International Journal of Lower Extremity Wounds最新文献

Usability of Different Methods to Assess and Improve Adherence to Therapeutic Footwear in Persons with the Diabetic Foot in Remission. A Systematic Review. 评估和改善糖尿病足缓解期患者治疗性鞋类依从性的不同方法的可用性。系统评价。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-08-07 DOI: 10.1177/15347346231190680

Mateo López-Moral, Raúl J Molines-Barroso, María Herrera-Casamayor, Marta García-Madrid, Esther García-Morales, José Luis Lázaro-Martínez

{"title":"Usability of Different Methods to Assess and Improve Adherence to Therapeutic Footwear in Persons with the Diabetic Foot in Remission. A Systematic Review.","authors":"Mateo López-Moral, Raúl J Molines-Barroso, María Herrera-Casamayor, Marta García-Madrid, Esther García-Morales, José Luis Lázaro-Martínez","doi":"10.1177/15347346231190680","DOIUrl":"10.1177/15347346231190680","url":null,"abstract":"Therapeutic footwear (TF) has been demonstrated to decrease the rate of recurrence in patients in remission. TF adherence determines the real effect of such treatment and, therefore, an appropriate evaluation of TF adherence is critical to decrease recurrence. The aim of this systematic review was to determine the usability of different methods of assessing adherence to TF in patients with diabetic foot ulcers under remission. The search strategy retrieved 506 articles. Title and abstract review excluded 472, while the full-text review excluded an additional 18 articles because the included data did not meet the selection criteria. Finally, we included 16 articles in this systematic review. Six (37.5%) of the 16 studies combined objective (OM) and subjective methods (SM). Only five (31.25%) evaluated OM and six (37.5%) studies only evaluated SM. Objective methods (temperature sensor, activity monitor) and subjective methods (survey, questionnaire) have successfully been used in the literature to evaluate TF adherence. Objective methods provided accurate data, whereas subjective methods led to response bias or missing data. Methods of evaluation showed that patients use the TF more frequently outdoors and on weekdays than indoors or on the weekend. In conclusion, objective methods are the most usable way to measure adherence to TF.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"55-64"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implication of Peripheral Neuropathy on Unplanned Readmissions in Patients Hospitalized for Complicated Diabetic Foot Disease. 周围神经病变对合并糖尿病足病住院患者意外再入院的影响。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-08-31 DOI: 10.1177/15347346231197885

Erwin Yii, Amos Au, Justin Bradley, Alan Saunder, Roger Bell, Ming K Yii

{"title":"Implication of Peripheral Neuropathy on Unplanned Readmissions in Patients Hospitalized for Complicated Diabetic Foot Disease.","authors":"Erwin Yii, Amos Au, Justin Bradley, Alan Saunder, Roger Bell, Ming K Yii","doi":"10.1177/15347346231197885","DOIUrl":"10.1177/15347346231197885","url":null,"abstract":"Introduction. Unplanned readmissions are common following discharge in patients after hospitalization for diabetic foot disease (DFD) complications. The aim of this study was to identify factors associated with readmissions in these high-risk patients, treated in a multidisciplinary setting and the implication of measures that could effectively reduce readmission rates. Methods. Patients presenting with DFDs admitted between 2015 and 2017 were studied retrospectively in a single-centre patient database. The demographics and clinical comorbidities were analyzed and comparison was made between 2 groups: patients readmitted within 30 days of discharge and those who did not require readmission. Multivariate analysis was performed to identify risk factors associated with readmissions. Results. In total, 340 patients were included. The unplanned readmission rate was 10.9%. More than half of readmissions (71%) were related to wound deterioration and infection. In the readmission group, the patients had lower body mass index, higher rate of osteomyelitis, lower rate of debridement, and evidence of peripheral vascular disease below the knee in the index admissions but these were not significant. In the multivariate analysis, peripheral neuropathy was the only significant risk associated with unplanned readmissions (odds ratio: 2.78, 95% confidence interval: 1.23-6.29, P = .014). Conclusion. This study demonstrates a significant association between peripheral neuropathy and unplanned readmissions. The implications of this nonmodifiable risk factor in reducing readmissions include all levels of patient care delivery such as adequate preparation for discharge and transition back into the community. Recognition and education in successful long-term offloading of insensate diabetic feet may help reduce rates of unplanned readmission.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"118-122"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Angiolymphoid Hyperplasia With Eosinophilia Associated With Stasis Dermatitis. 血管淋巴样增生伴嗜酸性粒细胞增多伴瘀血性皮炎。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-08-07 DOI: 10.1177/15347346231194111

Si-Yu Luo, Li-Jia Deng, Sheng Fang

引用次数: 0

Extracellular to Intracellular Water Ratio Determined by Bioimpedance is Associated with Mortality in Patients Admitted for Diabetic Foot Ulcers. 生物阻抗测定的细胞外与细胞内水分比与糖尿病足溃疡住院患者的死亡率相关。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-06-15 DOI: 10.1177/15347346231173861

María Eugenia López-Valverde, Javier Aragón-Sánchez, Gerardo Víquez-Molina, Pilar Rodríguez Ortega

引用次数: 0

Microbiological and Clinical Characteristics of Infected Diabetic Foot Ulcers Managed in a Tertiary Level Diabetic Foot Service. 感染糖尿病足溃疡的微生物学和临床特征在三级糖尿病足服务管理。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-06-01 DOI: 10.1177/15347346231178642

Cipriano Rossana, Marco Meloni, Laura Giurato, Jose Luis Lazaro-Martinez, Andreadi Aikaterini, Ruotolo Valeria, Alfonso Bellia, Davide Lauro, Luigi Uccioli

{"title":"Microbiological and Clinical Characteristics of Infected Diabetic Foot Ulcers Managed in a Tertiary Level Diabetic Foot Service.","authors":"Cipriano Rossana, Marco Meloni, Laura Giurato, Jose Luis Lazaro-Martinez, Andreadi Aikaterini, Ruotolo Valeria, Alfonso Bellia, Davide Lauro, Luigi Uccioli","doi":"10.1177/15347346231178642","DOIUrl":"10.1177/15347346231178642","url":null,"abstract":"The study aimed to evaluate the clinical and microbiological characteristics of diabetic foot infections (DFIs) in patients referring to a specialized diabetic foot service (DFS). The study is a retrospective observational study conducted in a single center, including patients who were referred for a new DFI. All patients were managed through a limb salvage protocol according to international guidelines. The following items were recorded: type of bacteria, presence of single or polymicrobial infection, and the antibiotic resistance. Overall, 268 patients were included. The mean age was 68.9 ± 10.9 years, 75% were male, and 97.2% had type 2 diabetes with a mean diabetes duration of 16 ± 9 years. One hundred thirty-nine (51.9%) DFU were ischemic, 120 (44.7%) patients had osteomyelitis, 107 (39.9%) had gangrene, 37 (13.9%) had phlegmon/abscess/cellulitis and 4 (1.5%) had necrotizing fasciitis. Among 370 bacteria isolated, gram positive were found in 207 (55.9%) cases, and gram negative in 163 (44.1%) cases. The higher rates of isolates were Staphylococcus aureus (32.9%), Pseudomonas aeruginosa (10.8%), and Enterococcus faecalis (8.9%). Polymicrobial infection was reported in 33.6% of cases and antibiotic resistance was recorded in 16.5% of isolates. Among them, 10.3% were methicillin-resistant S. aureus (MRSA). Antibiotic resistance was detected in 40.9% of cases in association with gangrene and osteomyelitis. The current study shows as polymicrobial infections and antibiotic resistance is frequently reported in DFIs, and antibiotic resistance was more associated with gangrene and osteomyelitis. Among bacteria reporting antimicrobial resistance, the highest rate was found for MRSA.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"74-80"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9562452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prediction Interval in Meta-Analyses. meta分析的预测区间。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-08-07 DOI: 10.1177/15347346231185615

Elena Christaina, Gregory Trypsianis, Miltos K Lazarides

引用次数: 0

The Role of Escin as a Topical Agent for Lymphedema Treatment in a Rat Model. Escin作为局部药物治疗大鼠淋巴水肿模型的作用。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-08-22 DOI: 10.1177/15347346231195944

Hyung Hwa Jeong, Donggeun Kim, Taehyun Kim, HyunSuk Peter Suh, ChangSik John Pak, Jae Yong Jeon, Joon Pio Hong

{"title":"The Role of Escin as a Topical Agent for Lymphedema Treatment in a Rat Model.","authors":"Hyung Hwa Jeong, Donggeun Kim, Taehyun Kim, HyunSuk Peter Suh, ChangSik John Pak, Jae Yong Jeon, Joon Pio Hong","doi":"10.1177/15347346231195944","DOIUrl":"10.1177/15347346231195944","url":null,"abstract":"Escin, a naturally derived material isolated from horse chestnut, is used as an anti-inflammatory and anti-edema agent. This study aimed to evaluate its effects on lymphedema in a rat tail model. We divided the rats into five groups. The treatment groups received topical application of escin gel at concentrations of 20%, 10%, 2%, and 0.5% for 4 weeks. The fifth group served as a control. We performed volumetric (water displacement) tests, H&E staining, and LYVE-1 immunohistochemical staining, followed by statistical evaluation. All treatment groups showed significant volumetric reductions compared with the control group, but no significant differences were observed between the treatment groups. H&E staining showed a significant reduction in dermal thickness in the 20%, 10%, and 2% escin treatment groups compared to the control group. Within the treatment groups, the 2% escin group showed a significant difference compared with the 20% and 10% escin groups (p = 0.021 for both). LYVE-1 immunohistochemical staining revealed a significantly higher mean lymphatic vessel count in the 2% escin group compared with the 20%, 10%, and 0.5% escin-treated groups and the control group (p = 0.019, p = 0.025, p = 0.019, and p = 0.032 respectively). Topical escin applied to a rat tail model of acute lymphedema resulted in a significant reduction in tail volume, reduced dermal thickness, and increased lymphatic structures. The 2% escin concentration may be the optimal dose for improving lymphedema in this model. Further research is warranted to explore the clinical application of escin in patients with lymphedema.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"109-117"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Clinical Characteristics of Patients With Pyoderma Gangrenosum in a Tertiary Referral Hospital: A Retrospective Cohort Study. 三级转诊医院坏疽性脓皮病患者的临床特征：一项回顾性队列研究

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-09-12 DOI: 10.1177/15347346231196957

Elif Afacan Yıldırım, Yusuf Can Edek, Esra Adısen

{"title":"The Clinical Characteristics of Patients With Pyoderma Gangrenosum in a Tertiary Referral Hospital: A Retrospective Cohort Study.","authors":"Elif Afacan Yıldırım, Yusuf Can Edek, Esra Adısen","doi":"10.1177/15347346231196957","DOIUrl":"10.1177/15347346231196957","url":null,"abstract":"Since pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis, epidemiological and clinical data on the disease are scarce. In this single-center retrospective study, we aim to evaluate the clinical characteristics, underlying systemic associations and treatment modalities in patients with PG in a university hospital between 2014 and 2022. It is known that PG most commonly affects the lower extremities, but extracutaneous involvement should also be kept in mind. PG is usually associated with various comorbidities that share a similar inflammatory pathogenesis with the disease. The prevalence of PG-related comorbidities varies in different studies, arthritis and solid organ malignancies were observed most frequently in the current study. Non-PG-related comorbidities including diabetes mellitus, hypertension and peripheral vascular disease can adversely affect wound healing and limit treatment options; therefore, a holistic approach to patients with PG is crucial. Consistent with literature, the mainstay of treatment for PG is systemic corticosteroids and cyclosporine. However, the implementation of biologic agents in treatment-resistant patients is an increasingly important issue in the literature. Antitumor necrosis factors (anti-TNFs) are the most commonly preferred biological therapies, and these agents seem to have paved the way for a paradigm shift in the treatment of PG. In the present study, a relatively high per cent of (23.3%) patients treated with anti-TNFs, most commonly infliximab (87.5%). Recurrence was observed in 46.7% of our patients in the follow-up period and the relapse rate was found to be higher in patients using multiple systemic agents compared to those using single agents (64.7% vs 23.1%, P < .05). In conclusion, we emphasize that early diagnosis and treatment by considering the patient's comorbidities are important in preventing complications, and biologic treatments seem particularly promising in treatment-resistant patients.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"150-154"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10226817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Poor Glycemic Control Is Associated With Lower Interleukin-2 (IL-2) Levels and Low Macrophage Viability in Chronic Diabetic Foot Ulcers (DFUs). 慢性糖尿病足溃疡（DFUs）患者血糖控制不良与白细胞介素-2 （IL-2）水平降低和巨噬细胞活力降低相关

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-07-06 DOI: 10.1177/15347346231182793

Tuhina Banerjee, Shailendra Rai, Aradhana Singh, Aakansha Giri Goswami, Mumtaz Ahmed Ansari, Arvind Pratap, Somprakas Basu, Vijay Kumar Shukla

{"title":"Poor Glycemic Control Is Associated With Lower Interleukin-2 (IL-2) Levels and Low Macrophage Viability in Chronic Diabetic Foot Ulcers (DFUs).","authors":"Tuhina Banerjee, Shailendra Rai, Aradhana Singh, Aakansha Giri Goswami, Mumtaz Ahmed Ansari, Arvind Pratap, Somprakas Basu, Vijay Kumar Shukla","doi":"10.1177/15347346231182793","DOIUrl":"10.1177/15347346231182793","url":null,"abstract":"Low macrophage viability in chronic diabetic foot ulcers (DFUs) may lead to inadequate interleukin (IL) expression and the persistence of infection. This study evaluates the association between macrophage function, IL-2 expression, and wound microflora in chronic DFUs. Diabetic patients with DFUs (group 1, n = 40) and without DFUs (group 2, n = 40) were compared for macrophage function in serum by viability testing. Immunological response was measured by serum IL-1β, IL-2β, and IL-10 levels. The aerobic and anaerobic microflora of the DFUs were assessed by culture and molecular methods. Demographic, clinical, and biochemical factors were statistically analyzed by χ2 test and Student t test. Multiple correspondence analysis (MCA) was used to detect the pattern of association between glycosylated hemoglobin (hemoglobin A1c), serum IL-2 levels, and macrophage viability. Of the total DFU cases, 22 (55%) showed the presence of polymicrobial microflora. Low macrophage viability with predominant Gram-negative flora was seen in 10 (25%) cases in group 1. Serum IL-2 levels were significantly lower (P = .004) in patients in group 1 along with elevated levels of hemoglobin A1c (P = .038). MCA showed an association between low viability of macrophages and lower IL-2 levels and elevated hemoglobin A1c levels with lower serum IL-2 levels. As compared to group 2, the low viability of macrophages was significantly associated (P = .007) with lower IL-2 levels in group 1. Elevated hemoglobin A1c levels are strongly associated with lower IL-2 levels and low macrophage viability. This might be a contributing factor to the persistence of infections in chronic DFUs.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"90-95"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9759539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mönckeberg's Medial Calcific Sclerosis Makes Traditional Arterial Doppler's Unreliable in High-Risk Patients with Diabetes. Mönckeberg内侧钙化硬化使传统动脉多普勒在高危糖尿病患者中的诊断不可靠。

IF 1.5 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2026-03-01 Epub Date: 2023-07-31 DOI: 10.1177/15347346231191588

Mehmet A Suludere, Sahab K Danesh, Amanda L Killeen, Peter A Crisologo, Matthew Malone, Michael C Siah, Lawrence A Lavery

{"title":"Mönckeberg's Medial Calcific Sclerosis Makes Traditional Arterial Doppler's Unreliable in High-Risk Patients with Diabetes.","authors":"Mehmet A Suludere, Sahab K Danesh, Amanda L Killeen, Peter A Crisologo, Matthew Malone, Michael C Siah, Lawrence A Lavery","doi":"10.1177/15347346231191588","DOIUrl":"10.1177/15347346231191588","url":null,"abstract":"ObjectiveTo assess Mönckeberg's medial calcific sclerosis (MMCS) severity in patients with a diabetic foot infection.MethodsThis was an analysis of 2 randomized clinical trials in which we evaluated the treatment of 233 patients admitted to the hospital for moderate and severe foot infections. Arterial calcification was defined as visible radiopaque arteries on foot and ankle radiographs, recorded as the most distal visible artery involved (toes, metatarsals, and ankle/hindfoot).ResultsMost subjects (57.1%, n = 133) had MMCS, with extension to toes in 79 (59.4%), to metatarsals in 32 (24.1%), and to ankle/hindfoot in 22 patients (16.5%). In 7 patients (5.2%) MMCS was solely seen in dorsalis pedis (DP) artery, in 13 patients (9.8%) in posterior tibialis (PT) artery, and in 113 patients (85.0%) MMCS was seen in both arteries. Only 29.2% (n = 68) of DP arteries and 34.8% (n = 81) of PT arteries were not compressible by Doppler. DP and PT arteries were not compressible more often in MMCS (DP 34.3% vs 20.4%, P = .02 and PT 43.1% vs 21.4%, P < .01), toe-brachial indices of ≥0.7 were significantly more common in people without MMCS (46.0% vs 67.4%, P < .01). In contrast, there were no differences in skin perfusion pressure measurements (>50 mmHg; 67.7% vs 68.0%, P = .96), waveforms (biphasic/triphasic 83.5% vs 77.0%, P = .22), and pulse volume recording (9.6 ± 3.3 vs 13.7 ± 36.0) between patients with and without MMCS.ConclusionMMCS is common in patients with diabetic foot infections. MMCS is associated with noncompressible arterial Doppler studies and likely interferes with the accuracy of arterial Doppler studies.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"103-108"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0