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Foot wound

Carla D McArdle, Katie M Lagan, David A McDowell
BACKGROUND: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs...
January 2018: Journal of the American Podiatric Medical Association
Lawrence A Lavery, David C Lavery, Nathan A Hunt, Javier La Fontaine, Ryan D Lavery
BACKGROUND: Dialysis therapy is associated with an increased incidence of lower-extremity wounds and amputations. We compared the incidence of foot ulcers and amputations before and after the start of dialysis. METHODS: We evaluated 150 consecutive diabetic patients receiving dialysis and compared the incidence of foot complications 30 months before and after initiation of hemodialysis. We used claims data for diabetes, ulceration, and dialysis and abstracted medical records to verify diagnoses and dates of ulcers and amputations...
January 2018: Journal of the American Podiatric Medical Association
Jie Gao, Gang Zhao, Wei Li, Jiayuan Zhang, Yanling Che, Meiyu Song, Shan Gao, Bin Zeng, Yuanhong Wang
Endothelial progenitor cells (EPCs) are involved in diabetes-associated complications, including diabetic foot ulcer (DFU). Recent reports showed that miR-155 downregulation promotes wound healing in diabetic rats and ameliorates endothelial injury induced by high glucose, but its role in DFU is unknown. We found that miR-155 was overexpressed in EPCs from patients with DFU and in high glucose-induced EPCs from healthy people. Reductions in cell viability, migration, tube formation and nitric oxide production, as well as increases in lactated hydrogenase, cell apoptosis, and reactive oxygen species induced by high glucose, were enhanced by miR-155 overexpression and restrained by miR-155 inhibition...
March 12, 2018: Experimental Cell Research
Cheng-Lin Wang, Kai-Xue Cao, Jun-Zhong Yang
OBJECTIVE: To investigate the clinical effect of a new bundle-to-bundle suturing method for acute Achilles tendon rupture. METHODS: From April 2013 to January 2015, 15 patients with acute Achilles tendon rupture were treated with a new bundle-to-bundle suturing method including 12 males and 3 females with an average age of 37.5 years old ranging from 27 to 56 years old. All of them were immobilized by cast for 6 weeks on the underlying limbs, and were educated for a rehabilitation training during the follow-up...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Lorena Bejarano-Pineda, Annunziato Amendola
Participation in sports activity has increased significantly during the last several decades. This phenomenon has exposed orthopedic sports medicine surgeons to new challenges regarding the diagnosis and management of common sport-related injuries. Arthroscopy is becoming more commonly used in many of the surgical procedures for these injuries and carries the risk of complications. Wound and nerve complications make up the bulk of complications in most procedures. This article describes these complications associated with the common surgical procedures related to foot and ankle sport-related injuries and how to address and prevent them...
April 2018: Clinics in Sports Medicine
Jen-Ta Shih, Chun-Lin Kuo, Tsu-Te Yeh, Hsain-Chung Shen, Ru-Yu Pan, Chia-Chun Wu
BACKGROUND: The ideal treatment for comminuted intraarticular calcaneal fractures is still debated. Open reduction and internal fixation (ORIF) is the most popular surgical procedure; however, wound complications, implant choice, and infection remain major concerns. This study aimed to demonstrate the results of an innovative, minimally invasive surgical procedure, namely, a closed reduction technique using large-diameter Steinmann pins and percutaneous calcaneoplasty using injectable calcium sulfate cement (MIIG X3, Wright Medical Technology, Inc...
March 9, 2018: BMC Musculoskeletal Disorders
Şahizer Eraydin, Gülçin Avşar
PURPOSE: The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. DESIGN: Prospective, randomized controlled study. SUBJECT AND SETTINGS: Sixty-five patients from an outpatient clinic with grade 1 or 2 ulcers (Wagner classification) who met study criteria agreed to participate; 60 patients completed the study and were included in the final analysis. Subjects were followed up between February 2014 and June 2015...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Paul J Kim, Christopher E Attinger, Thomas Bigham, Robert Hagerty, Samantha Platt, Ersilia Anghel, John S Steinberg, Karen K Evans
Outpatient-based sharp debridement is considered an important element for the care of a chronic ulcer. OBJECTIVE: The aim of this study is to evaluate the change in bacterial amounts with sharp debridement in a clinical setting. MATERIALS AND METHODS: Bacterial autofluorescence, quantitative cultures, semiquantitative cultures, and qualitative speciation were performed predebridement and postdebridement during a single clinic visit. RESULTS: Thirty-six wounds were included in the analysis...
February 23, 2018: Wounds: a Compendium of Clinical Research and Practice
Marek Kawecki, Jarosław Pasek, Grzegorz Cieślar, Aleksander Sieroń, Grzegorz Knefel, Mariusz Nowak, Justyna Glik
BACKGROUND: Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. OBJECTIVES: The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. MATERIAL AND METHODS: The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Sinuo Chen, Renren Li, Chun Cheng, Jing-Ying Xu, Caixia Jin, Furong Gao, Juan Wang, Jieping Zhang, Jingfa Zhang, Hong Wang, Lixia Lu, Guo-Tong Xu, Haibin Tian
Macrophages play critical roles in wound healing process. They switch from "classically activated" (M1) phenotype in the early inflammatory phase to "alternatively activated" (M2) phenotype in the later healing phase. However, the dynamic process of macrophage phenotype switching in diabetic wounds burdened with bacteria is unclear. In this report, Pseudomonas aeruginosa, frequently detected in diabetic foot ulcers, was inoculated into cutaneous wounds of db/db diabetic mice to mimic bacterium-infected diabetic wound healing...
March 7, 2018: Cell Biology International
Chris Manu, Elisabetta Lacopi, Benjamin Bouillet, Julien Vouillarmet, Raju Ahluwalia, Claas Lüdemann, José Luis Garcia-Klepzig, Marco Meloni, Víctor Rodriguez-Saenz De Buruaga, Juan Pedro Sánchez-Ríos, Mike Edmonds, Jan Apelqvist, Jose Luis Lazaro Martinez, Kristien Van Acker
OBJECTIVE: Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units. METHOD: A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU...
March 2, 2018: Journal of Wound Care
David Russell, Leanne Atkin, April Betts, Caroline Dowsett, Francis Fatoye, Sarah Gardner, Julie Green, Chris Manu, Tracey McKenzie, Helena Meally, Louise Mitchell, Julie Mullings, Isaac Odeyemi, Andrew Sharpe, Gillian Yeowell, Nancy Devlin
OBJECTIVE: Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing...
March 2, 2018: Journal of Wound Care
Caitlin W Hicks, Joseph K Canner, Nestoras Mathioudakis, Ronald L Sherman, Kathryn Hines, Christopher Lippincott, James H Black, Christopher J Abularrage
BACKGROUND: Socioeconomic deprivation is associated with poor glycemic control and higher hospital admission rates in patients with diabetes. We sought to quantify the effects of neighborhood socioeconomic deprivation on wound healing among a cohort of patients with diabetic foot ulceration (DFU) treated in a multidisciplinary setting. METHODS: Socioeconomic disadvantage was calculated for all patients using the area deprivation index (ADI) stratified by quartile (from ADI-0: least through ADI-3: most)...
April 2018: Journal of Surgical Research
Il Hoon Sung, Dong Woo Jang, Se Wan Kim, Youn Hwan Kim, Sang Wha Kim
BACKGROUND: Reconstruction of complicated diabetic lower leg and foot defects involving multiple tissue components remains a challenge. The purpose of this report is to introduce thoracodorsal artery perforator (TDAP) chimeric flaps for reconstructing diabetic lower leg and foot soft tissue defects. PATIENTS AND METHODS: Between April 2010 and August 2016, 17 patients with multiple diabetic lower leg and foot defects underwent reconstruction with TDAP chimeric flaps...
March 5, 2018: Microsurgery
Raymond Cavaliere, Danielle M Mercado, Malary Mani
Squamous cell carcinoma (SCC) has been commonly reported by foot and ankle specialists. Marjolin's ulcer is a malignancy that involves a posttraumatic scar or ulceration that can develop into SCC from chronic neuropathic pedal wounds, venous stasis, or decubitus ulcerations. Most Marjolin's ulcers are found in the lower extremity, specifically the feet, and it is twice as common in females as males. Biopsy of the tumor is the reference standard to diagnose SCC, and wide excision of SCC is the most common treatment option...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Rabih A Chaer, Steven A Leers, Aureline Boitet, Michael J Singh, Eric S Hager
OBJECTIVE: 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 than patients with forefoot wounds. METHODS: A retrospective chart review was performed of 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...
February 28, 2018: Annals of Vascular Surgery
Øyvind Heiberg Sundby, Ingebjørg Irgens, Lars Øivind Høiseth, Iacob Mathiesen, Eivind Lundgaard, Hanne Haugland, Harald Weedon-Fekjær, Jon O Sundhagen, Gunnar Sandbæk, Jonny Hisdal
STUDY DESIGN: Randomized, assessor-blinded crossover pilot study. OBJECTIVES: To explore the use of an intermittent negative pressure (INP) device for home use in addition to standard wound care (SWC) for patients with spinal cord injury (SCI) and chronic leg and foot ulcers before conducting a superiority trial. SETTING: Patient homes and outpatient clinic. METHODS: A 16-week crossover trial on 9 SCI patients (median age: 57 years, interquartile range [IQR] 52-66), with leg ulcers for 52 of weeks (IQR: 12-82) duration...
March 1, 2018: Spinal Cord
Erica Y Xue, Laurel K Chandler, Stephen L Viviano, Jonathan D Keith
OBJECTIVE: Forward-looking infrared (FLIR) thermography technology uses a handheld camera that measures skin infrared emissivity, captures photographs, and can be analyzed through specialized software. Forward-looking infrared images can be used to analyze and correlate burn wound temperature with burn depth, burn progression, and the number of days needed for healing. FLIR ONE is a miniature, smartphone-compatible thermal imaging camera that has been used to assess inflammation in diabetic foot ulcers, as well as locating perforators in flap surgery...
February 28, 2018: Annals of Plastic Surgery
Abhisekh Mohapatra, Mikayla N Lowenkamp, Jon C Henry, Aureline Boitet, Efthimios D Avgerinos, Rabih A Chaer, Michel S Makaroun, Steven A Leers, Eric S Hager
INTRODUCTION: Endovascular strategies are often preferred for revascularization of ischemic foot wounds secondary to infrapopliteal disease due to the less invasive technique and faster recovery. Bypass is typically reserved for failures or lesions not amenable to balloon angioplasty. However, the effects of an endovascular-first approach on subsequent bypass grafts is largely unknown. This study evaluates the effects of prior tibial interventions on successive bypasses to pedal targets...
February 23, 2018: Annals of Vascular Surgery
Anthony Tickner, Cheri Klinghard, Jonathan F Arnold, Valerie Marmolejo
INTRODUCTION: As the majority of diabetic foot ulcerations (DFUs) occur on the plantar foot, excessive pressure is a major contributing factor to delayed healing. The gold standard for offloading is the total contact cast (TCC); yet, TCC use is contraindicated in patients with ischemia. Lower extremity ischemia typically presents in the more severe end stages of peripheral arterial disease (PAD). As PAD exists on a severity spectrum from mild to severe, designation of a clear cutoff where TCC use is an absolute contraindication would assist those who treat DFUs on a daily basis...
February 2018: Wounds: a Compendium of Clinical Research and Practice
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