International Journal of Lower Extremity Wounds最新文献

{"title":"Incidence and Risk Factors of Diabetic Foot Syndrome in Patients Early After Pancreas or Kidney/Pancreas Transplantation and its Association with Preventive Measures.","authors":"E Vrátná, J Husáková, K Králová, S Kratochvílová, P Girman, F Saudek, M Dubský, R Bém, V Wosková, A Jirkovská, K Dad'ová, J Vařeková, V Lánská, V Fejfarová","doi":"10.1177/15347346211052155","DOIUrl":"10.1177/15347346211052155","url":null,"abstract":"<p><p>Diabetic foot (DF) can develop in diabetic patients after organ transplantation (Tx) due to several factors including peripheral arterial disease (PAD), diabetic neuropathy and inappropriate DF prevention. <b>Aim:</b> To assess the occurrence of DF and associated risk factors in transplant patients. <b>Methods:</b> Fifty-seven diabetic patients were enrolled as part of this prospective study. All patients underwent organ Tx (01/2013-12/2015) and were followed up for minimum of 12 months up to a maximum of 50 months. Over the study period we evaluated DF incidence and identified a number of factors likely to influence DF development, including organ function, presence of late complications, PAD, history of DF, levels of physical activity before and after Tx, patient education and standards of DF prevention. <b>Results:</b> Active DF developed in 31.6% (18/57) of patients after organ Tx within 11 months on average (10.7 ± 8 months). The following factors significantly correlated with DF development: diabetes control (p = .0065), PAD (p<0.0001), transcutaneous oxygen pressure (TcPO_2;p = .01), history of DF (p = .0031), deformities (p = .0021) and increased leisure-time physical activity (LTPA) before Tx (p = .037). However, based on logistic stepwise regression analysis, the only factors significantly associated with DF during the post-transplant period were: PAD, deformities and increased LTPA. Education was provided to patients periodically (2.6 ± 2.5 times) during the observation period. Although 94.7% of patients regularly inspected their feet (4.5 ± 2.9 times/week), only 26.3% of transplant patients used appropriate footwear. <b>Conclusions:</b> Incidence of DF was relatively high, affecting almost 1/3 of pancreas and kidney/pancreas recipients. The predominant risk factors were: presence of PAD, foot deformities and higher LTPA before Tx. Therefore, we recommend a programme involving more detailed vascular and physical examinations and more intensive education focusing on physical activity and DF prevention in at-risk patients before transplantation.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"283-290"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834226","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":"Topical Administration of <i>Teucrium polium</i> on Diabetic Foot Ulcers Accelerates Healing: A Placebo-Controlled Randomized Clinical Study.","authors":"Hasan Fallah Huseini, Maryam Yaghoobi, Farhad Fallahi, Farzaneh Boroumand, Mohammad Hassan Ezzati, Seyyed Mohammad Tabatabaei, Homa Sotvan, Maryam Ahvazi, Shapour Badiee Aval, Mojtaba Ziaee","doi":"10.1177/15347346211048371","DOIUrl":"10.1177/15347346211048371","url":null,"abstract":"<p><p>Diabetic foot ulcer is one of the most devastating complications of uncontrolled diabetes. Although there have been advances in the management of diabetic foot ulcers, still diabetic foot ulcers are a major cause of many amputations in diabetic patients. <i>Teucrium polium</i> (<i>T. polium</i>) is widely used by folk medicine practitioners in Iran for the treatment of diabetic ulcers.The present study was designed to evaluate the safety and efficacy of topical <i>T. polium</i> ointment besides the standard treatment in diabetic foot ulcers.A total of 70 diabetic patients with foot ulcers grade 1 or 2 according to Wagner's scale were enrolled in this study. Patients were randomly divided into two groups. Patients in both groups received standard treatment for diabetic foot ulcers. In addition, group 1 received topical <i>T. polium</i> ointment, and group 2 received topical placebo ointment for 4 weeks. The <i>T. polium</i> and placebo ointments were rubbed twice daily two hours before the conventional dressing. The ulcer size, healing time, and laboratory tests were measured in both groups at baseline and end of the study after 4 weeks.Twenty-nine patients remained in the <i>T. polium</i> group and 26 in the placebo group until the end of the study. The mean surface area of ulcers was 3.52 ± 1.47 and 3.21 ± 1.67 cm² in <i>T. polium</i> group and placebo group respectively at baseline which decrease to .717 ± .19 and 1.63 ± .72 cm² respectively at the endpoint. The mean ulcer surface area was significantly lower in <i>T. polium</i> compared with the placebo group (<i>p</i> < .0001) at end of the study. Also, the number of patients that completely recovered in the <i>T. polium</i> group was significantly higher than the placebo group (<i>p</i> < .001) at the end of the study.The addition of topical <i>T. polium</i> ointment to standard treatment significantly improves the healing time of diabetic non-infected foot ulcers.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"238-246"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39844742","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":"Cases of Lower Extremity and Perianal Burns at the Burn Center in the Southeast Anatolia of Turkey.","authors":"Ebral Yiğit, Yasemin Demir Yiğit","doi":"10.1177/15347346211049064","DOIUrl":"10.1177/15347346211049064","url":null,"abstract":"<p><p><b>Introduction:</b> In this study, the aim is to discuss the cases of lower extremity and perianal burns at the burn center in the southeast Anatolia of Turkey. <b>Material and methods:</b> A 4-year retrospective study was conducted on 775 patients who had been admitted to Gazi Yaşargil Training and Research Hospital Burn Centre with lower extremity and perianal burn injuries between January 2016 and January 2020. <b>Results:</b> Of the patients, 427 were male and 348 were female. Scald burns are most commonly affect the perianal and lower extremities. The right lower extremity was affected in 602 (77.7%) patients, the left lower extremity was affected in 574 (74.1%) patients and the perineum was affected in 70 (9.0%) patients. Most burn injuries occur in individuals between 0 to 4 years old, and the rate of burn injuries gradually decreases in individuals outside of this age range. No patient underwent colostomy for perianal burns. <b>Conclusion:</b> Early, aggressive and extensive debridement, in addition to adequate antimicrobial therapy, should be performed as the basis of treatment.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"247-251"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39492952","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":"Superficial Tissue Swabs Versus Deep Tissue Samples in the Detection of Microbiological Profile of Infected Diabetic Foot Ulcerations.","authors":"F Camilleri Attard, A Gatt, C Formosa","doi":"10.1177/15347346211053481","DOIUrl":"10.1177/15347346211053481","url":null,"abstract":"<p><p>This study aimed to determine the most accurate microbiological test for the detection of micro-organisms in infected diabetic foot ulcerations in people living with type-2 Diabetes. For 20 eligible patients, a superficial tissue swab and a deep tissue sample were taken during a regular appointment at a Diabetes out-patient's Podiatry Clinic. Two specimens were collected from each wound for microbial culturing after debridement. Infected foot ulcerations were graded according to the Wagner's classification as per clinical protocol. This study found a significant difference [p = 0.028] between the two different samples. The deep tissue sample was found to be more accurate in identifying micro-organisms than the superficial swabs, although the latter is more widely used in clinical practice. Further studies are warranted to provide more evidence to clinicians on the best method to adopt when swabbing different types of diabetic foot ulcerations with different wound classification since, it is clearly still a matter of debate how to detect wound infection.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"315-319"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39557687","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":"Challenges and Prospects of Development of Herbal Biomaterial Based Ethical Wound Care Products-A Scoping Review.","authors":"Jayasutha Jayram, Satish S Kondaveeti, Christian Gnanaraj Johnson, Preethi J Sampath, Mangathayaru Kalachaveedu","doi":"10.1177/15347346211052140","DOIUrl":"10.1177/15347346211052140","url":null,"abstract":"<p><p>Total wound care is an unmet therapeutic need considering the morbidity and mortality associated with the rising prevalence of nonhealing/chronic wounds. Current wound management fails to address all aspects/types of wounds despite the availability of scores of traditional and modern, investigational products. Traditional medicine drugs of wound healing repute validated to target multiple biological pathways and key events in the mammalian wound healing cascade, reportedly affecting wound healing phases. Advances in the development of biocomposite matrices and their analytical characterization warrant a relook at consolidating time-tested wound healing properties of herbal bioactives for prospective development as ethical wound care products. Aside from the bottlenecks of their multiconstituent profiling and clinical trial data generation, regulatory hurdles also cloister any systematic attempts at their re-engineering into clinical deliverables. In the context of national policy changes to bring in totally indigenous solutions, countries with a huge knowledge/material resource on wound healing bioactives need to essentially facilitate the same.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"291-305"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39570104","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":"Retracted: \"The Leg Subcutaneous Tissue Calcification and Venous Ulcer-a Case Series\".","authors":"","doi":"10.1177/15347346231175814","DOIUrl":"10.1177/15347346231175814","url":null,"abstract":"","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"347"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9566105","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":"Efficacy and Safety of Pentoxifylline for Venous Leg Ulcers: An Updated Meta-Analysis.","authors":"Shi-Yi Sun, Yan Li, Yun-Yi Gao, Xing-Wu Ran","doi":"10.1177/15347346211050769","DOIUrl":"10.1177/15347346211050769","url":null,"abstract":"<p><p>The venous leg ulcers are debilitating, painful, and often unresponsive to advanced dressing treatments, so drugs used locally and systematically are essential adjuvant therapy-pentoxifylline (PTX) whose anti-inflammatory effects may offer a promising avenue to treat venous leg ulcers. However, the current results are controversial. To further evaluate the efficacy and safety of PTX, we performed an updated meta-analysis of randomized placebo-controlled trials of PTX in the treatment of venous leg ulcers. We systematically searched multiple electronic databases PubMed, Web of Science, Embase, the Cochrane Library, the Cochrane Central Register of Controlled Trials, China Science and Technology Journal Database, WanFang Data, China National Knowledge Infrastructure, and the Chinese Biomedical Literature Database to identify eligible studies. Randomized clinical trials of pentoxifylline versus placebo treatment in patients with venous leg ulcers were considered for inclusion. The primary outcomes included ulcer healing rate and the incidence of adverse events after treatment. The secondary outcomes were the ulcer significant improvement (the ulcer size shrank by more than 60% after treatment) rate, mean duration of complete wound healing and changes in mean ulcer size. A meta-analysis and qualitative analysis were conducted to estimate endpoints. A total of 13 randomized clinical trials, including 921 individuals, were finally included. Compared with placebo, pentoxifylline significantly improved the ulcer healing rate (RR = 1.59, 95%CI 1.22 to 2.07, <i>P</i> < .001) and significant improvement rate (RR = 2.36, 95%CI 1.31 to 4.24, <i>P</i> = .004) while increased the incidence of gastrointestinal disturbances (RR = 2.29, 95%CI 1.04 to 5.03, <i>P</i> = .04) at the same time. Moreover, pentoxifylline also shortened mean duration of complete wound healing (<i>P</i> = .007) and shrank ulcer size (<i>P</i> = .02). Currently available evidence suggests that pentoxifylline could help venous leg ulcers heal more quickly and effectively. However, the evidence is insufficient to prove the results due to moderate-certainty evidence. Large-scale, well-designed randomized clinical trials are warranted.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"264-274"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39625571","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":"Clinical and Microbiological Profile of Diabetic Foot Ulcers Infected With <i>Staphylococcus aureus</i> in a Regional General Hospital in Bahia, Brazil.","authors":"Luciano Dias Nascimento, Arthur César Pacheco Lopes, Mariana Morais Teixeira, Jade Magalhães Alves da Silva, Letícia Oliveira Silva, Jessica Bomfim de Almeida, Guilherme Barreto Campos, Rosa Teodósio, Lucas Miranda Marques","doi":"10.1177/15347346211050771","DOIUrl":"10.1177/15347346211050771","url":null,"abstract":"<p><p>It is necessary to know the resistance profile of <i>Staphylococcus aureus</i> to better control diabetic foot ulcer infections, to establish rational antibiotic therapy, and to avoid the development of resistant strains. This cross-sectional study evaluated the clinical parameters, virulence, and antimicrobial resistance profiles of <i>S aureus</i> in patients with diabetic foot disease admitted to a public hospital. <i>S aureus</i> strains were identified in patients with diabetes with amputation indication. Infected tissue samples were collected, microbes were isolated and identified. The microbial resistance profile was determined. Samples were also analyzed for biofilm formation and other virulence markers. The 34 individuals examined were mostly men, black, aged 60 years on average, and generally had a low income and education level. Most individuals had type 2 diabetes, and the mean time since diagnosis was 13.9 years. On an SF-36 (the Medical Outcomes Study 36-item short-form health survey) quality-of-life questionnaire, 75% of individuals obtained a score equal to 0 for physical impairment. <i>S aureus</i> specimens from 17 patients were isolated, corresponding to 50% of samples. Five isolates were classified as methicillin-resistant <i>S aureus</i> (MRSA). Molecular typing revealed that 20% of MRSA strains were SCC<i>mec</i> type V and 80% were type I. All isolates were sensitive to doxycycline; 61.5% were resistant to erythromycin, 38.5% to cefoxitin, 30.7% to clindamycin and ciprofloxacin, 23% to meropenem, 15.3% to gentamicin, 38.5% to oxacillin, and 7.7% (one strain) to vancomycin. Regarding biofilm production, 53% of samples were able to produce biofilms, and 84.6% had <i>icaA</i> and/or <i>icaD</i> genes<i>.</i> Additionally, the following enterotoxin genes were identified in the isolates: <i>seb, sec, seg,</i> and <i>sei</i> (5.9%, 5.9%, 11.8%, and 23.9%, respectively) and <i>agr</i> types 1 (5.9%) and 2 (11.8%). Genotypic evaluation made it possible to understand the pathogenicity of <i>S aureus</i> strains isolated from the diabetic foot; laboratory tests can assist in the monitoring of patients with systemic involvement.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"252-263"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39688314","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":"Leg Ulcers in a Patient With Systemic Lupus Erythematosus and Successful Treatment With Anticoagulant Therapy","authors":"Öykü Gönüllü, Filiz C. Kahraman, Umut Mert Yıldırım","doi":"10.1177/15347346241248260","DOIUrl":"https://doi.org/10.1177/15347346241248260","url":null,"abstract":"Among specific skin manifestations of systemic lupus erythematosus such as leukocytoclastic vasculitis, and vasculopathy, the development of leg ulcers is rare and frequently seen in patients with antiphospholipid antibody positivity. Here we report the rapid healing of a leg ulcer without antiphospholipid antibody positivity in a patient with lupus in response to anticoagulant therapy. As in our case, when immunosuppressive agents are inadequate in lupus patients who develop leg ulcers, it may be beneficial to support the treatment with anticoagulants.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":"4 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140625226","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":"Appropriateness of Artificial Intelligence Chatbots and Diabetic Foot Ulcer Management: Comment","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/15347346241247914","DOIUrl":"https://doi.org/10.1177/15347346241247914","url":null,"abstract":"","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":"103 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140614824","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}