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Diabetic wound care

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https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#1
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#2
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28512404/painful-leg-ulceration-in-a-poorly-controlled-hypertensive-patient-a-case-report-of-martorell-ulcer
#3
Harsimran Kaur Malhi, Ali Didan, Stefan Ponosh, Sujith Prasad Kumarasinghe
Martorell ulcer is a form of lower limb ulceration, preceded by a small area of excruciating pain. It often appears as a solitary lesion on the outer aspect of the lower limb, and is primarily associated with poorly controlled hypertension and diabetes. Treatment of the ulcer involves awareness and early correct diagnosis, adequate control of blood pressure, management of infection, and wound care. We describe a 77-year-old diabetic and hypertensive woman presenting with excruciating pain in her right lower lateral leg leading to a necrotic ulcer...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28508349/the-contemporary-role-of-stents-and-angioplasty-for-the-treatment-of-infrapopliteal-disease-in-critical-limb-ischemia
#4
REVIEW
Tarek A Hammad, Anand Prasad
PURPOSE OF REVIEW: Critical limb ischemia (CLI) is associated with significant morbidity, mortality, and increased health care expenses. Revascularization has a central role in the treatment of CLI. Following publication of BASIL (bypass versus angioplasty in severe ischemia of the leg) trial a decade ago, an "endovascular first" approach had gained momentum and the technologies available for endovascular therapy have exponentially increased. Both the development of technology and technique, highlighted in this review, have allowed operators to treat complex infrapopliteal lesions which are central to CLI pathology...
July 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28507863/amnion-membrane-in-diabetic-foot-wounds-a-meta-analysis
#5
Alexandra M Haugh, Jacqueline G Witt, Adam Hauch, Michael Darden, Geoffrey Parker, Warren A Ellsworth, Joseph F Buell
BACKGROUND: Amniotic membrane is tissue obtained from human placenta rich in cytokines, growth factors, and stem cells that possess the ability to inhibit infection, improve healing, and stimulate regeneration. METHODS: A meta-analysis was performed examining randomized controlled trials comparing amniotic tissue products with standard of care in nonhealing diabetic foot ulcers including PubMed, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28502546/cryopreserved-saphenous-vein-as-a-last-ditch-conduit-for-limb-salvage
#6
Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
OBJECTIVE: In patients lacking autogenous vein suitable for infrainguinal bypass, cryopreserved saphenous vein (CSV) allograft (CryoLife, Inc, Kennesaw, Ga) may be an acceptable alternative. The purpose of this study was to examine outcomes of CSV conduit for infrainguinal revascularization. METHODS: Between February 2008 and August 2015, 70 patients underwent infrainguinal bypass grafts in 73 limbs using CSV. All patients lacked suitable arm or leg vein. Demographic data and patient outcomes were retrospectively collected using electronic medical records...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28497248/-aseptic-loosening-of-total-ankle-replacement-one-stage-revision-ankle-arthroplasty
#7
G Pagenstert, M D Wimmer, M Jacxsens, C L Saltzman, A Barg
OBJECTIVE: To revise one or both loosened prosthesis components, to achieve postoperative pain relief, and preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components without substantial bone defect of the tibial or talar bone stock. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28485879/evidence-for-silver-in-wound-care-meta-analysis-of-clinical-studies-from-2000-2015
#8
Joachim Dissemond, Johannes Georg Böttrich, Horst Braunwarth, Jörg Hilt, Patricia Wilken, Karl-Christian Münter
BACKGROUND: Given that the scientific evidence for silver in wound care is generally considered insufficient, there is uncertainty among users regarding its clinical use. MATERIAL AND METHODS: A group of experts evaluated the clinical studies on silver in wound management published from 2000-2015. RESULTS: Overall, 851 articles were identified, 173 of which were included and categorized. There were 31 randomized controlled trials (RCTs) and eight cohort studies...
May 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28475444/the-cost-effectiveness-of-a-novel-soluble-beta-glucan-gel
#9
K F Cutting
OBJECTIVE: Wounds that have stalled healing are costly in terms of patient morbidity and increase in use of material and financial resources. A natural polymer beta-glucans has been incorporated into a methylcellulose gel to provide a topical gel designed to accelerate healing in wounds where it has stalled. Although the gel provides an environment conducive to moist wound healing the active agent, beta-glucans, activate the innate immune response. METHOD: Using a Markov cohort simulation model, data were extrapolated from a double-blind randomised trial to evaluate the economic benefits of the soluble beta-glucan (SBG) gel in the treatment of diabetic foot ulcers (DFUs)...
May 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28472912/controlled-delivery-of-bioactive-molecules-for-the-treatment-of-chronic-wounds
#10
J Anjana, V K Rajan, R Biswas, R Jayakumar
A cut or break on the surface of the skin is usually referred to as a wound. Any wound has a potential to heal by itself through a complex cascade of events. However, some wounds show delayed healing due to their underlying physiology and are referred to as chronic wounds like diabetic ulcers, venous ulcers, pressure ulcers and chronic infected ulcers. Extensive care has to be taken for the management of chronic wounds and these have become a major concern in the current medical scenario. The use of bioactive molecules or in other words the molecules that can actively interact with the wound environment and help in wound healing are gaining much importance...
May 3, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28448266/a-prospective-randomized-blinded-controlled-trial-comparing-transdermal-continuous-oxygen-delivery-to-moist-wound-therapy-for-the-treatment-of-diabetic-foot-ulcers
#11
Vickie R Driver, Alexander Reyzelman, Jill Kawalec, Michael French
Worldwide, diabetic foot ulcers (DFUs) continue to exact a major burden on patients and health care providers. Although hyperbaric oxygen therapy is well-known as an adjunct option, less is known about the efficacy of transdermal continuous oxygen therapy (TCOT). A prospective, randomized, blinded, multicenter, parallel study was conducted from October 2009 to November 2012 to evaluate healing time and the proportion of DFUs healed after 12 weeks of moist wound therapy (MWT) with or without TCOT. Study participants (persons with type 1 or type 2 diabetes and a nonhealing [>1-month but <1-year duration], 1 cm² to 10 cm² in area, infection-free DFU) were randomized to TCOT or a sham device (control) in addition to receiving MWT...
April 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28448264/use-of-ovine-based-collagen-extracellular-matrix-and-gentian-violet-methylene-blue-antibacterial-foam-dressings-to-help-improve-clinical-outcomes-in-lower-extremity-wounds-a-retrospective-cohort-study
#12
Eric L Lullove
Dressings that provide broad spectrum metalloprotease reduction along with inherent aspects of an extracellular matrix may contribute to improved wound healing outcomes and shorter treatment times. OBJECTIVE: The author performed a retrospective case series analysis to determine the clinical outcomes of regular debridement with the use of ovine-based collagen extracellular matrix dressings and gentian violet/methylene blue polyurethane antibacterial foam dressings in treating 53 patients with 53 chronic lower extremity wounds (diabetic foot ulcers [DFUs], venous leg ulcers, and heel pressure ulcers)...
April 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28444845/preoperative-sepsis-is-an-independent-risk-factor-for-major-complications-after-lower-extremity-amputation-in-patients-with-diabetic-end-stage-renal-disease
#13
Young Hwan Park, Jong Hyub Song, Gi Won Choi, Hak Jun Kim
AIM: Patients with diabetic end-stage renal disease (ESRD) are at increased risk of lower extremity amputation (LEA) and postoperative complications compared to those without diabetic ESRD. This study sought to determine the factors that influence complications following LEA in patients with diabetic ESRD. METHODS: A total of 41 patients with diabetic ESRD (total of 46 amputations) who underwent LEA were enrolled in this study. The electronic medical records were retrospectively reviewed to identify the predictors of postoperative complications...
April 26, 2017: Nephrology
https://www.readbyqxmd.com/read/28438078/ten-year-follow-up-of-a-case-of-necrotizing-fasciitis-successfully-treated-with-negative-pressure-wound-therapy-dermal-regeneration-template-application-and-split-thickness-skin-autograft
#14
Sagi Martinov, Soccoro Ortiz
INTRODUCTION: Necrotizing fasciitis is a rapidly progressive and often fatal infection of the fasciae and subcutaneous tissues. PATIENT AND METHODS: In this case report, we present the treatment of a 63-year-old patient suffering from diabetes mellitus, who was admitted to the emergency unit for severe right gluteal pain, which had begun 24 hours before admission. Cutaneous symptoms, oliguria, metabolic acidosis, acute renal failure, severe hypotension, and tachycardia occurred, and the patient was admitted to Intensive Care a few hours after initial admission...
April 25, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28426572/nonhealing-ulcers-in-patients-with-tophaceous-gout-a-systematic-review
#15
Gretl Lam, Frank L Ross, Ernest S Chiu
GENERAL PURPOSE: To provide information from a review of the literature about chronic ulcers associated with tophaceous gout. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Identify the pathophysiology of tophaceous gout, its presentation, phases, and common comorbidities...
May 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28400658/complication-rate-during-multilevel-lumbar-fusion-in-patients-above-60-years
#16
Bijjawara Mahesh, Bidre Upendra, S Vijay, Gc Arun Kumar, Srinivas Reddy
BACKGROUND: Spine surgery in elderly with comorbidities is reported to have higher complication rates and increased cost. However, the surgical outcome is good irrespective of the complications. Hence, it is essential to identify the factors affecting the complication rates in such patients and the measures to reduce them. This retrospective observational study determines the perioperative complications, their incidence and the measures to reduce complications in the elderly with comorbidities, operated by instrumented multilevel lumbar fusion...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#17
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#18
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28346194/case-report-diabetic-foot-ulcer-infection-treated-with-topical-compounded-medications
#19
Kelechi E Agbi, Maria Carvalho, Ha Phan, Cristiane Tuma
An adult diabetic male with three toes amputated on his right foot presented with an ulcer infection on his left foot, unresponsive to conventional antifungal oral medication for over two months. The ulcerated foot wound had a large impairment on the patient's quality of life, as determined by the Wound-QoL questionnaire. The compounding pharmacist recommended and the physician prescribed two topical compounded medicines, which were applied twice a day, free of charge at the compounding pharmacy. The foot ulcer infection was completely resolved following 13 days of treatment, with no longer any impairment on the patient's quality of life...
January 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28331365/mastectomy-skin-flap-necrosis-challenges-and-solutions
#20
REVIEW
Stuart A Robertson, Johann A Jeevaratnam, Avi Agrawal, Ramsey I Cutress
INTRODUCTION: Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%-30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. METHODS: A MEDLINE search was performed using the search term "mastectomy skin flap necrosis". Titles and abstracts from peer-reviewed publications were screened for relevance. RESULTS: MSFN is a common complication and may present as partial- or full-thickness necrosis...
2017: Breast Cancer: Targets and Therapy
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