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Diabetic wound care

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https://www.readbyqxmd.com/read/28810801/may-dietary-supplementation-augment-respiratory-burst-in-wound-site-inflammatory-cells
#1
Amitava Das, Ryan Dickerson, Piya Das Ghatak, Gayle Gordillo, Scott Chaffee, Abhijoy Saha, Savita Khanna, Sashwati Roy
Persistent infection contributes to wound chronicity. At the wound-site, NADPH oxidase activity in immune cells fights infection to enable the healing process. Fermented Papaya Preparation (FPP) is a carbohydrate-rich nutritional supplement that has demonstrated ability to bolster respiratory burst in experimental rodent systems. In FPP, glucose co-exists with fructose and maltose in addition to multiple other sugar alcohols such as inositol. We have previously reported that FPP supplementation augments wound healing in diabetic mice via improvement of respiratory-burst activity of wound innate immune cells...
August 16, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28807206/graft-loss-review-of-a-single-burn-center-s-experience-and-proposal-of-a-graft-loss-grading-scale
#2
Lauren B Nosanov, Melissa M McLawhorn, Lamisa Hassan, Taryn E Travis, Shawn Tejiram, Laura S Johnson, Lauren T Moffatt, Jeffrey W Shupp
BACKGROUND: There exists neither a consensus definition of burn "graft loss" nor a scale with which to grade severity. We introduced an institutional scale in 2014 for quality improvement. MATERIALS AND METHODS: We reviewed all burned patients with graft loss on departmental Morbidity and Mortality reports between July 2014 and July 2016. Graft loss grades were assigned during the course of clinical care per institutional scale. Chronic nonhealing wounds and nonburn wounds were excluded...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28802182/inflammatory-markers-as-risk-factors-for-infection-with-multidrug-resistant-microbes-in-diabetic-foot-subjects
#3
Saba Noor, Abhijit Girish Borse, Maaz Ozair, Alok Raghav, Iqbal Parwez, Jamal Ahmad
BACKGROUND: Diabetic foot ulcers (DFUs), a dreadful microvascular complication of diabetes is responsible for substantial increase in morbidity and mortality. Infection, not a cause, but a consequence in DFUs that accounts for minor or major limb loss. The current study aimed to evaluate the microbial etiology of infected diabetic foot ulcers in northern tertiary care hospital, assessment of risk factors and role of inflammatory markers involved in colonization of multidrug-resistant organisms (MDROs) and their impact on the outcome...
May 3, 2017: Foot
https://www.readbyqxmd.com/read/28798504/molecular-aspects-of-wound-healing-and-the-rise-of-venous-leg-ulceration-omics-approaches-to-enhance-knowledge-and-aid-diagnostic-discovery
#4
REVIEW
Daniel A Broszczak, Elizabeth R Sydes, Daniel Wallace, Tony J Parker
Chronic wounds, in particular venous leg ulcers (VLU), represent a substantial burden for economies, healthcare systems and societies worldwide. This burden is exacerbated by the recalcitrant nature of these wounds, despite best practice, evidence-based care, which substantially reduces the quality of life of patients. Furthermore, co-morbidities such as diabetes and cardiovascular disease within ageing populations further contribute to the increasing prevalence in developed countries. This review provides an overview of the literature concerning the cellular and molecular mechanisms of wound healing and aspects where this process fails, resulting in a chronic wound...
February 2017: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#5
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28795891/experience-using-closed-incision-negative-pressure-wound-therapy-in-sternotomy-patients
#6
B Philip, P McCluskey, J Hinchion
OBJECTIVE: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre...
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
#7
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/28760584/the-endothelial-cell-secretome-as-a-novel-treatment-to-prime-adipose-derived-stem-cells-for-improved-wound-healing-in-diabetes
#8
Marc W Fromer, Shaohua Chang, Ashleigh L R Hagaman, Kiavash R Koko, Ryan S Nolan, Ping Zhang, Spencer A Brown, Jeffrey P Carpenter, Francis J Caputo
BACKGROUND: Chronic wounds are a common surgical problem exacerbated by diabetes and ischemia. Although adipose-derived stem cells (ASCs) have shown promise as a wound healing therapy, their function and proliferation are hindered in diabetes. This study examines the ability of the human umbilical vein endothelial cell (HUVEC) secretome to reverse the deleterious effects of high glucose concentrations on ASCs through priming, thereby enhancing their ability to participate in angiogenesis and wound healing...
July 28, 2017: Journal of Vascular Surgery
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
#9
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
#10
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/28757465/mini-encyclopaedia-of-the-wound-healing-opportunities-for-integrating-multi-omic-approaches-into-medical-practice
#11
Lara Stolzenburg-Veeser, Olga Golubnitschaja
Wound healing is a highly complex life-important repair process triggered by plenty of local and/or systemic organ and tissue damaging events, such as an acute surgical invasion, accidental organ and tissue damages, acute and chronic diseases, aggressive local and systemic therapeutic approaches (e.g. irradiation and systemic chemotherapy). Individual health condition determines over the quality of wound healing. Impaired wound healing, in turn, may lead, for example, to post-surgical complications frequently observed in elderly, chronic ulcers in diabetic patients, hindered and ineffective pain management, etc...
July 28, 2017: Journal of Proteomics
https://www.readbyqxmd.com/read/28740785/coronary-artery-disease-in-patients-with-critical-limb-ischemia-undergoing-major-amputation-or-not
#12
Akio Nishijima, Naoto Yamamoto, Ryuichi Yoshida, Koji Hozawa, Satoshi Yanagibayashi, Megumi Takikawa, Rie Hayasaka, Junko Nishijima, Masahiko Gosho, Haruo Nishijima
BACKGROUND: Due to the increase of elderly and diabetes patients, surgeons encounter patients requiring treatment of critical limb ischemia (CLI) in the presence of systemic arteriosclerotic diseases. In this study, we retrospectively investigated the prevalence of coronary artery disease (CAD) in patients with CLI who underwent major (above-the-ankle) amputation or nonmajor amputation (below-the-ankle amputation or debridement of wound). METHODS: We retrospectively investigated 129 consecutive patients surgically managed for CLI in our institution between January 2013 and December 2015...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28734103/levels-of-wound-calprotectin-and-other-inflammatory-biomarkers-aid-in-deciding-which-patients-with-a-diabetic-foot-ulcer-need-antibiotic-therapy-induce-study
#13
J R Ingram, S Cawley, E Coulman, C Gregory, E Thomas-Jones, T Pickles, R Cannings-John, N A Francis, K Harding, K Hood, V Piguet
AIMS: Deciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point-of-care tests. Four inflammatory biomarkers were investigated to develop a composite algorithm for mildly infected diabetic foot ulcers: venous white cell count, C-reactive protein (CRP) and procalcitonin, and a novel wound exudate calprotectin assay. Calprotectin is a marker of neutrophilic inflammation. METHODS: In a prospective study, people with uninfected or mildly infected diabetic foot ulcers who had not received oral antibiotics in the preceding 2 weeks were recruited from community podiatry clinics for measurement of inflammatory biomarkers...
July 22, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28727481/leucocyte-and-platelet-rich-fibrin-l-prf-as-a-regenerative-medicine-strategy-for-the-treatment-of-refractory-leg-ulcers-a-prospective-cohort-study
#14
Nelson R Pinto, Matias Ubilla, Yelka Zamora, Verónica Del Rio, David M Dohan Ehrenfest, Marc Quirynen
Chronic wounds (VLU: venous leg ulcer, DFU: diabetic foot ulcer, PU: pressure ulcer, or complex wounds) affect a significant proportion of the population. Despite appropriate standard wound care, such ulcers unfortunately may remain open for months or even years. The use of leukocyte- and platelet-rich fibrin (L-PRF) to cure skin ulcers is a simple and inexpensive method, widely used in some countries but unknown or neglected in most others. This auto-controlled prospective cohort study explored and quantified accurately for the first time the adjunctive benefits of topical applications of L-PRF in the management of such refractory ulcers in a diverse group of patients...
July 20, 2017: Platelets
https://www.readbyqxmd.com/read/28718238/bacteriology-of-diabetic-foot-in-tertiary-care-hospital-frequency-antibiotic-susceptibility-and-risk-factors
#15
Syeda Sadia Amjad, Jamal Zafar, Nadia Shams
BACKGROUND: Diabetic foot being one of the frequent and disabling complications of diabetes. In view of widespread regional variation in causative organisms and antimicrobial susceptibility, the current study aimed to determine frequency of causative organisms, their antimicrobial susceptibility and associated risk factors. METHODS: This descriptive cross-sectional study was conducted in 6 months' duration at dept. of Medicine; PIMS Hospital Islamabad. Type 2 Diabetes mellitus patients with diabetic foot ulcer were enrolled after informed consent...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28709874/analysis-of-hospital-readmissions-after-prosthetic-urologic-surgery-in-the-united-states-nationally-representative-estimates-of-causes-costs-and-predictive-factors
#16
Filippo Pederzoli, Meera R Chappidi, Sarah Collica, Max Kates, Gregory A Joice, Nikolai A Sopko, Francesco Montorsi, Andrea Salonia, Trinity J Bivalacqua
BACKGROUND: The surgical treatment of urinary incontinence and erectile dysfunction by prosthetic devices has become part of urologic practice, although sparse data exist at a national level on readmissions and hospital costs. AIM: To assess causes and costs of early (≤30 days) and late (31-90 days) readmissions after implantation of penile prostheses (PPs), artificial urinary sphincters (AUSs), or PP + AUS. METHODS: Using the 2013 and 2014 US Nationwide Readmission Databases, sociodemographic characteristics, hospital costs, and causes of readmission were compared among PP, AUS and AUS + PP surgeries...
August 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28696493/total-contact-cast-system-to-heal-diabetic-foot-ulcers
#17
Brock Liden
Off-loadinga diabetic foot ulcer is a cornerstone of quality wound care for diabetic patients to allow cellular growth in the wound bed. While total contact casts (TCC) have been described as the gold standard for off-loading the wound, the complexity of application and the time commitment for both application and drying have discouraged health professionals from using them. This retrospective case series, conducted in a podiatric practice, evaluated using a TCC system that helps address the three components in which guidelines should be addressed when caring for a diabetic foot: V - vascular management, I - infection management and prevention, and P - pressure relief...
July 25, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28682855/management-of-a-complex-peristomal-calciphylaxis-a-case-study
#18
Mary Famorca, Debra Beauchaine, Nancy Angulo
BACKGROUND: Calciphylaxis, also referred to as calcific uremic arteriolopathy, is a rare and serious syndrome of small blood vessels with a high mortality rate. Calciphylaxis lesions require intensive wound management with medical interventions for the patient to survive the sequelae of sepsis and present unique challenges when found in the peristomal skin. CASE: A 33-year-old man presented with multiple malodorous stage 4 pressure injuries of his sacrococcygeal and gluteal area...
July 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28665245/prophylactic-use-of-intraoperative-vancomycin-powder-and-postoperative-infection-an-analysis-of-microbiological-patterns-in-1200-consecutive-surgical-cases
#19
Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Victoria D Vuong, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
OBJECTIVE Wound infections following spinal surgery for deformity place a high toll on patients, providers, and the health care system. The prophylactic application of intraoperative vancomycin powder has been shown to lower the infection risk after thoracolumbar decompression and fusion for deformity correction. The purpose of this study was to assess the microbiological patterns of postoperative surgical site infections (SSIs) after prophylactic use of vancomycin powder in adult patients undergoing spinal deformity surgery...
June 30, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28654593/population-health-implications-of-medical-tourism
#20
Kian Adabi, Carrie S Stern, Katie E Weichman, Evan S Garfein, Aravind Pothula, Lawrence Draper, Oren M Tepper
BACKGROUND: Fifteen million U.S. patients each year seek medical care abroad; however, there are no data on outcomes and follow-up of these procedures. This study aims to identify, evaluate, and survey patients presenting with complications from aesthetic procedures abroad and estimate their cost to the U.S. health care system. METHODS: A single-center retrospective review was conducted. A cohort of patients presenting with complications from aesthetic procedures performed abroad was generated...
July 2017: Plastic and Reconstructive Surgery
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