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Toe amputation

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https://www.readbyqxmd.com/read/29240587/reclaiming-autologous-amputated-tissue-for-limb-salvage-of-a-diabetic-foot-burn-with-underlying-critical-limb-ischemia
#1
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/29240584/dermatofibrosarcoma-protuberans-of-distal-extremities-and-acral-sites-a-clinicopathologic-analysis-of-27-cases
#2
Kabeer K Shah, Jonathan B McHugh, Andrew L Folpe, Rajiv M Patel
Dermatofibrosarcoma protuberans (DFSP) of the distal extremities and acral sites are extremely rare and incompletely characterized. Twenty-seven DFSP occurring in these sites were retrieved from our collective archives and reevaluated. Tumors occurred in 16 males and 11 females. Median age at presentation was 42.5 years (range, 7 to 78 y). Lesions involved the foot (18 with 6 in the toes and 2 on the plantar foot), distal ankle (4), hand (4 with 2 in the thumbs), and wrist (1). All cases showed predominantly classic DFSP morphology and were diffusely CD34 positive...
December 7, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29184493/step-to-step-ankle-inversion-eversion-torque-modulation-can-reduce-effort-associated-with-balance
#3
Myunghee Kim, Steven H Collins
Below-knee amputation is associated with higher energy expenditure during walking, partially due to difficulty maintaining balance. We previously found that once-per-step push-off work control can reduce balance-related effort, both in simulation and in experiments with human participants. Simulations also suggested that changing ankle inversion/eversion torque on each step, in response to changes in body state, could assist with balance. In this study, we investigated the effects of ankle inversion/eversion torque modulation on balance-related effort among amputees (N = 5) using a multi-actuated ankle-foot prosthesis emulator...
2017: Frontiers in Neurorobotics
https://www.readbyqxmd.com/read/29169658/-symmetrical-peripheral-gangrene-4%C3%A2-cases
#4
F Smaoui, M Koubaa, K Rekik, Y Mejdoub, S Mezghani, I Maaloul, A Hammami, C Marrakchi, M Ben Jemaa
BACKGROUND: Symmetric peripheral gangrene (SPG) is a symmetrical distal ischemic lesion on at least 2 or more extremities in the absence of proximal arterial obstruction and vasculitis. It is a rare and severe clinical entity. The aim of this study was to describe clinical symptoms, etiological agents and the management of SPG through a series of 4 cases. PATIENTS AND METHODS: We included all cases of SPG hospitalized between 2000 and 2014. The inclusion criterion was the presence of distal ischemic damage at two or more sites in the absence of large vessel obstruction...
November 20, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/29162147/a-systematic-review-describing-incidence-rate-and-prevalence-of-dysvascular-partial-foot-amputation-how-both-have-changed-over-time-and-compare-to-transtibial-amputation
#5
Michael P Dillon, Matthew Quigley, Stefania Fatone
BACKGROUND: Partial foot amputation (PFA) is a common consequence of advanced peripheral vascular disease. Given the different ways incidence rate and prevalence data have been measured and reported, it is difficult to synthesize data and reconcile variation between studies. As such, there is uncertainty in whether the incidence rates and prevalence of PFA have increased over time compared to the decline in transtibial amputation (TTA). The aims of this systematic review were to describe the incidence rate and prevalence of dysvascular PFA over time, and how these compare to TTA...
November 21, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29148242/infrapopliteal-peripheral-arterial-disease-and-critical-limb-ischemia-the-time-has-come-for-collaborative-streamlined-diagnostic-and-treatment-paradigms
#6
EDITORIAL
Michael S Levy
The diagnosis, surveillance, and management of infrapopliteal critical limb ischemia remain inconsistent among clinicians. This study demonstrates that using an absolute ankle pressure of >73 mm Hg or an absolute toe pressure increase of 1 mm Hg or greater post endovascular intervention in patients with infrapopliteal critical limb ischemia may be predictive of a reduction in target limb revascularization, amputation, and death. This study highlights the need for vascular societies to come together to promote standardized screening, surveillance, and treatment paradigms for this complex population...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29131751/a-diabetic-foot-ulcer-treated-with-hydrogel-and-hyperbaric-oxygen-therapy-a-case-study
#7
P Aguiar, C Amaral, A Rodrigues, A H de Souza
This study reports on the case of an elderly patient, with diabetes, and a bullous wound on the left big toe that led to an amputation of the first and second left toes. The amputation was because of deep injury as it was not able to heal with a conventional treatment. After completing the normal treatment and the removal of a bacterial infection in the lesion, the patient underwent a treatment that was based on a hydrogel gel (0.9% saline solution) and hyperbaric oxygen therapy (HBOT). After 60 sessions of the therapy, almost complete closure of the wound was observed...
November 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29121845/improving-outcomes-for-lower-extremity-amputations-using-intraoperative-fluorescent-angiography-to-predict-flap-viability
#8
Andrew E Yang, Charles A Hartranft, Alisha Reiss, Charles R Holden
OBJECTIVES: Nearly 25% of vascular surgery patients operated on for peripheral vascular disease are readmitted within 30 days. Development of adjuncts to minimize wound complications remains an area of great interest. Here, we present our experience with intraoperative fluorescent angiography (IFA) as a tool to predict skin flap viability following lower extremity amputations (LEAs). METHODS: Experience with IFA using indocyanine green (ICG) dye was reviewed retrospectively at a single institution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29076328/modified-toe-pulp-fillet-flap-coverage-better-wound-healing-and-satisfactory-length-preservation
#9
Sang Oon Baek, Hyo Wan Suh, Jun Yong Lee
Background: Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes...
October 27, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29020882/quality-of-time-spent-without-symptoms-of-disease-or-toxicity-of-treatment-for-transmetatarsal-amputation-versus-digital-amputation-in-diabetic-patients-with-digital-gangrene
#10
Mohamed Elsherif, Wael Tawfick, Patrick Canning, Niamh Hynes, Sherif Sultan
Aim We aim to compare the outcome of diabetic patients with gangrenous toes who were managed initially either by digital amputation or by transmetatarsal amputation. The null hypothesis is that transmetatarsal amputation had less theatre trips and better healing. Materials and Methods A parallel observational comparative study of all diabetic patients who underwent either digital or transmetatarsal amputation in a tertiary referral center from 2002 through 2015. Comorbid conditions, subsequent amputations, hospital stay, and readmission were noted...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28922325/metacarpal-like-hand-classification-and-treatment-guidelines-for-microsurgical-reconstruction-with-toe-transplantation
#11
Fu-Chan Wei, Nidal F Al Deek, Yu-Te Lin, Chung-Chen Hsu, Cheng-Hung Lin
The metacarpal-like hand is a severe hand injury, never addressed before. It describes a hand that lost a significant degree of prehension through a wide array of amputations, involving all digits proximal to the functional length except in one finger or in two digits, including the thumb.Thumb condition can be used to differentiate between two types.In type I, the thumb is intact or amputated at/or distal to the interphalangeal joint (functional length); and therefore, the reconstruction is focused on fingers mainly...
September 14, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28887264/toe-pressures-are-superior-to-duplex-parameters-in-predicting-wound-healing-following-toe-and-foot-amputations
#12
Patrick A Stone, Alexis Glomski, Stephanie N Thompson, Elliott Adams
BACKGROUND: No criteria, including preamputation vascular diagnostic thresholds, have been established to reliably predict healing versus nonhealing following minor lower extremity amputations. Thus, the goal of our study was to identify clinical factors, including noninvasive vascular laboratory measures, associated with wound healing following toe, forefoot, and midfoot amputations. METHODS: We retrospectively examined records of patients receiving elective toe, forefoot, or midfoot amputation at our institution over a 5-year span (2010-2015)...
January 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28876598/spectrum-of-disease-and-outcome-of-primary-amputation-for-diabetic-foot-sepsis
#13
S Cheddie, C Manneh, H Zulu
BACKGROUND: Guillotine amputation for diabetic foot sepsis followed by an elective refashioning of the stump is regarded as standard practice. Primary amputation is associated with higher reamputation rates. METHOD: A prospective cohort study of 85 patients who underwent surgery for diabetic foot sepsis from 2014 to 2016 at Madadeni Provincial Hospital, KwaZulu-Natal was done. Ethical approval was granted. The Wagner classification (Wag) was used to classify disease severity...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28872035/prevalence-and-severity-of-peripheral-arterial-disease-among-patient-with-heel-pressure-ulcer-a-retrospective-study-of-42-patients
#14
Guillaume Tisserand, Nora Zenati, Christophe Seinturier, Sophie Blaise, Gilles Pernod
Heel pressure ulcer is a major complication in elderly hospitalized patients. The association with peripheral arterial disease (PAD) which is also a frequent disease in this population is poorly known. The aim of this study was to assess the prevalence of PAD and critical limb ischemia (CLI) in patients with heel pressure ulcer. Patients referred to the vascular medicine department for heel pressure ulcer from October 2014 to June 2015 were included in the study. The assessment of peripheral arterial disease was made with the results of ankle brachial index and/or doppler ultra sound of lower limb arteries...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28866701/p40-in-metastatic-pulmonary-trophoblastic-tumour-potential-diagnostic-pitfall-on-histopathology
#15
A G Vallonthaiel, R Walia, R Pramanik, M C Sharma, D Jain
p40, one of the two isomers of p63, is nowadays widely used for diagnosis of squamous cell carcinoma, especially in subtyping non-small cell carcinoma on lung biopsies. We describe a case in which lung tumour was misdiagnosed as squamous cell carcinoma due to p40 immunopositivity. A 36-year-old lady presented with cough and left sided chest pain of 2 months duration. Chest imaging revealed a lesion in left lower lobe of the lung and biopsy was suggestive of squamous cell carcinoma. However, past history revealed amputation of great toe for non-healing discharging ulcer which on histopathology was diagnosed as choriocarcinoma...
August 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28864313/toe-to-finger-combined-with-free-flap-transfer-for-primary-one-stage-post-traumatic-reconstruction-of-the-complex-fingerless-hand
#16
Hua Chen, Chaoyin Jiang, Yaozeng Xu, Yangbai Sun
Toe-to-finger transplantation is intimately related to the development of microsurgical free tissue transplantation, which is one of the most important advances in the history of reconstructive surgery. It is also generally acknowledged that a mangled hand with massive tissue loss and amputation of multiple digits presents a challenge for plastic and reconstructive surgeons. In this retrospective study we reviewed 11 cases of primary one-stage post-traumatic reconstruction of complex fingerless hands using a combination of toe-to-finger and free tissue transplantation performed in Shanghai Jiao Tong University affiliated Sixth People's Hospital and Shanghai Jiao Tong University School of Medicine affiliated Ninth People's Hospital from January 2001 to November 2014...
August 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28862375/analysis-of-in-pact-deep-trial-on-the-association-between-changes-in-perfusion-from-pre-to-postrevascularization-and-clinical-outcomes-in-critical-limb-ischemia
#17
Tarek A Hammad, Thomas Zeller, Iris Baumgartner, Dierk Scheinert, Krishna J Rocha-Singh, Mehdi H Shishehbor
OBJECTIVES: To quantify changes in ankle and toe pressure from pre- to post-endovascular revascularization for critical limb ischemia (CLI) and examine their association with major adverse limb events (MALE). BACKGROUND: Despite societal guidelines recommendation of routine hemodynamic surveillance following revascularization, little is known about hemodynamic assessment in CLI. METHODS: Among the 358 patients with CLI from the international multicenter IN...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28830248/naja-atra-snakebite-in-taiwan
#18
Yan-Chiao Mao, Po-Yu Liu, Liao-Chun Chiang, Chih-Sheng Lai, Kuo-Lung Lai, Cheng-Hsuan Ho, Te-Huo Wang, Chen-Chang Yang
BACKGROUND: Naja atra snakebite is uncommon in Taiwan and causes distinct effects on its victims. Although the Taiwan government produces its own specific antivenom, little information on the management of N. atra snakebite is available. MATERIALS AND METHODS: We retrospectively evaluated 183 patients admitted to two medical centers. Of these, 45 were identified as definite cases of N. atra snakebite, 86 as suspected cases, and 52 as clinical cases. Demographic data, symptomatology, and management were compared between these case groups...
August 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28827300/near-toe-amputation-from-prolonged-compression-stocking-use
#19
Victoria Ward, Ben Lovell
No abstract text is available yet for this article.
August 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28820834/super-thin-scip-flap-for-reconstruction-of-subungual-melanoma-aesthetic-functional-surgery
#20
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
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