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Wound Care

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30 papers 1000+ followers General diabetic, venous stasis, and traumatic wound care focusing on the lower extremity.
By Alex McKanna Podiatry Resident @ Franciscan Alliance/MWU based in Dyer, IN USA
J R W Brownrigg, R J Hinchliffe, J Apelqvist, E J Boyko, R Fitridge, J L Mills, J Reekers, C P Shearman, R E Zierler, N C Schaper
Prediction of wound healing and major amputation in patients with diabetic foot ulceration is clinically important to stratify risk and target interventions for limb salvage. No consensus exists as to which measure of peripheral artery disease (PAD) can best predict outcomes. To evaluate the prognostic utility of index PAD measures for the prediction of healing and/or major amputation among patients with active diabetic foot ulceration, two reviewers independently screened potential studies for inclusion. Two further reviewers independently extracted study data and performed an assessment of methodological quality using the Quality in Prognostic Studies instrument...
January 2016: Diabetes/metabolism Research and Reviews
Yuji Inoue, Minoru Hasegawa, Takeo Maekawa, Andres Le Pavoux, Yoshihide Asano, Masatoshi Abe, Takayuki Ishii, Takaaki Ito, Taiki Isei, Shinichi Imafuku, Ryokichi Irisawa, Masaki Ohtsuka, Mikio Ohtsuka, Fumihide Ogawa, Takafumi Kadono, Masanari Kodera, Tamihiro Kawakami, Masakazu Kawaguchi, Ryuichi Kukino, Takeshi Kono, Keisuke Sakai, Masakazu Takahara, Miki Tanioka, Takeshi Nakanishi, Yasuhiro Nakamura, Akira Hashimoto, Masahiro Hayashi, Manabu Fujimoto, Hiroshi Fujiwara, Koma Matsuo, Naoki Madokoro, Osamu Yamasaki, Yuichiro Yoshino, Takao Tachibana, Hironobu Ihn
The Japanese Dermatological Association determined to prepare the Wound/Burn Guidelines focusing on treatments, catering to needs for the clinical practice of dermatology. Among these guidelines, "Wounds in General" was intended to explain knowledge necessary "to heal wounds" without specifying particular disorders.
April 2016: Journal of Dermatology
Paul A Butterworth, Tom P Walsh, Yvonne D Pennisi, Anna D Chesne, Christoph Schmitz, Susan A Nancarrow
Extracorporeal shock wave therapy has been reported as an effective treatment for lower limb ulceration. The aim of this systematic review was to investigate the effectiveness of extracorporeal shock wave therapy for the treatment of lower limb ulceration. Five electronic databases (Ovid MEDLINE, CINAHL, Web of Knowledge, Scopus and Ovid AMED) and reference lists from relevant studies were searched in December 2013. All study designs, with the exception of case-reports, were eligible for inclusion in this review...
2015: Journal of Foot and Ankle Research
D Warwick, A Shaikh, P Worsley, S Gadola, D Bain, A Tucker, S D Gadola, M Stokes
AIM: Aim of the study was to examine the effects of the geko™ device (a portable electical nerve stimulator) on microcirculatory flow on the dorsum of the foot, and whether this is influenced by lower limb postures and application of a plaster cast. METHODS: This was a cross-sectional, healthy cohort, open label, physiological response study. In 10 healthy volunteers, aged 19 to 24 years, laser Doppler fluxmetry measurements were made on the dorsum of the foot in four postures: standing (weight bearing and non-weight bearing) and supine lying (with the lower limb horizontal and then elevated)...
April 2015: International Angiology: a Journal of the International Union of Angiology
Emilio Trignano, Nefer Fallico, Hung-Chi Chen, Mario Faenza, Alfonso Bolognini, Andrea Armenti, Fabio Santanelli Di Pompeo, Corrado Rubino, Gian Vittorio Campus
BACKGROUND: According to recent studies, peripheral nerve decompression in diabetic patients seems to not only improve nerve function, but also to increase microcirculation; thus decreasing the incidence of diabetic foot wounds and amputations. However, while the postoperative improvement of nerve function is demonstrated, the changes in peripheral microcirculation have not been demonstrated yet. The aim of this study is to assess the degree of microcirculation improvement of foot after the tarsal tunnel release in the diabetic patients by using transcutaneous oximetry...
January 2016: Microsurgery
Noah G Oliver, John S Steinberg, Kelly Powers, Karen K Evans, Paul J Kim, Christopher E Attinger
Partial calcanectomy (PC) is an established limb salvage procedure for treatment of deep heel ulceration with concomitant calcaneal osteomyelitis. The purpose of this study is to determine if a relationship exists between the amount of calcaneus removed during PC and the resulting lower extremity function and limb salvage outcomes. Consecutive PC patients were retrospectively divided into two cohorts defined by the amount of calcaneus resected before wound closure: patients in cohort 1 retained = 50% of calcaneus, while patients in cohort 2 underwent resection of >50% of the calcaneus...
2015: Journal of Diabetes Research
Sohaib Akhtar, Imran Ahmad, A H Khan, M Fahud Khurram
OBJECTIVE: The objective of this study was to establish an algorithm for surgical reconstruction of diabetic foot ulcers (DFUs). STUDY DESIGN: Retrospective study MATERIALS AND METHODS: : In this series, 75 patients with diabetic foot ulceration were treated at the Jawaharlal Nehru Medical College from October 2008 to August 2013, and were retrospectively reviewed. All patients in the study underwent surgical reconstruction of the foot in the form of a skin graft, local flaps, or free flaps, depending upon the characteristic of the defect, general condition of the patient, and vascular status of the limb...
April 2015: Advances in Skin & Wound Care
Takumi Matsumoto, Selene G Parekh
BACKGROUND: Wound healing problems of the anterior ankle incision are among the most common complications after total ankle arthroplasty, possibly resulting in exposure of the prostheses and infection. The aim of this study was to investigate the role of negative pressure wound therapy (NPWT) in decreasing the rate of wound healing problems after total ankle arthroplasty. METHODS: This is a retrospective cohort study including consecutive patients who underwent total ankle arthroplasty by a single surgeon at a single institution between 2009 and 2013...
July 2015: Foot & Ankle International
Shehan Hettiaratchy, Peter Dziewulski
No abstract text is available yet for this article.
June 12, 2004: BMJ: British Medical Journal
Guilermo E Umpierez
Many patients admitted to the hospital have diabetes mellitus-diagnosed or undiagnosed-and others develop hyperglycemia from the stress of hospitalization. This paper discusses the prevalence, outcomes, and evidence for best management of hyperglycemia and diabetes in hospitalized patients outside the critical care setting.
June 2011: Cleveland Clinic Journal of Medicine
Sabitha Rajan
Skin and soft-tissue infections (SSTIs) are a common presenting problem in both inpatients and outpatients. SSTIs have been broadly classified as complicated or uncomplicated, but specific disease processes and patient characteristics are important in guiding clinical management. Early recognition of the extent of infection, close follow-up, and familiarity with local antibiotic susceptibility data are critical to successful treatment.
January 2012: Cleveland Clinic Journal of Medicine
S Crone, C Garde, T Bjarnsholt, M Alhede
OBJECTIVE: Bacterial biofilms remain difficult to treat. The biofilm mode of growth enables bacteria to survive antibiotic treatment and the inflammatory reaction. Low-frequency ultrasound has recently been shown to improve healing in a variety of settings. It is hypothesised that ultrasound disrupts the biofilm leaving bacteria more vulnerable to antiseptic or antibiotic treatment. The objective of this study is to develop a realistic model to elucidate the effect of ultrasound on biofilms...
February 2015: Journal of Wound Care
J A Schwartz, S G Goss, F Facchin, C Gendics, J C Lantis
OBJECTIVE: Lower extremity ulcers are caused by multiple disease processes and contribute to a high level of patient morbidity and health-care spending in the US. Negative pressure wound therapy (NPWT) has been used extensively for wound bed preparation. Our aim is to assess the efficacy of an affordable, low-profile single-use NPWT (single-use NPWT) on chronic lower extremity wounds that would usually be deemed too small or superficial for traditional NPWT. METHOD: A prospective pilot study was undertaken in which chronic lower extremity wounds were treated with single-use NPWT...
February 2015: Journal of Wound Care
Lee C Rogers, Michael P DellaCorte, James W Stavosky, J Thomas Millington, John V Capotorto
Hyperbaric oxygen therapy (HBOT) is a useful tool for many conditions within the scope of practice of a Doctor of Podiatric Medicine (DPM). More wound-care clinics are adding HBOT as a service line. The increasing prevalence of DPMs operating inside of these wound-care clinics has raised questions about the licensure and privileging of DPMs to supervise HBOT. This document reviews the safety of outpatient HBOT and provides guidelines for hospitals to credential DPMs to supervise treatments.
July 2015: Journal of the American Podiatric Medical Association
Naoki Morimoto, Atsuyuki Kuro, Takashi Yamauchi, Ai Horiuchi, Natsuko Kakudo, Michiharu Sakamoto, Kenji Suzuki, Kenji Kusumoto
We report a case of circumferential venous leg ulcer in a rheumatoid arthritis patient. Mesh skin grafting was performed in another hospital, but the graft failed and the patient was referred to our hospital. This ulcer was treated by the combination therapy of a fenestrated-type artificial dermis with negative pressure wound therapy (NPWT) and secondary mesh grafting using our 'grip tape technique'. NPWT was started at -100 mmHg and continued until the formation of dermis-like tissue. A section stained using haematoxylin and eosin and an anti-αSMA (α smooth muscle actin) immunohistological section of the biopsy from dermis-like tissue showed an abundant infiltration of fibroblasts and capillary formation beneath the fenestration of the silicone sheet...
February 2016: International Wound Journal
Elaine Caldeira de Oliveira Guirro, Rinaldo Roberto de Jesus Guirro, Almir Vieira Dibai-Filho, Siane Cristina Santarosa Pascote, Delaine Rodrigues-Bigaton
OBJECTIVE: The purpose of this study was to assess the effects of high-voltage electrical stimulation (HVES), continuous short wave diathermy, and physical exercise on arterial blood flow in the lower limbs of diabetic women with peripheral arterial disease. METHODS: A crossover study was carried out involving 15 diabetic women (mean age of 77.87 ± 6.20 years) with a diagnosis of peripheral arterial disease. One session of each therapeutic resource was held, with a 7-day washout period between protocols...
March 2015: Journal of Manipulative and Physiological Therapeutics
Afsaneh Alavi, R Gary Sibbald, Reza Nabavizadeh, Farnaz Valaei, Pat Coutts, Dieter Mayer
OBJECTIVE: To determine the accuracy of audible arterial foot signals with an audible handheld Doppler ultrasound for identification of significant peripheral arterial disease as a simple, quick, and readily available bedside screening tool. METHODS: Two hundred consecutive patients referred to an interprofessional wound care clinic underwent audible handheld Doppler ultrasound of both legs. As a control and comparator, a formal bilateral lower leg vascular study including the calculation of Ankle Brachial Pressure Index and toe pressure (TP) was performed at the vascular lab...
December 2015: Vascular
Ayelet Levy, Mor Ben-Or Frank, Amit Gefen
The heels are the most common site for facility-acquired pressure ulcers (PUs), and are also the most susceptible location for deep tissue injuries. The use of multilayer prophylactic dressings to prevent heel PUs is a relatively new prevention concept, generally aimed at minimizing the risk for heel ulcers (HUs) through mechanical cushioning and reduction of friction at the dressing-support interface. We used 9 finite element model variants of the posterior heel in order to evaluate the biomechanical performance of a multilayer dressing in prevention of HUs during supine lying...
February 2015: Journal of Tissue Viability
Mesut Mutluoglu, Gunalp Uzun, Onur Sildiroglu, Vedat Turhan, Hakan Mutlu, Senol Yildiz
BACKGROUND: We investigated the validity of probe-to-bone testing in the diagnosis of osteomyelitis in a selected subgroup of patients clinically suspected of having diabetic foot osteomyelitis. METHODS: Between January 1, 2007, and December 31, 2008, inpatients and outpatients with a diabetic foot ulcer were prospectively evaluated, and those having a clinical diagnosis of foot infection and at least one of the osteomyelitis clinical suspicion criteria were consecutively included in this study...
September 2012: Journal of the American Podiatric Medical Association
M L Grayson, G W Gibbons, K Balogh, E Levin, A W Karchmer
OBJECTIVE: To assess a bedside technique for diagnosing osteomyelitis. DESIGN: We prospectively assessed infected pedal ulcers for detectable bone by probing with a sterile, blunt, stainless steel probe. We then examined the relationship between detection of bone and the presence or absence of osteomyelitis that was defined histopathologically and/or clinically. SETTING: A tertiary care center. PATIENTS: Seventy-five hospitalized diabetic patients with a total of 76 infected foot ulcers were studied...
March 1, 1995: JAMA: the Journal of the American Medical Association
2014-12-18 03:28:36
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