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transmetatarsal amputation

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https://www.readbyqxmd.com/read/27696694/the-care-of-transmetatarsal-amputation-in-diabetic-foot-gangrene
#1
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
https://www.readbyqxmd.com/read/27555884/the-evaluation-of-off-loading-using-a-new-removable-orthosis-in-diabetic-foot-orthodiab-randomized-controlled-trial-study-design-and-rational
#2
Kamel Mohammedi, Louis Potier, Maud François, Dured Dardari, Marilyne Feron, Estelle Nobecourt-Dupuy, Manuel Dolz, Roxane Ducloux, Abdelkader Chibani, Dominique-François Eveno, Teresa Crea Avila, Ariane Sultan, Laurence Baillet-Blanco, Vincent Rigalleau, Gilberto Velho, Florence Tubach, Ronan Roussel, Jean-Claude Dupré, Dominique Malgrange, Michel Marre
BACKGROUND: Off-loading is essential for diabetic foot management, but remains understudied. The evaluation of Off-loading using a new removable oRTHOsis in DIABetic foot (ORTHODIAB) trial aims to evaluate the efficacy of a new removable device "Orthèse Diabète" in the healing of diabetic foot. METHODS/DESIGN: ORTHODIAB is a French multi-centre randomized, open label trial, with a blinded end points evaluation by an adjudication committee according to the Prospective Randomized Open Blinded End-point...
2016: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/27496697/the-development-and-validation-of-a-novel-outcome-measure-to-quantify-mobility-in-the-dysvascular-lower-extremity-amputee-the-amputee-single-item-mobility-measure
#3
Daniel C Norvell, Rhonda M Williams, Aaron P Turner, Joseph M Czerniecki
OBJECTIVE: This study describes the development and psychometric evaluation of a novel patient-reported single-item mobility measure. DESIGN: Prospective cohort study. SETTING: Four Veteran's Administration Medical Centers. SUBJECTS: Individuals undergoing their first major unilateral lower extremity amputation; 198 met inclusion criteria; of these, 113 (57%) enrolled. INTERVENTIONS: None. MAIN MEASURES: The Amputee Single Item Mobility Measure, a single item measure with scores ranging from 0 to 6, was developed by an expert panel, and concurrently administered with the Locomotor Capabilities Index-5 (LCI-5) and other outcome measures at six weeks, four months, and 12 months post-amputation...
September 2016: Clinical Rehabilitation
https://www.readbyqxmd.com/read/27475711/reoperation-and-reamputation-after-transmetatarsal-amputation-a%C3%A2-systematic-review-and-meta-analysis
#4
REVIEW
Jakob C Thorud, Daniel C Jupiter, Jonathan Lorenzana, Tea Tu Nguyen, Naohiro Shibuya
Transmetatarsal amputations have generally been accepted as a relatively more definitive amputation compared with other lesser ray resections. However, many investigators have reported a high occurrence of more proximal amputation after transmetatarsal amputation. A systematic review was performed to evaluate the occurrence of reamputation and reoperation after transmetatarsal amputations. A search of the Medline, CINAHL, and Cochrane Central databases yielded 159 abstracts. After review, 24 reports were included in the study...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27372177/lacking-the-protective-label-of-diabetes-phenytoin-induced-distal-symmetrical-peripheral-neuropathy-a-clinical-case-report
#5
A M Mahon
This report documents an unusual case of distal symmetrical peripheral neuropathy (DSPN) in an otherwise healthy patient without diabetes mellitus (DM) presenting to a podiatric wound care clinic. The development of gas gangrene coupled with Charcot neuroarthropathic changes ultimately resulted in a potentially life-saving transmetatarsal (TMT) amputation. Causation of, or at least a contributor to, the DSPN was likely phenytoin usage for epileptic seizures. Long-term use of phenytoin can lead to axonal shrinkage and random clusters of nerve demyelination [1]...
June 24, 2016: Journal of Tissue Viability
https://www.readbyqxmd.com/read/27079487/serratia-marcescens-bullous-cellulitis-in-a-splenectomized-patient-a-case-report-and-review-of-the-literature
#6
John B Fournier, Ganary Dabiri, Vinod Thomas, Gail Skowron, Polly Carson, Vincent Falanga
Serratia marcescens is a Gram-negative bacillus belonging to the Enterobacteriaceae family. Cutaneous infection with Serratia is rare, and usually occurs in immunocompromised individuals. Primary cutaneous infections are uncommon, but they are typically severe and are associated with significant morbidity and mortality. The pathogenetic factors leading to S. marcescens infection are not fully understood, but contributing virulence factors include proteases, secreted exotoxins, and the formation of biofilm. We report a case of cellulitis occurring in a splenectomized patient, which led to multiple wound debridements and a transmetatarsal amputation...
June 2016: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/27031281/group-b-and-f-beta-streptococcus-necrotizing-infection-surgical-challenges-with-a-deep-central-plantar-space-abscess-a-diabetic-limb-salvage-case-report
#7
Jason M Mendivil, David Jolley, Jodi Walters, Jim Dancho, Billy Martin
We present the case of a 66-year-old, type II diabetic male with a deep wound to the plantar-lateral aspect of his right hallux. On examination, the central plantar compartment of his right foot was moderately erythematous and tender on palpation. After obtaining a deep wound culture, treatment was complicated by a progression of a group B and F beta streptococcus, necrotizing infection. The patient underwent a right hallux amputation, followed by a plantar medial incision for drainage of an abscess to the medial and central plantar compartments of the foot...
May 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/26799609/group-b-and-f-beta-streptococcus-necrotizing-infection-surgical-challenges-with-a-deep-central-plantar-space-abscess-a-diabetic-limb-salvage-case-report
#8
Jason M Mendivil, David Jolley, Jodi Walters, James F Dancho, Billy Martin
We present the case of a 66-year-old, type II diabetic male with a deep wound to the plantar-lateral aspect of his right hallux. On examination, the central plantar compartment of his right foot was moderately erythematous and tender on palpation. After obtaining a deep wound culture, treatment was complicated by a progression of a group B and F beta streptococcus, necrotizing infection. The patient underwent a right hallux amputation, followed by a plantar medial incision for drainage of an abscess to the medial and central plantar compartments of the foot...
January 22, 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/26100590/a-rare-case-of-acroangiodermatitis-associated-with-a-congenital-arteriovenous-malformation-stewart-bluefarb-syndrome-in-a-young-veteran-case-report-and-review-of-the-literature
#9
REVIEW
Mark Archie, Saieh Khademi, David Aungst, Aksone Nouvong, Shanna Freeman, Hugh Gelabert, David Rigberg, Christian deVirgilio, Michael Lewis, Jessica O'Connell
Acroangiodermatitis (AD) is a rare angioproliferative disease manifesting with cutaneous lesions clinically similar to Kaposi's sarcoma. AD is a benign hyperplasia of preexisting vasculature and may be associated with acquired or congenital arteriovenous malformations (AVM), or severe chronic venous insufficiency (because of hypostasis, elevated venous pressure, arteriovenous shunting). Stewart-Bluefarb syndrome is the rare syndrome in which AD is associated with a congenital AVM. We present the case of a young veteran with a painful, chronic nonhealing ulcer and ipsilateral popliteal artery occlusion likely because of trauma, who elected transmetatarsal amputation for symptomatic relief...
October 2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/25903674/%C3%AF-%C3%AF-%C3%AF-%C3%AF-%C3%AF-%C3%AF-use-of-negative-pressure-therapy-on-closed-surgical-incisions-a-case-series
#10
James P Stannard, Broadus Zane Atkins, David O'Malley, Hardayal Singh, Brent Bernstein, Michael Fahey, Derek Masden, Christopher E Attinger
Multiple patient comorbidities and environmental factors increase the risk of incisional wound complications. The literature suggests that negative pressure therapy (NPT) on clean closed surgical incisions may help reduce the risk of wound infections and other complications. In this case study, NPT was applied in the operating room to clean closed surgical wounds in four high-risk patients (two men, two women) following coronary artery bypass grafting using bilateral internal mammary arteries, transmetatarsal amputation, and abdominal hysterectomy...
August 2009: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/25827965/rates-and-predictors-of-readmission-after-minor-lower-extremity-amputations
#11
Robert J Beaulieu, Joshua C Grimm, Heather Lyu, Christopher J Abularrage, Bruce A Perler
OBJECTIVE: One goal of the Patient Protection and Affordable Care Act is to reduce hospital readmissions, with financial penalties applied for excessive rates of unplanned readmissions within 30 days among Medicare beneficiaries. Recent data indicate that as many as 24% of Medicare patients require readmission after vascular surgery, although the rate of readmission after limited digital amputations has not been specifically examined. The present study was therefore undertaken to define the rate of unplanned readmission among patients after digital amputations and to identify the factors associated with these readmissions to allow the clinician to implement strategies to reduce readmission rates in the future...
July 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/25681945/medial-and-lateral-plantar-artery-angiosome-rotational-flaps-for-transmetatarsal-and-lisfranc-amputation-in-patients-with-compromised-plantar-tissue
#12
Troy J Boffeli, Brett J Waverly
Traditional incision techniques for midfoot amputation might not provide immediate soft tissue coverage of the underlying metatarsal and tarsal bones in the presence of a large plantar soft tissue defect. Patients undergoing transmetatarsal and Lisfranc amputation frequently have compromised plantar tissue in association with neuropathic ulcers, forefoot gangrene, and infection, necessitating wide resection as a part of the amputation procedure. Open amputation will routinely be performed under these circumstances, although secondary healing could be compromised owing to residual bone exposure...
March 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/25581966/surgical-techniques-in-the-treatment-of-multilevel-arterial-occlusive-disease
#13
Livia Genoveva Baroi, L Iacob, R F Popa
AIM OF THE STUDY: To report the surgical techniques for multilevel arterial lesions of the lower extremities and to evaluate the clinical outcomes. In patients with multilevel arterial disease, the treatment consisting of sequentially surgical intervention on the same vascular axis is one of the methods indicated in order to obtain an adequate inflow and outflow. MATERIAL AND METHODS: we have performed a nonrandomized study during a 44-month period (January 2010-September 2013) in a number of 58 patients treated by classical revascularization techniques...
October 2014: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
https://www.readbyqxmd.com/read/25407083/the-incidence-of-lower-extremity-amputation-and-bone-resection-in-diabetic-foot-ulcer-patients-treated-with-a-human-fibroblast-derived-dermal-substitute
#14
Robert G Frykberg, William A Marston, Matthew Cardinal
OBJECTIVE: Diabetic foot ulcers (DFUs) are frequently recalcitrant and at risk for infection, which may lead to lower-extremity amputation or bone resection. Reporting the incidence of amputations/bone resections may shed light on the relationship of ulcer healing to serious complications. This study aimed to evaluate the incidence of amputations/bone resections in a randomized controlled trial comparing human fibroblast-derived dermal substitute plus conventional care with conventional care alone for the treatment of DFUs...
January 2015: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/25341299/clinical-and-epidemiological-assessment-concerning-hybrid-revascularization-techniques-in-the-treatment-of-multilevel-arterial-occlusive-disease
#15
MULTICENTER STUDY
Livia Genoveva Baroi, J Verbist, P Peeters, R F Popa
UNLABELLED: Aim of the study was to report a novel hybrid technique for multilevel arterial lesions of the lower extremities and to evaluate the clinical outcomes. In patients with multilevel arterial disease, the combined (hybrid) treatment, consisting of endovascular intervention and classical surgical intervention on the same vascular axis seems to be the most indicated treatment in order to obtain an adequate inflow and outflow. MATERIAL AND METHODS: We have performed a non-randomized study during a 44-month period (January 2010 - September 2013) in a number of 94 patients treated by hybrid revascularization techniques...
July 2014: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
https://www.readbyqxmd.com/read/25283968/increase-in-skin-perfusion-pressure-after-maggot-debridement-therapy-for-critical-limb-ischaemia
#16
T M Maeda, C K Kimura, K T Takahashi, K I Ichimura
Skin perfusion pressure (SPP) is the perfusion pressure at the skin level, and it can serve as an index of peripheral circulation in the skin and subcutaneous tissue. We report a 78-year-old man with critical limb ischaemia who, despite having undergone several catheter interventions, still had severe ulcers with exposed bone on his right foot. We performed transmetatarsal amputation. The tissue around the surgical site became necrotic several days later, and did not respond to conservative therapy. Therefore, we opted for maggot debridement therapy (MDT), given that maggots favour necrotic tissue...
December 2014: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/25249400/conservative-surgical-treatment-of-infected-ulceration-of-the-first-metatarsophalangeal-joint-with-osteomyelitis-in-diabetic-patients
#17
Luca Dalla Paola, Anna Carone, Claudio Morisi, Sara Cardillo, Marco Pattavina
Ulceration of the plantar aspect of the first metatarsophalangeal joint is a common localization in the diabetic foot. Conservative treatment of this lesion is a challenging problem, performed through the soft tissues and osseous debridement. The present study included a cohort of 28 patients affected by diabetes mellitus and a first ray lesion penetrating the bone. After surgical debridement with removal of the infected bone, we positioned antibiotic-loaded bone cement and stabilized the treated area with an external fixator...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/24985536/risk-factors-and-indications-for-readmission-after-lower-extremity-amputation-in-the-american-college-of-surgeons-national-surgical-quality-improvement-program
#18
MULTICENTER STUDY
Thomas Curran, Jennifer Q Zhang, Ruby C Lo, Margriet Fokkema, John C McCallum, Dominique B Buck, Jeremy Darling, Marc L Schermerhorn
BACKGROUND: Postoperative readmission, recently identified as a marker of hospital quality in the Affordable Care Act, is associated with increased morbidity, mortality, and health care costs, yet data on readmission after lower extremity amputation (LEA) are limited. We evaluated risk factors for readmission and postdischarge adverse events after LEA in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). METHODS: All patients undergoing transmetatarsal (TMA), below-knee (BKA), or above-knee amputation (AKA) in the 2011-2012 NSQIP were identified...
November 2014: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/24901580/is-scintigraphy-a-guideline-method-in-determining-amputation-levels-in-diabetic-foot
#19
Yakup Barbaros Baykal, Emre Yaman, Halil Burc, Huseyin Yorgancigil, Tolga Atay, Mustafa Yıldız
BACKGROUND: In this study, we aimed to evaluate the potential use of a 3-phase bone scintigraphy method to determine the level of amputation on treatment cost, morbidity and mortality, reamputation rates, and the duration of hospitalization in diabetic foot. METHODS: Thirty patients who were admitted to our clinic between September 2008 and July 2009, with diabetic foot were included. All patients were evaluated according to age, gender, diabetes duration, 3-phase bone scintigraphy, Doppler ultrasound, amputation/reamputation levels, and hospitalization periods...
May 2014: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/24810296/verrucous-carcinoma-of-the-foot-not-your-typical-plantar-wart-a-case-study
#20
REVIEW
Diandra K Gordon, Erinn N Ponder, B Hudson Berrey, Melanie J Kubik, Joseph Sindone
STATEMENT OF PURPOSE: Verrucous carcinoma of the foot is often misdiagnosed initially as plantar warts. Delayed diagnostic treatments with the use of optimal biopsy techniques may result in significant hindrances for patient care and may often result in detrimental outcomes to the patient. With the use of various epidermal biopsy methods, early diagnostic treatment can be implemented to a slow-growing lesion unresponsive to topical agents preventing unfavorable pedal amputations. DESIGN: A case study of verrucous carcinoma of the foot with surgical resection was conducted along with a literature review...
June 2014: Foot
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