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Plantar ulcer

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https://www.readbyqxmd.com/read/29057609/the-efficacy-of-removable-devices-to-offload-and-heal-neuropathic-plantar-forefoot-ulcers-in-people-with-diabetes-a-single-blinded-multicentre-randomised-controlled-trial
#1
Sicco A Bus, Jaap J van Netten, Anke Ir Kottink, Erik A Manning, Maximilian Spraul, Arend-Jan Woittiez, Jeff G van Baal
Non-removable offloading is the 'gold standard' treatment for neuropathic diabetic plantar forefoot ulcers. However, removable offloading is the common 'standard of care'. We compared three removable offloading devices for ulcer healing efficacy. In this multicentre, randomised controlled trial, 60 persons with neuropathic diabetic plantar forefoot ulcers were randomly assigned to wear a custom-made knee-high cast [BTCC (bivalved TCC)], custom-made ankle-high cast shoe or a prefabricated ankle-high forefoot-offloading shoe (FOS)...
October 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28990362/an-explorative-study-on-the-validity-of-various-definitions-of-a-2%C3%A2-2%C3%A2-c-temperature-threshold-as-warning-signal-for-impending-diabetic-foot-ulceration
#2
Anke M Wijlens, Samantha Holloway, Sicco A Bus, Jaap J van Netten
Home monitoring of skin temperature is effective to prevent diabetic foot ulceration. We explored the validity of various definitions for the >2·2°C left-to-right threshold used as a warning signal for impending ulceration. Twenty patients with diabetes and peripheral neuropathy monitored their skin temperature with an infrared thermometer at the plantar hallux, metatarsal heads, midfoot and heel four times a day for 6 consecutive days. Environmental temperature and walking activity were monitored and associated with foot temperature...
October 9, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28987067/reconstruction-of-severe-atherosclerotic-and-obstructive-diabetic-feet-using-thoracodorsal-artery-perforator-flaps-with-long-vascular-pedicles
#3
Sang Wha Kim, Il Hoon Sung, Youn Hwan Kim
BACKGROUND: Foot ulcers in diabetic patients often require free flaps. A long vascular pedicle is mandatory so that more proximal vessels can be used as recipient vessels, especially when the flap is used to reconstruct distal foot defects. We evaluated the outcome of diabetic foot defect that were reconstructed using thoracodorsal artery perforator (TDAP) flaps with long vascular pedicles. PATIENTS AND METHODS: We reconstructed the foot defects of 22 diabetic patients...
October 7, 2017: Microsurgery
https://www.readbyqxmd.com/read/28985487/lower-extremity-dynamics-of-walking-in-neuropathic-diabetic-patients-who-wear-a-forefoot-offloading-shoe
#4
Sicco A Bus, Josina C Maas, Nicoline M Otterman
BACKGROUND: A forefoot-offloading shoes has a negative-heel rocker outsole and is used to treat diabetic plantar forefoot ulcers, but its mechanisms of action and their association with offloading and gait stability are not sufficiently clear. METHODS: Ten neuropathic diabetic patients were tested in a forefoot-offloading shoe and subsequently in a control shoe with no specific offloading construction, both worn on the right foot (control shoe on left), while walking at 1...
October 2, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28965863/a-methodological-framework-for-detecting-ulcers-risk-in-diabetic-foot-subjects-by-combining-gait-analysis-a-new-musculoskeletal-foot-model-and-a-foot-finite-element-model
#5
Alessandra Scarton, Annamaria Guiotto, Tiago Malaquias, Fabiola Spolaor, Giacomo Sinigaglia, Claudio Cobelli, Ilse Jonkers, Zimi Sawacha
Diabetic foot is one of the most debilitating complications of diabetes and may lead to plantar ulcers. In the last decade, gait analysis, musculoskeletal modelling (MSM) and finite element modelling (FEM) have shown their ability to contribute to diabetic foot prevention and suggested that the origin of the plantar ulcers is in deeper tissue layers rather than on the plantar surface. Hence the aim of the current work is to develop a methodology that improves FEM-derived foot internal stresses prediction, for diabetic foot prevention applications...
September 1, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28964719/relationship-of-planter-pressure-and-glycemic-control-in-type-2-diabetic-patients-with-and-without-neuropathy
#6
Mohammed R Halawa, Yara M Eid, Rana A El-Hilaly, Mona M Abdelsalam, Amr H Amer
INTRODUCTION: Foot disease is a common complication of type 2 diabetes that can have tragic consequences. Abnormal plantar pressures are considered to play a major role in the pathologies of neuropathic ulcers in the diabetic foot. AIM: To examine Relationship of Planter Pressure and Glycemic Control in Type 2 Diabetic Patients with and without Neuropathy. MATERIALS AND METHODS: The study was conducted on 50 type 2 diabetic patients and 30 healthy volunteers...
September 23, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28948477/plantar-melanoma-is-associated-with-certain-poor-prognostic-histopathological-factors-but-not-correlated-with-nodal-involvement-recurrence-and-worse-survival
#7
F Tas, K Erturk
BACKGROUND: Plantar surface melanoma affects the Caucasian race less likely than it does other races, e.g., the Asians and the Blacks. So far, small numbers of researches on plantar melanoma have yielded controversial results. The aim of this study was to define the histopathological and clinical characteristics pertinent to plantar melanoma and to compare them with melanomas that emerged in other sites by using a large group of patients from a single institution. PATIENTS AND METHODS: A total of 104 Turkish Caucasian plantar melanoma patients and 1065 patients with non-plantar melanomas were analyzed retrospectively...
September 25, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28942120/immobilization-induced-osteolysis-and-recovery-in-neuropathic-foot-impairments
#8
David R Sinacore, Mary K Hastings, Kathryn L Bohnert, Michael J Strube, David J Gutekunst, Jeffrey E Johnson
BACKGROUND: Neuropathic foot impairments treated with immobilization and off-loading result in osteolysis. In order to prescribe and optimize rehabilitation programs after immobilization we need to understand the magnitude of pedal osteolysis after immobilization and the time course for recovery. OBJECTIVE: To determine differences in a) foot skin temperature; b) calcaneal bone mineral density (BMD) after immobilization; c) calcaneal BMD after 33-53weeks of recovery; and d) percent of feet classified as osteopenic or osteoporotic after recovery in participants with neuropathic plantar ulcers (NPU) compared to Charcot neuroarthropathy (CNA)...
December 2017: Bone
https://www.readbyqxmd.com/read/28917976/low-molecular-weight-fucoidan-ameliorates-hindlimb-ischemic-injury-in-type-2-diabetic-rats
#9
Zhiqiang Wang, Tiantian Liu, Xiaoping Chen, Hongjie You, Quanbin Zhang, Jingyi Xue, Yuanyuan Zheng, Dali Luo
ETHNOPHARMACOLOGICAL RELEVANCE: Low molecular weight fucoidan (LMWF), extracted from Laminaria japonica Areschoug, is a traditional Chinese medicine, commonly used to alleviate edema, particularly for feet with numbness and pain. AIM OF THE STUDY: Diabetic mellitus (DM) patients are at high risk of developing peripheral arterial disease (PAD). Individuals with DM and PAD co-morbidity have a much higher risk of critical limb ischemia. LMWF showed several beneficial effects, such as anti-inflammation, anti-thrombosis, and enhancing revascularization...
September 14, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28904744/clinical-and-surgical-characteristics-of-infected-diabetic-foot-ulcers-in-a-tertiary-hospital-of-mexico
#10
Estrella Cervantes-García, Paz María Salazar-Schettino
Background: The objective of this study was to determine the clinical and surgical characteristics of diabetic foot ulcers in a tertiary level hospital in Mexico. Methods: We performed a longitudinal, descriptive study from July, 2012 to August, 2015 on a sample composed of 100 patients with type 2 diabetes mellitus and infected diabetic foot ulcers. We analyzed socio-demographic variables, comorbidities, characteristics of ulcers, and the applied treatment. Results: We found that the most affected areas were the forefoot (48%) and the plantar region (55%) of the foot...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28892975/caudal-regression-syndrome-with-pressure-ulcers-of-the-foot-a-case-report
#11
Kosaku Yamamichi, Tsuyoshi Manabe, Tatsuya Uekihara
Caudal Regression Syndrome (CRS) is a rare disorder which consists of abnormalities in the lumbosacral spine, rectum, urinary system and lower limbs. These abnormalities also include orthopaedic deformities, such as hip dislocation, knee-flexion contracture with popliteal webbing and talipes equinovarus. Because of the rarity of this condition, few medical personnel are aware of it. Here, we present a case of CRS in a 15-year-old girl with pressure ulcers on the lateral malleolus and plantar surface of the foot, which had come into contact with the wheelchair footrest...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28866982/protein-profile-of-leprosy-patients-with-plantar-ulcers-from-the-eastern-amazon-region
#12
Marineia Porto de Oliveira, Jorge Rodrigues de Sousa, Rafael Silva de Araujo, Tinara Leila de Sousa Aarão, Juarez Antonio Simões Quaresma
BACKGROUND: Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse. Therefore, the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region. METHODS: A case record form was created for 75 patients with leprosy (31 with plantar ulcers and 44 without plantar ulcers) with the following data: sociodemographic characteristics, clinical form of leprosy, presence or absence of plantar ulcers, and nutritional assessment using anthropometry consisting of the measurement of body mass index, arm circumference, arm muscle circumference, and triceps skinfold...
September 4, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28862974/clostridial-collagenase-for-the-management-of-diabetic-foot-ulcers-results-of-four-randomized-controlled-trials
#13
John C Lantis Ii, Ian Gordon
BACKGROUND: Despite major treatment advances, diabetic foot ulcers (DFUs) remain a frequent and debilitating complication of diabetes mellitus and a major cause of significant morbidity and mortality. OBJECTIVE: This study evaluates and compares clinical effectiveness of clostridial collagenase ointment (CCO) with standard care (SC) in patients with DFUs, with the goal to define best clinical criteria under which to use CCO in the DFU population. MATERIALS AND METHODS: This is a pooled data analysis of 4 randomized controlled trials that compared clinical effectiveness of CCO to SC...
August 25, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28859516/novel-in-shoe-exoskeleton-for-offloading-of-forefoot-pressure-for-individuals-with-diabetic-foot-pathology
#14
Mark C Roser, Paul K Canavan, Bijan Najafi, Marcy Cooper Watchman, Kairavi Vaishnav, David G Armstrong
INTRODUCTION: Infected diabetic foot ulcers are the leading cause of lower limb amputation. This study evaluated the ability of in-shoe exoskeletons to redirect forces outside of body and through an exoskeleton as an effective means of offloading plantar pressure, the major contributing factor of ulceration. METHODS: We compared pressure in the forefoot and hind-foot of participants (n = 5) shod with novel exoskeleton footwear. Plantar pressure readings were taken during a 6-m walk at participant's self-selected speed, and five strides were averaged...
September 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28859075/plantar-pressures-are-elevated-in-people-with-longstanding-diabetes-related-foot-ulcers-during-follow-up
#15
Malindu E Fernando, Robert G Crowther, Peter A Lazzarini, Saiumaeswar Yogakanthi, Kunwarjit S Sangla, Petra Buttner, Rhondda Jones, Jonathan Golledge
OBJECTIVE: High plantar pressures are implicated in the development of diabetes-related foot ulcers. Whether plantar pressures remain high in patients with chronic diabetes-related foot ulcers over time is uncertain. The primary aim of this study was to compare plantar pressures at baseline and three and six months later in participants with chronic diabetes-related foot ulcers (cases) to participants without foot ulcers (controls). METHODS: Standardised protocols were used to measure mean peak plantar pressure and pressure-time integral at 10 plantar foot sites (the hallux, toes, metatarsals 1 to 5, mid-foot, medial heel and lateral heel) during barefoot walking...
2017: PloS One
https://www.readbyqxmd.com/read/28852403/recovery-of-sympathetic-nerve-function-after-lumbar-sympathectomy-is-slower-in-the-hind-limbs-than-in-the-torso
#16
Zhi-Fang Zheng, Yi-Shu Liu, Xuan Min, Jian-Bing Tang, Hong-Wei Liu, Biao Cheng
Local sympathetic denervation by surgical sympathectomy is used in the treatment of lower limb ulcers and ischemia, but the restoration of cutaneous sympathetic nerve functions is less clear. This study aims to explore the recovery of cutaneous sympathetic functions after bilateral L2-4 sympathectomy. The skin temperature of the left feet, using a point monitoring thermometer, increased intraoperatively after sympathectomy. The cytoplasm of sympathetic neurons contained tyrosine hydroxylase and dopamine β-hydroxylase, visualized by immunofluorescence, indicated the accuracy of sympathectomy...
July 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28843185/effects-of-flexible-and-rigid-rocker-profiles-on-in-shoe-pressure
#17
Roy Reints, Juha M Hijmans, Johannes G M Burgerhof, Klaas Postema, Gijsbertus J Verkerke
Rocker profiles are commonly used in the prevention of diabetic foot ulcers. Rockers are mostly stiffened to restrict toe plantarflexion to ensure proper offloading. It is also described that toe dorsiflexion should be restricted. However, the difference in effect on plantar pressure between rigid rockers that restrict this motion and flexible rockers that do not is unknown. In-shoe plantar pressure data were collected for a control shoe and the same shoe with rigid and flexible rockers with the apex positioned at 50% and 60%...
October 2017: Gait & Posture
https://www.readbyqxmd.com/read/28842095/functional-outcomes-after-heel-pad-reconstruction-a-review-of%C3%A2-7%C3%A2-cases
#18
Koh Khai Luen, Wan Azman Wan Sulaiman
Sensate, durable heel pad reconstruction is challenging. The present study assessed the functional outcomes after heel pad reconstruction using various flap techniques at our institution. From June 2011 to June 2016 (5-year period), 7 consecutive patients underwent heel pad reconstruction for various etiologies, with 3 microvascular free flaps (42.9%; 2 musculocutaneous flaps [66.7%] and 1 contralateral medial plantar flap [33.3%]) and 4 local pedicle flaps (57.1%; 3 instep medial plantar artery flaps [75.0%] and 1 distally based reverse sural flap [25...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28840130/development-of-a-plantar-load-estimation-algorithm-for-evaluation-of-forefoot-load-of-diabetic-patients-during-daily-walks-using-a-foot-motion-sensor
#19
Ayano Watanabe, Hiroshi Noguchi, Makoto Oe, Hiromi Sanada, Taketoshi Mori
Forefoot load (FL) contributes to callus formation, which is one of the pathways to diabetic foot ulcers (DFU). In this study, we hypothesized that excessive FL, which cannot be detected by plantar load measurements within laboratory settings, occurs in daily walks. To demonstrate this, we created a FL estimation algorithm using foot motion data. Acceleration and angular velocity data were obtained from a motion sensor attached to each shoe of the subjects. The accuracy of the estimated FL was validated by correlation with the FL measured by force sensors on the metatarsal heads, which was assessed using the Pearson correlation coefficient...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28804593/an-innovative-sealed-shoe-to-off-load-and-heal-diabetic-forefoot-ulcers-a-feasibility-study
#20
Gustav Jarl, Roy Tranberg
Background: Non-removable knee-high devices are the gold standard to treat diabetic foot ulcers located on the plantar forefoot, but they immobilize the ankle, which restricts daily life activities and has negative effects on joint functioning. Objective: To investigate the feasibility of sealing a therapeutic shoe to off-load and heal diabetic forefoot ulcers. Design: A case series of seven men with type 2 diabetes and a metatarsal head ulcer were prescribed therapeutic shoes and custom-made insoles. The shoe was sealed with a plastic band...
2017: Diabetic Foot & Ankle
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