International Journal of Lower Extremity Wounds最新文献

{"title":"Exercise Training as an Adjunctive Therapy for Chronic Venous Insufficiency Patients: Evidence from Research to Practice.","authors":"Sothida Nantakool, Busaba Chuatrakoon, Maurits van der Veen, Amaraporn Rerkasem, Kittipan Rerkasem","doi":"10.1177/15347346211060126","DOIUrl":"10.1177/15347346211060126","url":null,"abstract":"<p><p>Chronic venous insufficiency, which is defined as a condition relevant to persistent ambulatory venous hypertension, is a common cause of venous leg ulcers. Compression therapy is commonly used to relieve ambulatory venous hypertension and heal leg ulcers. Exercise is considered as adjunctive therapy, targeting calf muscle pump function, to additionally favor the compression treatment for facilitating the healing process. Different exercise training regimens for promoting wound healing and its relevant outcomes are reviewed and discussed in this study.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"360-364"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634989","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}

{"title":"The Effect of Topically Applied Boric Acid on Ephrin-Eph Pathway in Wound Treatment: An Experimental Study.","authors":"Başak Büyük, Cemre Aydeğer, Yasemen Adalı, Hüseyin Avni Eroğlu","doi":"10.1177/15347346211055260","DOIUrl":"10.1177/15347346211055260","url":null,"abstract":"<p><p><b>Background:</b> Wound healing has a vital importance for the organism and various agents are used to accelerate wound healing. Although the effect of boron on wound healing is known, its mechanisms are not completely clear yet. In this study, the effect of boron in the Ephrin /Eph pathway will be evaluated. <b>Methods:</b> Forty adult female rats were used in the study. A full-thickness excisional wound model was created in all groups divided as Control, Fito, Boron and Plu groups. After the applications performed twice a day and lasting 7 days, skin tissues obtained and evaluated histopathological (inflammatory cell infiltration, oedema, and fibroblast proliferation density) and immunohistochemical (TNF-α, EphrinA1, EphrinB1, EphrinB2 and EphB4). <b>Results:</b> Inflammatory cell infiltration score was found to be higher in the Fito group compared to Boron group (p = .018). Fibroblast proliferation density was higher in Plu group than Boron group (p = .012). While TNF-α was lower in boron group than Plu (p = .027) and Fito (p = .016) groups, EphrinA1 was higher in Boron group than Plu group (p = .005). EphrinB1 expression was higher in Boron group compared to Plu (p = .015) and Fito (p = .015) groups, and the same difference was also observed in EphrinB2 (p values .000). Similarly, EphB4 immunoreactivity was higher in the Boron group compared to Plu (p = .000) and Fito (p = .002). <b>Conclusion:</b> One of the mechanisms of action of boron in wound healing is to increase EphrinB1, EphrinB2 and EphB4. Low TNF-α and histopathological findings indicate that boron limits extensive wound healing.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"379-389"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39889199","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}

{"title":"Evaluation of Wound Healing Activity of Sea Cucumber <i>Holothuria parva</i> Hydroalcoholic Extract in Rat.","authors":"Elnaz Bazmakdar, Eskandar Moghimipour, Neda Sistani Karampour, Annahita Rezaie, Seyed Mohammad Bagher Nabavi","doi":"10.1177/15347346211059331","DOIUrl":"10.1177/15347346211059331","url":null,"abstract":"<p><p>A significant challenge in biomedicine is the development of Biomaterials with the potential to accelerate wound healing. The aim of this study was to investigate the effect of the gel prepared from sea cucumber on wound healing in rats. Full-thickness wounds were created in male rats divided into five experimental groups, negative control (NC), positive control (PC), and treatments. The NC and PC groups received respectively gel base and phenytoin cream 1%. Treatment groups were treated topically by gels of 1%, 3%, and 5% <i>Holothuria parva</i> extract (HPE) in the gel base. The rats were sacrificed on days 7, 14, and 21. Pathological reports revealed the proliferation of keratinocytes in the borders of the wound in treatment groups and controls. Formation of granulation tissue was seen on day 7 in treatment groups, collagen fibers in granulation tissue were randomly organized, and the rate of fibroblast decreased. Results showed that there were statistically significant differences in wound contraction between all groups in comparison to the NC group (<i>P</i> < .05) on day 8. It was concluded that the 1% HPE gel has a good potential for promoting wound healing.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"412-420"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39901990","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}

{"title":"Sensory Reconstruction of a Posterior Heel Defect Using a Proximally Based Sensate Medial Plantar Flap with Retrograde Nerve Cleavage Technique.","authors":"Sung Yoon Jung, Min Bom Kim, Young Ho Lee","doi":"10.1177/15347346211055261","DOIUrl":"10.1177/15347346211055261","url":null,"abstract":"<p><p>Reconstruction of posterior heel defects is important because it requires thick and durable skin that can withstand pressure and shear from shoe and bed contact. Therefore, the sensate flap could be a better option for the defect. This paper reports on the safety of a medial plantar sensory flap for these defects as well as an objective measurement of the sensation of the medial plantar flap and the plantar surface distal to the donor site. Twelve patients had soft-tissue defects in the posterior heel and underwent reconstructive surgery using a proximally based sensate medial plantar sensory flap. Cases of plantar defects involving not posterior heel were excluded. For wider flap coverage, special neurovascular dissection was required. We evaluated levels of sensation quantitatively using Semmes-Weinstein (SW) monofilaments and a two-point discriminator at the final follow-up. All flaps survived without major complications. Postoperative follow-up was 12 to 64 months (mean 26 months). All 12 flaps healed without postoperative complications. There was no significant difference in minimal two-point discrimination and SW evaluator size between the transferred medial plantar flap area and the contralateral heel area or between the plantar area distal to the donor site and the contralateral side. Patients could walk normally and sleep without protective shoes or brace. A proximally based sensate medial plantar flap is a good option for the reconstruction of posterior heel defects. It can restore the characteristics of the posterior heel for shoe wearing and sleeping.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"372-378"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39599021","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}

{"title":"Sticking to What Matters: A Matched Comparative Study of Fibrin Glue and Mechanical Fixation for Split-Thickness Skin Grafts in the Lower Extremity.","authors":"Sammy Othman, Charles A Messa, Omar Elfanagely, Bradford Bormann, Joseph A Mellia, Robyn B Broach, Stephen J Kovach, John P Fischer","doi":"10.1177/15347346211047748","DOIUrl":"10.1177/15347346211047748","url":null,"abstract":"<p><p><b>Background:</b> Split-thickness skin grafts (STSGs) remain a valuable tool in the reconstructive surgeons' armamentarium. Staple or suture mechanical fixation (MF) serves as the gold standard of care, though fibrin glue (FG) has gained popularity as a fixation modality. We compare STSG outcomes following application of FG versus MF through a study of lower extremity wounds. <b>Methods:</b> A retrospective review (2016-2019) of patients who underwent a STSG was performed. Two cohorts consisting of patients undergoing a STSG with FG or MF (suture or staple) were matched according to wound size, wound location, and body mass index. <b>Results:</b> A total of 67 patients with 79 wounds were included (FG: n = 30, wounds = 39; MF: n = 37; wounds = 40). There was no significant difference between groups regarding time to 100% graft take (FG: 39 days, MF: 35.1 days; <i>P</i> < .384) or 180-day graft complications (FG: 10.3%, MF: 15%; <i>P</i> < .737). Adjusted operative time for FG (51.8 min) was lower than for MF cases (67.5 min) at a level that approached significance (<i>P</i> < .094). FG patients were significantly less likely to require a postoperative wound vacuum-assisted closure (VAC) (FG: 16.7%; MF: 76.7%; <i>P</i> < .001) and required a significantly lower number of 30-day postoperative visits (FG: 1.5 ± .78 visits; MF: 2.5 ± .03 visits; <i>P</i> < .001). The MF group had higher mean aggregate charges ($211,090) compared with the FG group (mean: $149,907), although these were not statistically significant (<i>P</i> > .05). <b>Conclusion:</b> The use of FG for STSG shows comparable clinical outcomes to MF, with a significantly decreased need for postoperative wound VAC, the number of 30-day postoperative visits, and a lower wound-adjusted operative time.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"231-237"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39483039","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}

{"title":"An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox^™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial).","authors":"Tjun Yip Tang, Manfred Y Q Mak, C J Q Yap, J E C Boey, Sze Ling Chan, Shereen X Y Soon, I A B Ishak, R W L Lee, Xin Jie Soh, Wan Xi Goh","doi":"10.1177/15347346211053694","DOIUrl":"10.1177/15347346211053694","url":null,"abstract":"<p><p>Natrox^™ topical oxygen therapy (TOT) (<i>Inotec AMD Ltd</i>, Cambridgeshire, UK) employs a small battery-powered \"oxygen generator\" to concentrate atmospheric oxygen and feeds pure, moist, oxygen through a fine, soft tube to a dressing-like \"oxygen distribution system\", which is placed over the wound and is held in place by a conventional dressing. The aim was to determine the effectiveness of Natrox^™ for non-healing diabetic foot ulcers (DFU) over a 3-month period.Longitudinal, single-arm, open prospective registry study using 12 weeks of TOT using a 4 week run-in period. 20 patients recruited to <i>OTONAL</i> had chronic DFU greater than 3 months duration or minor amputation sites with less than 50% healing in 4 weeks.There were 13 (65%) males and the mean age was 65.7 (±11.6) years. The mean glycated haemoglobin (HbA1c) was 6.9 (±1.3) mmol mol^-1 and mean wound duration before TOT was 114 (±79.1) days. 18/20 (90.0%) patients had concomitant lower limb revascularization angioplasty for chronic limb threatening ischaemia. The mean size of the foot ulcer at baseline was 11.3 ± 14.8 cm² and mean transcutaneous oxygen measurement value was 34.1 (±19.6) mm Hg. Wound closure of >75% was observed in 14/20 (70.0%) patients. There was a 91.3% (±14.9%) wound area reduction by 3 months (P = .001) and mean time for 100% closure was 77.6 ± 32.5 days. Mean pain scores reduced from 2.4 (±1.8) at baseline to .5 (±1.0) at 3 months (P = .008). All patients were very satisfied using the ambulatory device. Use of TOT in chronic diabetic foot wounds stimulates a healing state, underpinning the concept that oxygen plays a central role in wound healing. Our results are more compelling if you consider they started with relatively large-sized DFUs and majority of patients were frail with underlying peripheral artery disease. (NCT03863054).</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"326-337"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11059837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39599319","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}

{"title":"Microbiological Species and Antibiotic Resistance in Diabetic and Nondiabetic Lower Extremity Wounds: A Comparative Cross-Sectional Study.","authors":"Vanessa P Dos Santos, Maria G M de Andrade Barberino, Carlos A S Alves","doi":"10.1177/15347346211053936","DOIUrl":"10.1177/15347346211053936","url":null,"abstract":"<p><p>Severe lower extremity wounds have an increased risk of complications and limb loss. The aim of this study was to evaluate and compare the microbiological profile and antibiotic resistance of wounds in diabetic and nondiabetic patients. A cross-sectional comparative study was carried out at a public hospital including 111 patients with moderate to severe wound infections. Tissue samples were collected during a surgical procedure. One hundred and four patients (94%) had positive cultures and 88 (79%) had a Gram-negative microorganism. Among the 185 cultured microorganisms, 133 (72%) were Gram-negative species. <i>Pseudomonas aeruginosa</i> (23 cases) was the most isolated Gram-negative species, and <i>Enterococcus faecalis</i> (26 cases) was the most prevalent Gram-positive species. Among 185 isolated species, 45 (24%) were extended-spectrum beta-lactamase producers, 23 (12%) were carbapenem-resistant, and 5 (3%) were methicillin-resistant <i>Staphylococcus aureus</i>. Findings revealed that there was no significant difference in the microbiological profile and antibiotic resistance among patients with lower extremity wounds whether they were diabetic or nondiabetic.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"338-346"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11059827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39599422","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}

{"title":"Significance of Neutrophil to Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in Diabetic Foot Ulcer and Potential New Therapeutic Targets.","authors":"Dragos Serban, Nikolaos Papanas, Ana Maria Dascalu, Peter Kempler, Itamar Raz, Ali A Rizvi, Manfredi Rizzo, Corneliu Tudor, Mihail Silviu Tudosie, Denisa Tanasescu, Anca Pantea Stoian, Evanthia Gouveri, Daniel Ovidiu Costea","doi":"10.1177/15347346211057742","DOIUrl":"10.1177/15347346211057742","url":null,"abstract":"<p><p>Diabetic foot ulcer (DFU) is a well-known complication of diabetes and a significant burden on the national health systems. The neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio are inexpensive and easily accessible biomarkers that have proved to be useful in several inflammatory, infectious and cardiovascular diseases. We carried out a comprehensive review examining the association of NLR and PLR with the onset and progression of DFU. PLR and NLR were significantly increased in patients with DFU, compared with a control group of T2DM patients without DFU, and correlate well with DFU severity, evaluated by Wagner and IWGDF grading scales. In patients with diabetic foot infections (DFI), elevated NLR and PLR were correlated with osteomyelitis, increased risk of amputation, and septic complications. The significance of the elevated value of these biomarkers in DFU is related to chronic hyperglycemia and low-grade systemic inflammation, atherosclerotic and vascular complications, and also the associated septic factor. Serial, dynamic follow-up can provide useful information in planning and monitoring DFU treatment, as well as in risk stratification of these vulnerable patients. Further randomized studies are needed to set the cut-off values with clinical significance.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"205-216"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39887750","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}

{"title":"Neuroanatomy of the Cutaneous Nervous System Regarding Wound Healing.","authors":"Shealinna Ge, Amor Khachemoune","doi":"10.1177/15347346211054598","DOIUrl":"10.1177/15347346211054598","url":null,"abstract":"<p><p>Wound healing is an important topic in modern medicine across many disciplines. Healing of all cutaneous wounds, whether accidentally sustained or intentionally created, requires the common yet complex set of interactions between the immune, circulatory, nervous, endocrine, and integumentary systems. Deficits in any of these systems or the molecular factors that mediate their communications can contribute to impaired healing of cutaneous wounds. While the stages of wound repair, angiogenesis, growth factors, and cytokines involved have been extensively studied, the role of the cutaneous nervous system in wound healing has not been well outlined. We have provided a basic overview of cutaneous innervation and wound repair for the dermatologic surgeon by outlining the normal cutaneous nervous anatomy and function and discussing the most important neuropeptides that mediate the wound healing process.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"191-204"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39625416","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}

{"title":"Differential Diagnosis of Charcot Neuroarthropathy in Subacute and Chronic Phases: Unusual Diseases.","authors":"Gabriela Verónica Carro, Anahí Ricci, Ivan Torterola, Rubén Saurral, Valeria Portillo, Pablo Salvador Amato, Pablo Breppe, Brenda Rosito, Brian Flores, Miguel Ticona Ortiz","doi":"10.1177/15347346211054326","DOIUrl":"10.1177/15347346211054326","url":null,"abstract":"<p><p>Charcot Neuroarthropaty (CN) is a complication of diabetes with devastating consequences as it produces severe deformities in the foot developing in recurrent ulcers that rise the probability of amputation. There are several diseases mentioned in the literature that have to be considered for the differential diagnosis of CN, often related to the acute phase (gout, ankle sprain, inflammatory arthritis, cellulitis, venous thrombosis) but there is paucity of information related to the differential diagnosis in later stages (coalescence, remodeling) when there is deformity of the foot. Clinicians and diabetologists are not familiarized with orthopedic pathology and do not have in mind certain diseases that could mimic CN in the subacute or chronic phases and this can develop in a wrong diagnosis. It is important to make a correct diagnosis in patients with suspected CN not only in the acute phase but also in the chronic phase to establish an accurate treatment. This article is a review of the differential diagnosis of CN in subacute and chronic phases showing similarities and differences that can help clinicians and diabetologists to make an accurate diagnosis and treatment. We describe unusual diseases like tendon and muscles disorders, Frieberg's disease, complex pain regional syndrome, transient regional osteoporosis and osteomyelitis superimposed to CN and the main features of each one that could help in making a differential diagnosis.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"181-190"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39625567","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}