International Journal of Lower Extremity Wounds最新文献_第4页

Management of Diabetic Foot Ulcer with MA-ECM (Minimally Manipulated Autologous Extracellular Matrix) Using 3D Bioprinting Technology - An Innovative Approach. 利用三维生物打印技术微调自体细胞外基质（MA-ECM）治疗糖尿病足溃疡--一种创新方法。

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-10-12 DOI: 10.1177/15347346211045625

Rajesh Kesavan, Changam Sheela Sasikumar, V B Narayanamurthy, Arvind Rajagopalan, Jeehee Kim

{"title":"Management of Diabetic Foot Ulcer with MA-ECM (Minimally Manipulated Autologous Extracellular Matrix) Using 3D Bioprinting Technology - An Innovative Approach.","authors":"Rajesh Kesavan, Changam Sheela Sasikumar, V B Narayanamurthy, Arvind Rajagopalan, Jeehee Kim","doi":"10.1177/15347346211045625","DOIUrl":"10.1177/15347346211045625","url":null,"abstract":"Chronic foot ulcers are the leading cause of prolonged hospitalization and loss of social participation in people with diabetes. Conventional management of diabetic foot ulcers (DFU) is associated with slow healing, high cost, and recurrent visits to the hospital. Currently, the application of autologous lipotransfer is more popular, as the regenerative and reparative effects of fat are well established. Herein we report the efficacy of minimally manipulated extracellular matrix (MA-ECM) prepared from autologous homologous adipose tissue by using 3D bioprinting in DFU (test group) in comparison to the standard wound care (control group). A total of 40 subjects were screened and randomly divided into test and control groups. In the test group, the customized MA-ECM was printed as a scaffold from the patient autologous fat using a 3D bioprinter device and applied to the wound directly. The control group received standard wound care and weekly follow-up was done for all the patients. We evaluated the efficacy of this novel technology by assessing the reduction in wound size and attainment of epithelialization. The patients in the test group (n = 17) showed complete wound closure with re-epithelialization approximately within a period of 4 weeks. On the other hand, most of the patients in the control group (n = 16) who received standard wound dressings care showed a delay in wound healing in comparison to the test group. This technique can be employed as a personalized therapeutic method to accelerate diabetic wound healing and may provide a promising potential alternative approach to protect against lower foot amputation a most common complication in diabetes.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"161-168"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39507430","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

Controversial Issues Regarding Positive Bone Margins in Surgery for Diabetic Foot Osteomyelitis: A Pilot Study. 糖尿病足骨髓炎手术中有关阳性骨缘的争议问题：一项试点研究。

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-09-07 DOI: 10.1177/15347346211041267

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

{"title":"Controversial Issues Regarding Positive Bone Margins in Surgery for Diabetic Foot Osteomyelitis: A Pilot Study.","authors":"Javier Aragón-Sánchez, Gerardo Víquez-Molina, María Eugenia López-Valverde","doi":"10.1177/15347346211041267","DOIUrl":"10.1177/15347346211041267","url":null,"abstract":"Obtaining clean margins in patients who undergo surgical treatment for diabetic foot osteomyelitis (DFO) is recommended. We hypothesize that the rate of recurrence of the infection is not associated with positive margins, even when using a short-term duration of postoperative antibiotic treatment. We conducted a retrospective pilot study of patients who underwent surgery for DFO confirmed by histopathological analysis of the resected bone from August 1, 2020, to December 1, 2020. Bone samples were taken from the proximal margins to be studied by microbiology and histopathology. Twenty-five (89.3%) patients underwent conservative surgery, and 3 (10.7%) patients underwent a minor amputation. After surgery, the antibiotics were stopped in 19 (67.9%) patients and continued in 9 (32.1%) patients for a median period of 4 days. The microbiology of the bone margins was positive in 20 (71.4%) cases, but the histopathology of the bone margins was positive in just 7 (25%) cases. Recurrence of the infection was detected in 3 (10.7%) patients. Seventeen (68%) patients with microbiological-positive margins did not have a recurrence of infection, while 3 (100%) patients had a recurrence of infection (P = .53). Six (24%) patients among those with histopathological-positive margins did not have a recurrence of infection, and1 (33.3%) patient had a recurrence of infection (P = 1). The recurrence of infection was low and always detected in soft tissues, including the cases with a histopathological-positive bone margin. Postoperative antibiotics were administered for a short period of time and not based on the analysis of bone margins.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"109-115"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39389085","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

Efficacy of Chinese and Western Medical Techniques in Treating Diabetic Foot Ulcers With Necrotizing Fasciitis of the Lower Leg. 中西医结合疗法治疗糖尿病足溃疡合并小腿坏死性筋膜炎的疗效。

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2023-01-17 DOI: 10.1177/15347346221150865

Yongchong Chen, Yunzhu Wang, TaiAn Zhang, Chao Meng, Qing Li, Bohui Zhang, Kai Zhang, Chunfang Qin

{"title":"Efficacy of Chinese and Western Medical Techniques in Treating Diabetic Foot Ulcers With Necrotizing Fasciitis of the Lower Leg.","authors":"Yongchong Chen, Yunzhu Wang, TaiAn Zhang, Chao Meng, Qing Li, Bohui Zhang, Kai Zhang, Chunfang Qin","doi":"10.1177/15347346221150865","DOIUrl":"10.1177/15347346221150865","url":null,"abstract":"To analyze and evaluate the clinical efficacy of Chinese and Western medical techniques in the treatment of severe diabetic foot ulcers complicated with necrotizing fasciitis of the lower leg and summarize the treatment experience of such patients to identify a new method of limb salvage treatment. A total of 46 patients with severe diabetic foot ulcers and necrotizing fasciitis of the lower leg were treated with such techniques as surgical debridement, bone drilling, open joint fusion, and microskin implantation. Wounds were treated with moisture-exposed burn therapy (a regenerative medical treatment for burns, wounds, and ulcers) and moisture-exposed burn ointment (a traditional Chinese medicine); underlying diseases were also treated effectively. The wound healing time, rate of high amputation, and mortality of these patients were summarized, and the clinical efficacy of such treatments was evaluated. Of the 46 patients enrolled, 38 patients were cured, with a cure rate of 82.61%. The average wound healing time was 130 ± 74.37 days. Two patients underwent high amputations, with an amputation rate of 4.35%, and 4 deaths occurred, with a mortality rate of 8.70%. The combination of Chinese and Western medical techniques in the treatment of severe diabetic foot ulcers complicated with necrotizing fasciitis of the lower leg not only effectively saved patients' lives and promoted wound healing but also greatly reduced the rates of high amputation and disability.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"70-79"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540994","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

Undergraduate Medical Education During the Pandemic: How do Academic Staff Members in Greece and Cyprus Feel About it? 大流行病期间的本科医学教育：希腊和塞浦路斯的教职员工有何感想？

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-09-20 DOI: 10.1177/15347346211045285

Anna Eleftheriou, Aikaterini Rokou, Polyxeni Doukaki, Ioannis Kapetanios, Panagiota Diamantopoulou, Theodore G Papaioannou, Theodore Lytras, Nikolaos Papanas, Theodoros C Constantinidis, Evangelia Nena

{"title":"Undergraduate Medical Education During the Pandemic: How do Academic Staff Members in Greece and Cyprus Feel About it?","authors":"Anna Eleftheriou, Aikaterini Rokou, Polyxeni Doukaki, Ioannis Kapetanios, Panagiota Diamantopoulou, Theodore G Papaioannou, Theodore Lytras, Nikolaos Papanas, Theodoros C Constantinidis, Evangelia Nena","doi":"10.1177/15347346211045285","DOIUrl":"10.1177/15347346211045285","url":null,"abstract":"This study used a questionnaire to examine how academic staff members in Greece and Cyprus feel about the changes in undergraduate medical education during the COVID-19 pandemic. In general, e-learning was not considered an adequate way of teaching and was less enjoyable. Participants aged 31-40 years experienced more (P = .001), while staff in higher academic ranks less difficulty (P < .001) in adjustment. There was a small increase in workload, which was higher among respondents researching into COVID-19 (P = .001). During the pandemic, daily screen use >6 h was increased from 28.8% to 57.5%. The majority (74.2%) stated that scientific and educational training opportunities were not affected by the pandemic. In conclusion, the pandemic has induced important changes in undergraduate medical education. This new condition was considered adequate but not pleasant, with younger faculty members being more burdened.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"148-152"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39431555","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

Ameliorative and Disinfection Effects of Ultraviolet-C Radiation on Experimentally Induced and Infected Skin Wounds: A Mice Model Study. 紫外线-C 辐射对实验性和感染性皮肤伤口的改善和消毒作用：小鼠模型研究。

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-09-13 DOI: 10.1177/15347346211041869

Ozlem Ozmen, Ezgi Sababoglu, Zafer Ozyildiz, Adem Milletsever, Gozde Okuyucu

{"title":"Ameliorative and Disinfection Effects of Ultraviolet-C Radiation on Experimentally Induced and Infected Skin Wounds: A Mice Model Study.","authors":"Ozlem Ozmen, Ezgi Sababoglu, Zafer Ozyildiz, Adem Milletsever, Gozde Okuyucu","doi":"10.1177/15347346211041869","DOIUrl":"10.1177/15347346211041869","url":null,"abstract":"Only ultraviolet-C (UV-C) from UV lights, which are emitted by the sun and absorbed by the atmosphere's ozone layer, does not reach the Earth's surface. UV-C is a powerful disinfection method that is commonly used to sterilize fluids, air, and surfaces. There is a little knowledge of the effects of UV-C radiation on living bodies. The purpose of this study is to examine the ameliorative effect of UV-C on skin lesions in mice that have been experimentally created and infected with Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus sp. In total, 32 mice were used, and 4 mm skin defects were created and lesions infected with bacteria. Half of the mice in each group were treated with 254 nm UV-C twice a day for 4 days before being euthanatized. Blood samples were collected for hematological analysis, while skin samples were collected for microbiological, pathological, and immunohistochemical examinations. In addition, pathological examinations were performed on visceral organ samples. UV-C treatment caused rapid healing and complete or significant disinfection of skin lesions. Moreover, UV-C treatment reduced caspase-3 expressions in lesioned areas, according to immunochemistry. There were no pathological findings in visceral organs as a result of UV-C treatment. This study found that UV-C can be used to treat and disinfect infected skin lesions in short period and repeated doses.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"116-123"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39414449","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

Photodynamic Therapy With RLP068 and 630-nm Red LED Light in Foot Ulcers in Patients With Diabetes: A Case Series. 使用 RLP068 和 630-nm 红色 LED 光的光动力疗法治疗糖尿病患者足部溃疡：病例系列。

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-10-25 DOI: 10.1177/15347346211053403

Rosario Mancusi, Gabriella Nosso, Salvatore Pecoraro, Mariella Barricelli, Andrea Russo

{"title":"Photodynamic Therapy With RLP068 and 630-nm Red LED Light in Foot Ulcers in Patients With Diabetes: A Case Series.","authors":"Rosario Mancusi, Gabriella Nosso, Salvatore Pecoraro, Mariella Barricelli, Andrea Russo","doi":"10.1177/15347346211053403","DOIUrl":"10.1177/15347346211053403","url":null,"abstract":"The management and healing of lower extremity ulcers have always been a complex health problem because the clinical course is typically chronic, the results are often poor, and the socioeconomic impact is considerable. The healing process of foot ulcers of people with diabetes is further hindered by the concomitant presence of obstructive arterial disease, neuropathy, and foot malformation. It is frequently associated with multiresistant infections and often results in micro/macro amputations. Photodynamic therapy employs a photosensitizer activated by light of a specific wavelength able to generate reactive oxygen species, which initiate further oxidative responses locally with components of the bacteria. The experience of the treatment center for the lower extremity ulcers in 17 persons with diabetes in Acerra (Italy) with photoactivated RLP068, reported here, corroborates the results of the clinical trials and of the previous case reports. In all cases, examined photodynamic therapy with photosensitizer RLP068 and red light at 630 nm was found to reduce lesion area and inflammation and to ensure the decrease of bacterial load, hence reducing treatment times and antibiotics use, improving patient outcomes, and reducing the incidence of amputations. The simultaneous combination of photodynamic therapy with other ancillary physical-based treatments such as therapeutic magnetic resonance or Bio-Electro-Magnetic-Energy-Regulation was observed to be safe, time-saving, and able to lead to faster healing.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"99-103"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39557681","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

Diagnostic Key Points and Surgical Management of Necrotizing Fasciitis: A Retrospective Study. 坏死性筋膜炎的诊断要点和手术治疗：一项回顾性研究

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-10-06 DOI: 10.1177/15347346211045282

Xiaojing Ge, Yute Sun, Jing Lin, Fang Zhou, Gang Yao, Binlin Luo, Xin Su

{"title":"Diagnostic Key Points and Surgical Management of Necrotizing Fasciitis: A Retrospective Study.","authors":"Xiaojing Ge, Yute Sun, Jing Lin, Fang Zhou, Gang Yao, Binlin Luo, Xin Su","doi":"10.1177/15347346211045282","DOIUrl":"10.1177/15347346211045282","url":null,"abstract":"Necrotizing fasciitis (NF) is a fatal disease with a high mortality rate that can be easily misdiagnosed. The aim of this study was to improve the diagnostic rate of NF and overall survival. We conducted a single-center, retrospective, noncontrolled study involving 36 patients who were admitted to our department between December 2017 and October 2019, and summarized the diagnostic key points and timing of surgical treatment. All patients were diagnosed at our department and underwent multiple courses of treatment. The records included information regarding underlying diseases, bacterial culture results, laboratory risk indicator for necrotizing fasciitis (LRINEC) score, number of procedures, and type of antibiotics. All 36 cases of NF were cured and showed good patient condition on follow-up; the mean number of surgeries was three, and the mean duration of hospitalization was 37 days (range, 21-83 days). The LRINEC scores of 16 patients were ≥8 points. Seventeen patients with underlying diabetic disease had higher inflammatory index scores than those without diabetes. The LRINEC scores of patients with (n = 17) and without (n = 19) DM were 7.40 ± 2.99 and 3.80 ± 2.39, respectively (P < .01). Cases of NF that were treated with early incision and surgical abscess drainage required fewer surgeries and a shorter length of hospitalization. Thus, surgeons should be more aware of NF and aim to make an early and accurate diagnosis using various approaches. Complete surgical debridement plays an essential role in NF treatment, and diabetes mellitus is a significant adverse factor that exacerbates the severity of NF. Negative-pressure techniques are useful in cases involving nonanaerobic infections and cause minimal complications.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"153-160"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39488628","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

Does the Type of Surgical Technique and the Use of Prophylactic Antibiotics Affect the Clinical Results in Symptomatic Ingrown Toenail Patients? 手术技术的类型和预防性抗生素的使用会影响症状性嵌甲患者的临床效果吗？

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-09-13 DOI: 10.1177/15347346211043602

Serdar Sargin, Anil Gulcu, Ahmet Aslan

{"title":"Does the Type of Surgical Technique and the Use of Prophylactic Antibiotics Affect the Clinical Results in Symptomatic Ingrown Toenail Patients?","authors":"Serdar Sargin, Anil Gulcu, Ahmet Aslan","doi":"10.1177/15347346211043602","DOIUrl":"10.1177/15347346211043602","url":null,"abstract":"Ingrown toenails are a common reason for referral to orthopedics and podiatry clinics. Recurrence and infection are common complications in ingrown toenail surgery. This study investigates the effect of an electrocautery matrixectomy on the recurrence and clinical outcomes in the Winograd technique applied in ingrown toenail surgery and whether prophylactic antibiotic use is necessary for these surgeries. One hundred forty-three patients who underwent surgery for ingrown toenails were analyzed retrospectively. Eighty-two patients underwent the Winograd procedure with electrocautery matrixectomy, whereas 61 patients underwent the Winograd procedure. While 78 patients were given prophylactic antibiotics, 65 patients were not. Patient satisfaction was evaluated with a surgical satisfaction questionnaire (SSQ). A visual analog score was used to evaluate the pain. Recurrence was observed in 3 toenails in the Winograd and electrocautery groups, while recurrence was observed in 9 toenails in the Winograd group (P = .018). In both groups, there was no statistically significant difference between the infection rates between patients who took antibiotics and those who did not (P > .05). There was no statistically significant difference between the groups in terms of SSQ scores (P > .05). It was observed that the surgery performed had a positive effect on pain, and this effect was statistically highly significant in both groups (P < .05). The outcomes of the present study suggest that the addition of an electrocautery matrixectomy to the Winograd technique in the surgical treatment of symptomatic Ingrown toenails may decrease recurrence rates. Additionally, this study showed that oral antibiotics, when used in addition to Ingrown toenail surgery, do not reduce postoperative morbidity.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"124-132"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39411210","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

A Parallel Randomized Clinical Trial for Comparison of Two Methods of Maggot Therapy, Free-Range Larvae and Larval-bag, in Diabetic Ulcer (Wagner 2). 比较两种蛆虫疗法--散养幼虫和幼虫袋--治疗糖尿病溃疡的平行随机临床试验（Wagner 2）。

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-09-17 DOI: 10.1177/15347346211044295

Omid Dehghan, Seyed Mehdi Tabaie, Javad Rafinejad, Mehrangiz Toutounchi, Amir Tiyuri, Sahar Azarmi, Gholamreza Esmaeeli Djavid, Kamran Akbarzadeh

{"title":"A Parallel Randomized Clinical Trial for Comparison of Two Methods of Maggot Therapy, Free-Range Larvae and Larval-bag, in Diabetic Ulcer (Wagner 2).","authors":"Omid Dehghan, Seyed Mehdi Tabaie, Javad Rafinejad, Mehrangiz Toutounchi, Amir Tiyuri, Sahar Azarmi, Gholamreza Esmaeeli Djavid, Kamran Akbarzadeh","doi":"10.1177/15347346211044295","DOIUrl":"10.1177/15347346211044295","url":null,"abstract":"In the present study, the efficiency of two formulations of maggot therapy: free-range larvae on the wounds and larvae in a special bag (larval-bag), was compared for healing diabetic ulcers with Wagner 2 diabetic ulcer. This study was conducted as a parallel randomized clinical trial. Out of 281 patients with Wagner grade 2 diabetic ulcers referred to the wound clinic, 54 patients who met the inclusion criteria were randomly assigned to intervention groups. The disinfected larvae of Lucilia sericata were put on the wounds with 2 methods, free-range larvae and larval-bag. Follow up was done at every 48 h interval until the full appearance of granulated tissues. The main measures were wound bed preparation, removing of necrotic tissues, appearing of granulated tissues, and removing of bacterial infections in the wounds. Statistical analysis based on the Kaplan-Meier curve and the Wilcoxon (Breslow) test showed a significant reduction in wound healing time by using free-range larvae in comparison with larval-bag (P = .03). The median time to debridement was 4 days in the free-range larval group (95% confidence interval: 3-9 days) while it was 9 days in the larval-bag group (95% confidence interval: 5-16 days). Debridement rate (proportion of removed necrotic tissue surfaces) at any time in the free-ranged larvae group was 1.78 times that of the bagged larvae group (95% confidence interval 1.01-3.15, P = .036). There was no significant difference between free-range larval use and larval-bag in the acceptability of maggot therapy by patients (P = .48). It can be concluded that both of two formulations of the larval therapy (free-range larvae and larval-bag) could be recommended for cleaning out and bed preparation of diabetic ulcers. However, using free-range larvae is hardly recommended on the wounds which are eligible to use.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"133-139"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39445449","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

A Clinical Study to Evaluate Autofluorescence Imaging of Diabetic Foot Ulcers Using a Novel Artificial Intelligence Enabled Noninvasive Device. 使用新型人工智能无创设备评估糖尿病足溃疡自发荧光成像的临床研究。

IF 1.7 4区医学

International Journal of Lower Extremity Wounds Pub Date : 2024-03-01 Epub Date: 2021-10-07 DOI: 10.1177/15347346211047098

Vijay Viswanathan, Senthil Govindan, Bamila Selvaraj, Secunda Rupert, Raghul Kumar

{"title":"A Clinical Study to Evaluate Autofluorescence Imaging of Diabetic Foot Ulcers Using a Novel Artificial Intelligence Enabled Noninvasive Device.","authors":"Vijay Viswanathan, Senthil Govindan, Bamila Selvaraj, Secunda Rupert, Raghul Kumar","doi":"10.1177/15347346211047098","DOIUrl":"10.1177/15347346211047098","url":null,"abstract":"Diabetic foot ulcers, with worldwide prevalence ranging from 12%-25%, are an important cause of nontraumatic lower limb amputation. Evidence-based assessment of early infection can help the clinician provide the right first line treatment thus helping improve the wound closure rate. Illuminate®, a novel point of care device working on multispectral autofluorescence imaging, helps in the rapid identification and classification of bacteria. This study was aimed to evaluate the diagnostic accuracy of the device in detecting bacterial gram type against standard culture methods. A total of 178 patients from a tertiary care center for diabetes was recruited and 203 tissue samples were obtained from the wound base by the plastic surgeon. The device was handled by the trained investigator to take wound images. The tissue samples were taken from the color-coded infected region as indicated by the device's Artificial Intelligence algorithm and sent for microbial assessment. The results were compared against the Gram type inferred by the device and the device was found to have an accuracy of 89.54%, a positive predictive value of 86.27% for detecting Gram-positive bacteria, 80.77% for Gram-negative bacteria, and 91.67% for no infection. The negative predictive value corresponded to 87.25% for Gram-positive, 92% for Gram-negative, and 96.12% for no infection. The Results exhibited the accuracy of this novel autofluorescence device in identifying and classifying the gram type of bacteria and its potential in significantly aiding clinicians towards early infection assessment and treatment.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"169-176"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39492951","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