds proximal of the foot for 30 days' duration...
March 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28777716/research-priorities-in-subspecialty-palliative-care-policy-initiatives
#12
Lynn F Reinke, Diane E Meier
Palliative care demonstrably improves quality of life for the seriously ill in a manner that averts preventable health crises and their associated costs. Because of these outcomes, palliative care is now broadening its reach beyond hospitals, and hospice care for those near death, to patients and their families living in the community with chronic multimorbidities that have uncertain or long expected survival. In this article, we address research needed to enable policies supportive of palliative care access and quality, including changes in regulatory, accreditation, financing, and training approaches in the purview of policy makers...
August 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28765052/predictors-of-lower-extremity-amputation-and-reamputation-in-the-diabetic-foot
#13
Erdinc Acar, Burkay Kutluhan Kacıra
In the present study, we aimed to identify the comorbidities that would be predictive of requiring lower extremity amputation or reamputation for diabetic foot wounds. We performed a retrospective review of 132 consecutive patients who had undergone lower extremity amputations (110 patients) or reamputations (22 patients) for diabetic wounds from January 2013 to March 2016. We used multivariate logistic regression to calculate the odds ratios (ORs) for amputation and reamputation for various comorbidities. The ORs of undergoing amputation were greatest for adult males (OR 5...
July 29, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28759431/venous-ulcers-treated-with-a-hyaluronic-acid-extracellular-matrix-and-compression-therapy-interim-analysis-of-a-randomized-controlled-trial
#14
Oscar M Alvarez, Lee Makowitz, Mayank Patel
Diabetic foot ulcers (DFUs) are a severe and costly complication of diabetes and may result in foot amputation. CASE REPORT: A 69-year-old man with a 10-year history of type 2 diabetes, who was undergoing routine care for diabetes in the authors' clinic, developed a DFU of his right foot of 4 years' duration. The wound did not respond to conventional treatments, and imaging studies were normal. His 2 biopsies tested negative for malignancy. The DFU was fully removed surgically. Following surgical removal, squamous cell carcinoma (SCC) was diagnosed in the histologic study of the wound...
July 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28759430/squamous-cell-carcinoma-arising-in-a-chronic-nonhealing-diabetic-foot-ulcer
#15
Bagher Larijani, Seyed Mohammad Tavangar, Fatemeh Bandarian
Diabetic foot ulcers (DFUs) are a severe and costly complication of diabetes and may result in foot amputation. CASE REPORT: A 69-year-old man with a 10-year history of type 2 diabetes, who was undergoing routine care for diabetes in the authors' clinic, developed a DFU of his right foot of 4 years' duration. The wound did not respond to conventional treatments, and imaging studies were normal. His 2 biopsies tested negative for malignancy. The DFU was fully removed surgically. Following surgical removal, squamous cell carcinoma (SCC) was diagnosed in the histologic study of the wound...
July 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28759424/treatment-of-thromboangiitis-obliterans-using-smoking-cessation-and-far-infrared-therapy-a-case-study
#16
I-Han Chiang, Shyi-Gen Chen, Yuan-Sheng Tzeng
Thromboangiitis obliterans (Buerger's disease) is a rare, nonatherosclerotic segmental inflammatory vasculitis that commonly involves small- and medium-sized vessels. Ischemic tenderness impairs patient quality of life and places patients at high risk for amputation. The only definitive known treatment is smoking cessation. Far-infrared (FIR) therapy has shown promising effects on blood flow and healing, but its use in patients with Buerger's disease has not been reported. A 31-year-old man with a 15-pack-year history of smoking, no drug abuse, and no other significant medical history, trauma, or family history diagnosed with thromboangiitis obliterans presented for care at the authors' clinic...
July 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28756345/gait-alterations-in-the-uae-population-with-and-without-diabetic-complications-using-both-traditional-and-entropy-measures
#17
Kinda Khalaf, Haitham M Al-Angari, Ahsan H Khandoker, Sungmun Lee, Wael Almahmeed, Habiba S Al Safar, Herbert F Jelinek
Diabetic foot, one of the most common and debilitating manifestations of type 2 diabetes mellitus (T2DM), is the leading cause of worldwide non-traumatic lower extremity amputations. Diabetics who are at risk of ulceration are currently mainly identified by a thorough clinical examination of the feet, which typically does not show clear symptoms during the early stages of disease progression. In this study, we used a non-linear dynamics tool, gait entropy (GaitEN), in addition to traditional linear gait analysis methods, to investigate gait alterations amongst diabetic patients with combinations of three types of T2DM related complications: retinopathy, diabetic peripheral neuropathy (DPN) and nephropathy...
July 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28756043/impact-of-angiosome-and-non-angiosome-targeted-peroneal-bypass-on-limb-salvage-and-healing-in-patients-with-chronic-limb-threatening-ischemia
#18
Jean-Baptiste Ricco, Mauro Gargiulo, Andrea Stella, Mohammad Abualhin, Enrico Gallitto, Mathieu Desvergnes, Romain Belmonte, Fabrice Schneider
BACKGROUND: Direct (DIR) or indirect (IND) revascularization of pedal angiosomes in patients with chronic limb-threatening ischemia (CLTI) has an unclear impact on limb salvage and healing. The aim of this study was to evaluate the outcomes of DIR and IND revascularization in patients with a peroneal bypass and tissue loss. METHODS: We conducted a retrospective study of a prospectively maintained database in two European university centers from 2004 to 2015. We extracted from this database all patients with CLTI and tissue loss who had received a bypass to the peroneal artery...
July 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28736121/potential-of-circulatory-procalcitonin-as-a-biomarker-reflecting-inflammation-among-south-indian-diabetic-foot-ulcers
#19
Dhamodharan Umapathy, Sireesh Dornadula, Arvind Rajagopalan, Narayana Murthy, Vairamani Mariappanadar, Rajesh Kesavan, Ramkumar Kunka Mohanram
OBJECTIVE: Diabetic foot ulcer (DFU), the major complication associated with diabetes mellitus, has been shown to precede amputation in up to 90% of cases. Recent data reveal that procalcitonin (PCT) is a valid marker for the diagnosis of bacterial infections compared with traditional markers like white blood cell count, C-reactive protein levels, and erythrocyte sedimentation rate in DFU patients. Furthermore, cytokines are proposed to act as modulators and mediators for the expression and release of PCT into the circulation...
July 20, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28730087/frequency-of-diabetic-retinopathy-and-associated-risk-factors-in-khartoum-sudan-population-based-study
#20
Einas S Elwali, Ahmed O Almobarak, Mona A Hassan, Amir A Mahmooud, Heitham Awadalla, Mohamed H Ahmed
AIM: To assess the frequency and associated risk factors of diabetic retinopathy among Sudanese individuals with diabetes attending Makka Eye complex in Khartoum, Sudan. METHODS: The cross sectional hospital based study recruited 316 individuals with diabetes from Makkah Eye Complex Retina Clinic. Standard questionnaire was used to collect demographic data, medical history and life style characteristics. Blood samples were taken to measure HbA1c and lipid profile...
2017: International Journal of Ophthalmology
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