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Wound Care

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38 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
Raj Kumar Nayak, Klaus Kirketerp-Møller
INTRODUCTION: Previous work has shown that uncontrolled diabetes mellitus is associated with adverse surgical outcomes. The purpose of the present study was to establish if a high peri-operative random blood sugar (RBS) concentration among patients with diabetes with non-traumatic lower-extremity amputation (LEA) is a decisive factor behind post-operative outcomes (re-amputation/mortality) within three months after the first amputation. METHODS: In this retrospective cohort study, the independent sample t-test, Pearson's chi-squared test and a Cox proportional hazards model were used...
April 2016: Danish Medical Journal
Efstathios Drampalos, Hasan Raza Mohammad, Chris Kosmidis, Moez Balal, Jason Wong, Anand Pillai
BACKGROUND: Chronic osteomyelitis necessities appropriate infected bone and soft tissue excision. The authors describe the Silo surgical technique for the treatment of calcaneal osteomyelitis using a new antibiotic-loaded absorbable calcium sulphate/hydroxyapatite biocomposite. METHODS: The Silo method involves debridement of the dead bone and local delivery of antibiotic in drilled tunnels using the biocomposite. It is combined with multiple sampling and culture-specific systemic antibiotic treatment guided by a multidisciplinary team...
March 2018: Foot
Irene Aprile, Marco Galli, Dario Pitocco, Enrica Di Sipio, Chiara Simbolotti, Marco Germanotta, Corrado Bordieri, Luca Padua, Maurizio Ferrarin
It has recently been suggested that first ray amputation in diabetic patients with serious foot complications can prolong bipedal ambulatory status, and reduce morbidity and mortality. However, no data are available on gait analysis and quality of life after this procedure. In the present case-control study (6 amputee and 6 nonamputee diabetics, 6 healthy non-diabetic), a sample of amputee diabetic patients were evaluated and compared with a sample of nonamputee diabetic patients and a group of age-matched healthy subjects...
January 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Michael J Mueller, David R Sinacore, Mary Kent Hastings, Michael J Strube, Jeffrey E Johnson
BACKGROUND: Limited ankle dorsiflexion has been implicated as a contributing factor to plantar ulceration of the forefoot in diabetes mellitus. The purpose of this study was to compare outcomes for patients with diabetes mellitus and a neuropathic plantar ulcer treated with a total-contact cast with and without an Achilles tendon lengthening. Our primary hypothesis was that the Achilles tendon lengthening would lead to a lower rate of ulcer recurrence. METHODS: Sixty-four subjects were randomized into two treatment groups, immobilization in a total-contact cast alone or combined with percutaneous Achilles tendon lengthening, with measurements made before and after treatment, at the seven-month follow-up examination, and at the final follow-up evaluation (a mean [and standard deviation] of 2...
August 2003: Journal of Bone and Joint Surgery. American Volume
S K McCallon, C A Knight, J P Valiulus, M W Cunningham, J M McCulloch, L P Farinas
Diabetic foot wounds present a great challenge to wound care practitioners. The objective of this pilot study was to determine whether vacuum-assisted closure (V.A.C.) therapy would afford quicker wound resolution as compared to saline-moistened gauze in the treatment of postoperative diabetic foot wounds. Ten patients were randomized into either the experimental V.A.C. group or control saline gauze group. Included in the study were diabetic patients 18 to 75 years of age who had a nonhealing foot ulceration...
August 2000: Ostomy/wound Management
Olga von Beckerath, Alexander Zapenko, Joachim Dissemond, Knut Kröger
Exact data regarding the clinical role of negative pressure wound therapy (NPWT) for wound care in a specific country are not available. Thus, we analysed the use of NPWT in hospitalised patients in Germany. Detailed lists of all hospitalised cases treated with NPWT in Germany for each of the years from 2005 to 2014 were obtained from the Federal Statistical Office, as well as lists of the 15 most frequent principal and additional diagnoses documented with NPWT in 2014. Within the 10-year time period of the study, the number of cases treated with NPWT increased by 349%, from 37 053 in 2005 to 129 269 in 2014...
June 2017: International Wound Journal
Tammer Elmarsafi, Noah G Oliver, John S Steinberg, Karen K Evans, Christopher E Attinger, Paul J Kim
When osteomyelitis occurs in the infected foot, cement spacers have been used as a limb salvage tool. The aim of the present study was to assess the longevity and outcomes in high-risk, low-demand patients who have undergone resection of bone and subsequent placement of permanent antibiotic-eluting cement spacers in the foot. A retrospective review case series of 30 patients who had undergone placement of a permanent antibiotic-eluting cement spacer in the foot were evaluated for retention, spacer exchange, removal, amputation, and functional status...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Hunter G Hoffman, David R Patterson, Eric Seibel, Maryam Soltani, Laura Jewett-Leahy, Sam R Sharar
OBJECTIVE: Most burn-injured patients rate their pain during burn wound debridement as severe to excruciating. We explored the adjunctive use of water-friendly, immersive virtual reality (VR) to distract patients from their pain during burn wound debridement in the hydrotherapy tank (hydrotank). SETTING: This study was conducted on inpatients at a major regional burn center. PATIENTS: Eleven hospitalized inpatients ages 9 to 40 years (mean age, 27 y) had their burn wounds debrided and dressed while partially submerged in the hydrotank...
May 2008: Clinical Journal of Pain
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
2015-02-06 23:33:16
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