Collections Wound Care

Wound Care

General diabetic, venous stasis, and traumatic wound care focusing on the lower extremity.
Robert Morley, Matt Rothwell, John Stephenson, Liza McIlvenny, Frank Webb, Aaron Barber
Complex foot infections involving bone and soft tissue in patients with co-morbidities such as diabetes and peripheral arterial disease (PAD) are a cause of significant hospital admission. They are associated with substantial economic costs to health services worldwide. Historically, severe foot infection has been treated with surgical debridement and prolonged courses of systemic antibiotics. Prolonged systemic antibiotic use increases the risk of drug side effects, antimicrobial resistance and Clostridium difficile infection...
2022: Journal of Foot and Ankle Surgery
Katherine Chen, Rachel Balloch
Calcaneal osteomyelitis is a complicated clinical scenario, which is often very difficult to treat. It can occur in individuals of any age who are injured or immunocompromised, and once diagnosed, aggressive management should be initiated. Treatment ranges from antibiotics alone to radical debridement or amputation. If there is a delay in both diagnosis and treatment, calcaneal osteomyelitis can be limb threatening or even life threatening.
July 2010: Clinics in Podiatric Medicine and Surgery
Marta Sabater-Martos, Irene Katharina Sigmund, Constantinos Loizou, Martin McNally
Introduction: Calcaneal osteomyelitis is an uncommon and challenging condition. In this systematic review we aim to analyse the outcomes from concomitant use of bone debridement and soft tissue management for patients diagnosed with calcaneal osteomyelitis. Materials & Methods: A complete computerised and comprehensive literature search of Pubmed and Cochrane database was undertaken from January 2000 to October 2018. During the review, studies were screened for information about the surgical and antimicrobial treatment, the complications, the reinfection rate and the functional outcome of patients with calcaneal osteomyelitis...
2019: Journal of Bone and Joint Infection
Takashi Iwakura, Sang Yang Lee, Takahiro Niikura, Masahiko Miwa, Yoshitada Sakai, Kotaro Nishida, Ryosuke Kuroda, Masahiro Kurosaka
We report a case of chronic calcaneal osteomyelitis in a diabetic patient who was successfully treated with radical debridement and gentamycin-impregnated calcium phosphate cement. At 1.5-year follow-up, the patient could walk without any assistance. Calcium phosphate cement is an effective local antibiotic delivery system and a biocompatible material for filling the debrided space to facilitate bone formation.
December 2014: Journal of Orthopaedic Surgery
Felix W A Waibel, Alexander Klammer, Tobias Götschi, Ilker Uçkay, Thomas Böni, Martin C Berli
BACKGROUND: Surgical procedures for calcaneal osteomyelitis are partial calcanectomy (PC), total calcanectomy (TC), and below-knee amputation (BKA). With calcaneal osteomyelitis, limb-saving surgery was described to have secondary BKA rates of 4% to 20%, while secondary amputation rates after BKA are unknown. The aim of this study was to describe and compare overall revision and secondary amputation rates for each surgical option in our institution's cohort and to identify risk factors for secondary amputation...
May 2019: Foot & Ankle International
K Adams, L Couch, G Cierny, J Calhoun, J T Mader
The elution of antibiotics from antibiotic-impregnated polymethylmethacrylate (PMMA) beads was measured in mongrel dogs. The antibiotics, used in mixture with Simplex cement, included cefazolin (Ancef; 4.5 g/40 g cement powder), ciprofloxacin (Cipro; 6 g/40 g powder), clindamycin (Cleocin; 6 g/40 g powder), ticarcillin (Ticar; 12 g/40 g powder), tobramycin (Nebcin; 9.8 g/40 g powder), and vancomycin (Vancocin; 4 g/40 g powder). After a pneumatic drill was used to dredge a trough in the tibia, five beads were implanted...
May 1992: Clinical Orthopaedics and related Research
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...
2018: Journal of Foot and Ankle Surgery
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...
2017: Journal of Foot and Ankle Surgery
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
2015-04-06 18:41:47
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