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Limb salvage

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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/29238756/outcomes-of-internal-hemipelvectomy-for-pelvic-tumors-a-developing-country-s-prospective
#2
REVIEW
Masood Umer, Moiz Ali, Rizwan H Rashid, Yasir Mohib, Haroon U Rashid
Introduction: Previously, external hemipelvectomy was the mainstay of treatment for pelvic tumors. However, with technological advancements, limb salvage procedures such as internal hemipelvectomy have emerged as a viable alternative. However, there is limited literature available on long-term outcomes and complications of internal hemipelvectomy, especially from developing countries. Therefore, the objective of this study was to share our experience of internal hemipelvectomy at a tertiary care center in a developing country...
May 2017: International Journal of Surgery. Oncology
https://www.readbyqxmd.com/read/29237360/endovascular-treatment-of-thromboangiitis-obliterans-buerger-s-disease
#3
Mohammad-Hadi S Modaghegh, Shahab Hafezi
PURPOSE: When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. This study aimed to evaluate the feasibility and efficacy of percutaneous transluminal angioplasty (PTA) for the treatment of patients with TAO and CLI. In addition, a review of the literature on endovascular management of TAO is included...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#4
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29220878/a-qualitative-study-of-the-experience-of-lower-extremity-wounds-and-amputations-among-people-with-diabetes-in-philadelphia
#5
Frances K Barg, Peter F Cronholm, Ebony E Easley, Trocon Davis, Michelle Hampton, D Scot Malay, Cornelius Donohue, Jinsup Song, Stephen R Thom, David J Margolis
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open-ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer (n = 19) or a lower extremity amputation (n = 20). Interviews were audio-recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts...
December 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29217446/the-use-of-the-profunda-femoral-artery-as-the-sole-target-vessel-to-bypass-aorto-iliac-disease-in-patients-with-critical-limb-ischemia-and-concomitant-unreconstructable-infra-inguinal-disease
#6
Nikolaos Kontopodis, Stella Lioudaki, Christos Chronis, Paris Kalogerakos, George Lazopoulos, Alexandra Papaioannou, Christos V Ioannou
BACKGROUND: Critical limb ischemia (CLI) often results from multilevel occlusive disease. There are occasions where a patent profunda femoral artery (PFA) is the only target artery that can be used as outflow during reconstruction to bypass aorto-iliac disease (AOID), with no further option for infra-inguinal revascularization. We aim to report results of the use of PFA as the sole target vessel for the treatment of these patients. METHODS: This is a retrospective, single-center study including CLI patients treated during 36-months...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29217442/posterior-approach-for-revascularization-in-blunt-popliteal-vessel-injury
#7
Vladimir Makaloski, Arno Stellmes, Doerte Wyss, Salome Weiss, Daniel Becker, Thomas R Wyss, Juerg Schmidli
BACKGROUND: Popliteal vessel injuries are associated with traumatic knee injury often requiring emergency revascularization. Medial and posterior approaches to the popliteal space have been proposed. This study evaluates the outcome of patients treated for traumatic popliteal vessel injuries via a posterior approach. METHODS: Consecutive patients with traumatic vascular injuries in the popliteal segments II and III undergoing surgical repair via a posterior approach between October 2008 and December 2016 were analyzed...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29214670/recanalization-of-native-superficial-femoral-artery-chronic-total-occlusion-after-failed-femoropopliteal-bypass-in-patients-with-critical-limb-ischemia
#8
Zhenjiang Li, Rui Feng, Feng Qin, Zhiqing Zhao, Liangxi Yuan, Yiming Li, Junjun Liu, Jiaxuan Feng, Jian Zhou, Junmin Bao, Zaiping Jing
OBJECTIVES: This study aimed to examine the outcomes of endovascular recanalization for native superficial femoral artery (SFA) chronic total occlusion (CTO) in patients with critical limb ischemia (CLI) after femoropopliteal bypass failure with limited surgical revascularization options. BACKGROUND: Endovascular recanalization of native artery occlusions has been recently used as a new alternative for threatened limbs after bypass graft occlusion. The feasibility and efficacy has not been widely reported...
December 6, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29212694/minimising-aseptic-loosening-in-extreme-bone-resections-custom-made-tumour-endoprostheses-with-short-medullary-stems-and-extra-cortical-plates
#9
J D Stevenson, C Wigley, H Burton, S Ghezelayagh, G Morris, S Evans, M Parry, L Jeys
AIMS: Following the resection of an extensive amount of bone in the treatment of a tumour, the residual segment may be insufficient to accept a standard length intramedullary cemented stem. Short-stemmed endoprostheses conceivably have an increased risk of aseptic loosening. Extra-cortical plates have been added to minimise this risk by supplementing fixation. The aim of this study was to investigate the survivorship of short-stemmed endoprostheses and extra-cortical plates. PATIENTS AND METHODS: The study involved 37 patients who underwent limb salvage surgery for a primary neoplasm of bone between 1998 and 2013...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29212693/clinical-functional-and-radiological-outcomes-of-extracorporeal-irradiation-in-limb-salvage-surgery-for-bone-tumours
#10
C W Jones, J Shatrov, J M Jagiello, S Millington, A Hong, R Boyle, P D Stalley
AIMS: We present a retrospective review of patients treated with extracorporeally irradiated allografts for primary and secondary bone tumours with the mid- and long-term survivorship and the functional and radiographic outcomes. PATIENTS AND METHODS: A total of 113 of 116 (97.4%) patients who were treated with extracorporeally irradiated allografts between 1996 and 2014 were followed up. Forms of treatment included reconstructions, prostheses and composite reconstructions, both with and without vascularised grafts...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29205902/therapeutic-options-and-postoperative-wound-complications-after-extremity-soft-tissue-sarcoma-resection-and-postoperative-external-beam-radiotherapy
#11
Mohamed H Abouarab, Iman L Salem, Magdy M Degheidy, Dominic Henn, Christoph Hirche, Ahmad Eweida, Matthias Uhl, Ulrich Kneser, Thomas Kremer
Soft tissue sarcomas occur most commonly in the lower and upper extremities. The standard treatment is limb salvage surgery combined with radiotherapy. Postoperative radiotherapy is associated with wound complications. This systematic review aims to summarise the available evidence and review the literature of the last 10 years regarding postoperative wound complications in patients who had limb salvage surgical excision followed by direct closure vs flap coverage together with postoperative radiotherapy and to define the optimal timeframe for adjuvant radiotherapy after soft tissue sarcomas resection and flap reconstruction...
December 5, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29199462/role-of-genetics-in-peripheral-arterial-disease-outcomes-significance-of-limb-salvage-quantitative-locus-1-genes
#12
Emmanuel Okeke, Ayotunde O Dokun
Peripheral artery disease is a major health care problem with significant morbidity and mortality. Humans with peripheral artery disease exhibit two major and differential clinical manifestations - intermittent claudication and critical limb ischemia. Individuals with intermittent claudication or critical limb ischemia have overlapping risk factors and objective measures of blood flow. Hence, we hypothesized that variation in genetic make-up may be an important determinant in the severity of peripheral artery disease...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29199033/psychosocial-reactions-to-upper-extremity-limb-salvage-a-case-series
#13
Lindsay Sposato, Kathleen Yancosek, Jill Cancio
STUDY DESIGN: Case series. INTRODUCTION: A salvaged limb is one that has undergone a major traumatic injury, followed by repeated surgical attempts in order to avoid amputation. Psychological recovery for individuals with lower extremity limb salvage has been examined in a number of studies. However, psychosocial reactions for individuals with upper extremity (UE) limb salvage are understudied in the literature. PURPOSE OF THE STUDY: The purpose of this study was to explore the process of psychosocial adaptation for 3 trauma cases after UE limb salvage...
November 30, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/29189524/magnitude-of-soft-tissue-defect-as-a-predictor-of-free-flap-failures-does-size-matter
#14
Mark Shasti, Julio J Jauregui, Awais Malik, Gerard Slobogean, Walter Andrew Eglseder, Raymond A Pensy
OBJECTIVES: To examine the relationship between the magnitude of soft-tissue defect and the risk of free-flap and limb-salvage complications/failures. DESIGN: Retrospective cohort. SETTING: Level I Trauma Center. PATIENTS: One hundred twelve patients with free tissue transfers between January 2009 and June 2015. INTERVENTION: A standardized approach using a consistent team of 2 orthopaedic microvascular surgeons was used for each free-flap reconstruction...
December 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29185295/complications-and-survival-of-megaprostheses-after-resection-of-bone-metastases
#15
M De Gori, A D’Arienzo, L Andreani, G Beltrami, D A Campanacci, P De Biase, F Frenos, S Giannotti, F Sacchetti, F Totti, P Parchi, R Capanna
Treatment of bone metastases is often palliative, aiming at pain control and stabilization or prevention of pathological fractures. However, a complete resection with healing purposes can be performed in selected cases. The aim of our work was to evaluate the survival of megaprostheses used for reconstruction after bone metastases. Between January 2001 and March 2015, we implanted 169 Megasystem-C® (Waldemar LINK® GmbH & Co. KG, Hamburg, Germany) after bone metastasis resection. Patients, 95 females and 74 males, were operated at an average age of 61 (12-87) years for proximal femoral resection in 135 (79...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29181955/soft-tissue-adhesion-patterns-over-trevira-tube-on-modular-endoprosthesis-for-malignant-bone-tumours-an-in-vitro-study
#16
S D’Adamio, G Cazzato, A Ziranu, A Sgambato, M A Rosa, G Maccauro
A reliable and effective technique in case of limb salvage surgery after resection of extensive bone tumors is represented by the implant of modular or custom-made megaprosthesis. Fixation of the residual surrounding soft tissue on the implant represent a challenge for the surgeon and the use of a polyethylene terephthalate (PET) tube over it, also known as Trevira, is currently a common choice for reattachment with good clinical outcomes. We compared fibroblastic cell culture potential over simple titanium coating vs titanium surrounded by Trevira and evaluated cell viability and replication at 24, 48 and 72 h using MTT cell growth assay and scanning electron microscopy to determine if there was any difference in the potential of cell growth associated to the material used...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29181352/a-case-report-of-dual-incision-technique-for-total-femur-arthroplasty-as-a-salvage-procedure-in-infected-non-unions
#17
Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29180271/reconstructive-techniques-for-revision-and-limb-salvage-surgery-in-persons-with-haemophilia
#18
C Carulli, M Zago, A R Rizzo, M Innocenti
Haemophilia is an inherited haemorrhagic disease characterized by the lack of coagulative factors associated nowadays mostly to musculoskeletal complications, particularly severe secondary arthritis in specific joints. Recurrent traumatic or spontaneous joint bleeding, induce severe arthropathy at a young age that can be treated only by joint replacement. Total knee or hip arthroplasty in young subjects may fail earlier due to wear or infections and in the haemophilic population, this means bone loss, pseudo tumours and the need of revision or even limb salvage surgery...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29180182/perioperative-warming-oxygen-and-ilomedin-on-oxygenation-and-healing-in-infrainguinal-bypass-surgery
#19
Nathaniel Chiang, Odette A Rodda, Jamie Sleigh, Thodur Vasudevan
BACKGROUND: Perioperative adjuncts are utilized across surgical specialities with the goal of improving patient outcomes. High-dose oxygen and extended warming are shown to increase wound collagen deposition during abdominal surgery. Prostacyclin is shown to improve limb salvage and patency rate in infrainguinal bypass (IIB) surgery. This study evaluated the impact of these adjuncts on healing and perfusion post IIB surgery. METHODS: This randomized controlled study allocated patients undergoing IIB surgery into three treatment arms (perioperative high-dose oxygen, extended warming, and a synthetic prostacyclin) or a control group...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29172758/deformity-and-clinical-outcomes-following-operative-correction-of-charcot-foot-a-new-classification-with-implications-for-treatment
#20
Michael S Pinzur, Adam P Schiff
BACKGROUND: The historic treatment of Charcot foot arthropathy has been immobilization during the active phase of the disease process, followed by accommodative bracing of the acquired deformity. Evidence derived from modern patient-reported outcomes investigations has convinced many surgeons to attempt operative correction of the acquired deformity with a goal of improving quality of life. METHODS: Over a 12-year period, 214 patients (9 bilateral) underwent reconstruction of the acquired deformity associated with midtarsal Charcot foot arthropathy...
November 1, 2017: Foot & Ankle International
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