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Diabetic Foot Ulcer Graft

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https://www.readbyqxmd.com/read/29091040/a-pilot-study-to-evaluate-the-effects-of-perfusion-decellularized-porcine-hepatic-derived-wound-matrix-on-difficult-to-heal-diabetic-foot-ulcers
#1
Robert Fridman, Jonathan Engelhardt
OBJECTIVE: The purpose of this prospective pilot study is to evaluate the effects of a novel perfusion-decellularized porcine hepatic-derived wound matrix (PDPHD-WM) on very difficult-to-heal diabetic foot ulcers (DFUs). MATERIALS AND METHODS: For the intent of this study, a very difficult-to-heal DFU is one with a duration > 3 months despite using at least 1 advanced healing modality. Seven patients were enrolled in the study for a length of 14 weeks, including a 2-week run-in phase of standard-of-care therapy with saline gel and offloading in a CAM walker...
October 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29091034/updating-the-diabetic-foot-treatment-algorithm-recommendations-on-treatment-using-advanced-medicine-and-therapies
#2
Peter Blume, Stephanie Wu
OBJECTIVE: Since the last diabetic foot ulcer (DFU) treatment algorithm was published in 2002, new options for diagnostic testing and treatments have been developed. This study seeks to update the DFU treatment algorithm to include new options available in diagnostic testing and treatment. MATERIALS AND METHODS: A computerized literature search of peer-reviewed articles published between January 2003 and January 2016 was conducted using MEDLINE (PubMed), EMBASE, and the Cochrane Library...
October 20, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29077498/split-thickness-skin-grafts-to-the-foot-and-ankle-of-diabetic-patients
#3
Kyle Sanniec, Tea Nguyen, Suzanne van Asten, Javier La Fontaine, Lawrence A Lavery
BACKGROUND: There is an increased prevalence of foot ulceration in patients with diabetes, leading to hospitalization. Early wound closure is necessary to prevent further infections and, ultimately, lower-limb amputations. There is no current evidence stating that an elevated preoperative hemoglobin A1c (HbA1c) level is a contraindication to skin grafting. The purpose of this review was to determine whether elevated HbA1c levels are a contraindication to the application of skin grafts in diabetic patients...
September 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29076318/polydeoxyribonucleotide-improves-peripheral-tissue-oxygenation-and-accelerates-angiogenesis-in-diabetic-foot-ulcers
#4
Seoyoung Kim, Jun Hyung Kim, Jaehoon Choi, Woonhyeok Jeong, Sunyoung Kwon
Background: Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. Methods: This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10)...
October 26, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28933697/enhanced-skin-regeneration-using-a-novel-amniotic-derived-tissue-graft
#5
Katie C Mowry, Paul P Bonvallet, Susan L Bellis
BACKGROUND: Chronic and recalcitrant wounds present a significant therapeutic challenge. Amniotic tissues contain many regenerative cytokines, growth factors, and extracellular matrix molecules including proteoglycans, hyaluronic acid, and collagens I, III, and IV. Dehydrated amnion/chorion grafts are currently used to treat a variety of wounds such as diabetic foot ulcers and burns. OBJECTIVE: The investigators hypothesized that processing methodologies, dehydration, and hypothermic processing and storage of amniotic tissues would affect overall quality of wound healing; they compared dehydrated amnion/chorion (dHACM) grafts to a novel hypothermically stored amniotic membrane (HSAM) graft in a full-thickness rat wound model...
September 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28873060/a-retrospective-crossover-study-of-the-use-of-aseptically-processed-placental-membrane-in-the-treatment-of-chronic-diabetic-foot-ulcers
#6
Lawrence A DiDomenico, Dennis P Orgill, Robert D Galiano, Thomas E Serena, Marissa J Carter, Jarrod P Kaufman, Nathan J Young, Charles M Zelen
BACKGROUND: In a recently published, prospective randomized controlled trial (RCT) comparing aseptically processed dehydrated human amnion/chorion allograft (dHACA) to standard of care (SOC), 85% wound closure rates were reported in the dHACA arm while only 25% of patients in the SOC arm healed. OBJECTIVE: The purpose of this retrospective crossover study is to evaluate the effectiveness of dHACA in those patients that failed to respond to the SOC treatments and who exited the original study after failing up to 12 weeks of SOC treatment...
July 26, 2017: Wounds: a Compendium of Clinical Research and Practice
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/28723771/malignant-melanoma-misdiagnosed-as-diabetic-foot-ulcer-a-case-report
#8
Wei Gao, Dawei Chen, Xingwu Ran
RATIONALE: Acral lentiginous melanoma (AML) does not exhibit the classic signs of malignant melanoma. ALM is frequently misdiagnosed because of its unusual sites and atypical clinical morphologies, which lead to poor prognosis. PATIENT CONCERNS: A female patient aged 78 years was presented to our center with two ulcers on her right foot. Diabetic foot ulcer was considered as the primary diagnosis. The ulcers failed to improve after 2 weeks' therapy. DIAGNOSES: An incisional biopsy of the lesion revealed malignant melanoma...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28597935/failure-rates-of-artificial-dermis-products-in-treatment-of-diabetic-foot-ulcer-a-systematic-review-and-network-meta-analysis
#9
Huidi Tchero, Christian Herlin, Farid Bekara, Pauline Kangambega, Fluieraru Sergiu, Luc Teot
Diabetic foot ulcer (DFU) is a frequent complication in diabetic patients, occurring in up to 25% of those affected. Among the treatments available to clinicians, the use of bioengineered skin substitutes is an attractive alternative. Artificial dermis functions as a matrix, covering the wound and supporting healing and reconstruction of the lost tissue. This study was aimed at reviewing the use of five regeneration matrices (namely, Integra, Nevelia, Matriderm, Pelnac, and Renoskin) as reported by clinical trials...
June 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28576196/management-of-osteomyelitis-and-bone-loss-in-the-diabetic-charcot-foot-and-ankle
#10
REVIEW
Daniel J Short, Thomas Zgonis
Bone loss and destruction due to diabetic Charcot neuroarthropathy (CN) and osteomyelitis of the foot and ankle is a challenging clinical condition when lower extremity preservation is considered. Resection and excision of osteomyelitis and associated nonviable soft tissue can lead into large osseous and soft tissue defects that will most likely need the utilization of bone grafting and subsequent arthrodesis for stability and anatomic alignment. In the diabetic population with peripheral neuropathy, osseous instability can lead to subsequent lower extremity deformity, ulceration, infection and/or amputation...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28277993/maggot-therapy-for-wound-care-in-iran-a-case-series-of-the-first-28-patients
#11
A Mirabzadeh, M J Ladani, B Imani, S A B Rosen, R A Sherman
OBJECTIVE: The need for improved wound care is receiving considerable attention in the Islamic Republic of Iran. Beginning in 2003, maggot therapy (MT) became part of Iran's effort to advance its wound care technology. The first cohort of patients treated with MT was analysed to evaluate the use of this treatment. METHOD: Patients treated with MT at three hospitals in Tehran were analysed retrospectively. Primary outcomes were time to wound debridement and time to wound healing...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28110796/effectiveness-of-hindfoot-arthrodesis-by-stable-internal-fixation-in-various-eichenholtz-stages-of-neuropathic-ankle-arthropathy
#12
Silvampatty R Sundararajan, Kanchana P Srikanth, Handenahally S Nagaraja, Shanmuganathan Rajasekaran
The optimal time to treat neuropathic (Charcot) arthropathy of the ankle and peritalar joint is controversial because of the various treatment options available and the variable results reported in published studies. We sought to determine the outcome of hind foot arthrodesis with stable internal fixation in patients with different Eichenholtz stages of arthropathy. We prospectively studied patients with substantial disabilities caused by neuropathic arthropathy in deformed, unstable ankle and peritalar joints, with or without ulcerations, who had undergone treatment from July 2007 to December 2012...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28098565/bio-engineering-tissue-and-v-a-c-therapy-a-new-method-for-the-treatment-of-extensive-necrotizing-infection-in-the-diabetic-foot
#13
Andrea Armenio, Daniela Anna Cutrignelli, Maria Luisa Nardulli, Giulio Maggio, Giuseppe Memeo, Valerio De Santis, Giuseppe Giudice, Cosmo Maurizio Ressa
AIM: The aim of the study is to compare the standard care for progressive necrotizing infection in diabetic foot with a treatment protocol based on the association between autologous fibroblast grafts and vacuum-assisted closure therapy (V.A.C.). MATERIAL OF STUDY: A retrospective matched Case-Control study was carried out on 20 patients with diabetic foot infection, 10 treated with the standard care and 10 with our new protocol. Inclusion criteria were: acute diabetic foot necrosis (Wagner III and IV), ulcer size (30 to 80 cm2), tendon and bone exposure...
December 6, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27826487/aseptically-processed-placental-membrane-improves-healing-of-diabetic-foot-ulcerations-prospective-randomized-clinical-trial
#14
Lawrence A DiDomenico, Dennis P Orgill, Robert D Galiano, Thomas E Serena, Marissa J Carter, Jarrod P Kaufman, Nathan J Young, Charles M Zelen
BACKGROUND: Allogeneic grafts derived from amnion/chorion are known to be efficacious in healing chronic diabetic foot ulcerations (DFUs). The goal of this study was to compare aseptically processed dehydrated human amnion and chorion allograft (dHACA) versus standard of care (SOC) in facilitating wound closure in nonhealing DFUs. METHODS: Patients with DFUs treated with SOC (off-loading, appropriate debridement, and moist wound care) after a 2-week screening period were randomized to either SOC or wound-size-specific dHACA (AmnioBand, Musculoskeletal Transplant Foundation, Edison, N...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27694302/combination-of-open-subtotal-calcanectomy-and-stabilization-with-external-fixation-as-limb-salvage-procedure-in-hindfoot-infected-diabetic-foot-ulcers
#15
Luca Dalla Paola, Anna Carone, Giulio Boscarino, Giuseppe Scavone, Lucian Vasilache
Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator...
December 2016: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/27662892/single-stage-bipedicle-local-tissue-transfer-and-skin-graft-for-achilles-tendon-surgery-wound-complications
#16
Travis J Dekker, Yash Avashia, Suhail K Mithani, Andrew P Matson, Alexander J Lampley, Samuel B Adams
INTRODUCTION: Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support...
February 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27649406/comparing-the-efficacy-of-viable-cryopreserved-placental-membrane-for-the-treatment-of-wounds-of-diverse-etiologies
#17
Derek S Anselmo, Marc Karpo, Ebony Love, Tracey Vlahovic
INTRODUCTION AND OBJECTIVES: The benefits of using amniotic tissue in skin regeneration are well documented. Today, cryopreservation technology allows for better availability and maintenance of mesenchymal stem cells. This is of particular interest in treating the diabetic foot ulcer as this population has fewer mesenchymal stem cells. The objective of this case series investigation was to compare the efficacy of cryopreserved human amniotic stem cells in treating foot wounds of different etiologies...
September 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27562158/-application-of-percutaneous-transluminal-angioplasty-in-the-surgical-treatment-of-patients-with-diabetic-feet
#18
Y Gao, Z J Cui, X Shi, P F Guo, Q N Meng, G Y Yang, R Q Yang
OBJECTIVE: To explore the application of percutaneous transluminal angioplasty (PTA) in the surgical treatment of patients with diabetic feet. METHODS: The clinical data of 83 patients with diabetic feet, 95 limbs (95 wounds) in total, hospitalized in our unit from September 2011 to September 2014, conforming to the study criteria, were retrospectively analyzed. Patients were divided into conventional treatment group (CT, n=43, 51 wounds) and PTA group (n=40, 44 wounds) according to whether receiving PTA treatment or not...
August 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27536489/plantar-fat-grafting-and-tendon-balancing-for-the-diabetic-foot-ulcer-in-remission
#19
Cynthia A Luu, Ethan Larson, Timothy M Rankin, Jennifer L Pappalardo, Marvin J Slepian, David G Armstrong
We report on the use of free fat grafting as a means of redistributing normal and shear stress after healing of plantar diabetic foot wounds. Although fat augmentation (lipofilling) has been described previously as an approach to supplement defects and prevent atrophy, including use as an adjunct to wound healing and to mitigate pain in the foot, we are unaware of any reports in the medical literature that have described its use in the high-risk diabetic foot in remission. An active 37-year-old man with type 2 diabetes and neuropathy presented with gangrene of his fifth ray, which was amputated...
July 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27458594/spontaneous-calcaneal-fracture-in-patients-with-diabetic-foot-ulcer-four-cases-report-and-review-of-literature
#20
Mehtap Evran, Murat Sert, Tamer Tetiker, Gamze Akkuş, Ömer Sunkar Biçer
Spontaneous calcaneal fractures in diabetic patients without obvious trauma may occur, sometimes accompanying diabetic foot ulcers. In the current study we report four cases who were hospitalized for diabetic foot ulcer with concomitant calcaneal fractures. There were four diabetic patients (one type 1 and three type 2) who registered with diabetic foot ulcers with coexisting calcaneal fractures, all of which were classified as Type A according to Essex Lopresti Calcaneal Fracture Classification. Two of the patients with renal failure were in a routine dialysis program, as well as vascular compromise and osteomyelitis in all of the patients...
July 16, 2016: World Journal of Clinical Cases
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