International Journal of Lower Extremity Wounds最新文献

{"title":"Burden of Diabetic Foot Patients' Caregivers and Affecting Factors: A Cross-Sectional Study.","authors":"Sadık Hançerlioğlu,&nbsp;İsmail Toygar,&nbsp;Ayşe Ayhan,&nbsp;İrem Yilmaz,&nbsp;Yavuz Orhan,&nbsp;Göksu S Özdemir,&nbsp;Ilgın Y Şimşir,&nbsp;Şevki Çetinkalp","doi":"10.1177/15347346211036530","DOIUrl":"10.1177/15347346211036530","url":null,"abstract":"<p><p>With the increase in the diabetic foot patients in recent decades, the caregivers of diabetic foot patients increase too. Most of these caregivers are informal caregivers. However, the studies examining the burden of the caregivers and affecting factors are limited. This study was conducted to determine the burden of the caregivers of diabetic foot patients and affecting factors. This cross-sectional study was conducted between the January and October 2020 in a diabetic foot council of a university hospital. Zarit Caregiver Burden Scale and a participant identification form were used for data collection. Most of the caregivers were female (75.2%) and the mean age was 51.27 ± 11.48 years. The burden of the caregivers was at moderate level in the current study. Factors affecting the caregivers' burden were caregivers' age, patients' family structure, caregivers' education level, caregivers' income level, hours per week spending for the care of the patients, and lack of choice.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"680-686"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/15347346211036530","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39267763","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":"Predictive Factors for Limb Salvage and Foot Ulcer Recurrence in Patients with Chronic Limb-Threatening Ischemia After Multidisciplinary Team Treatment: A 6-Year Japanese Single-Center Study.","authors":"Miki Fujii,&nbsp;Akitoshi Yamada,&nbsp;Kohei Yamawaki,&nbsp;Shigeyasu Tsuda,&nbsp;Naokazu Miyamoto,&nbsp;Kunio Gan,&nbsp;Hiroto Terashi","doi":"10.1177/15347346211041429","DOIUrl":"10.1177/15347346211041429","url":null,"abstract":"<p><p>Chronic limb-threatening ischemia (CLTI) is associated with a short-term risk of limb loss. Multidisciplinary teams are often involved in CLTI treatment; however, in Asian countries, multidisciplinary teams that include podiatrists specializing in foot wounds and vascular surgeons who can perform distal bypass surgery are lacking. We investigated predictive factors for limb salvage and foot ulcer recurrence in patients with CLTI treated by a Japanese single-center intensive multidisciplinary team over 6 years. We retrospectively investigated 84 patients with CLTI and foot ulcers who had undergone revascularization and wound treatment between October 2013 and December 2019. Following postrevascularization treatment, including undertaking minor amputations, the healing rate was 77.8%, and the average wound healing time was 75 ± 68 days. To achieve adequate blood supply, 17.7% of patients were treated using a combination of endovascular revascularization and bypass surgeries. Thirty-three (44%) patients had wound recurrence and there was wound recurrence within 6 months in 58.9% of these patients. Multivariate logistic regression analysis showed that postrevascularization skin perfusion pressure was significantly associated with wound healing (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.033-1.243, <i>P</i> = .0078). Diabetes mellitus (OR 9.72, 95% CI 1.855-50.937, <i>P</i> = .0071), and heart disease (OR 3.51, 95% CI 1.052-11.693, <i>P</i> = .0411) were significantly associated with wound recurrence (<i>P</i> < .05). Treatment within a single-center intensive multidisciplinary team resulted in good patient outcomes. Our study indicates that the revascularization endpoint of CLTI treatment should be marked by attainment of adequate blood supply and wound healing. The timing of revascularization and debridement is of utmost importance for the successful treatment of CLTI wounds.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"722-732"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39397728","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 the Effect of Pomegranate Seed Oil on Healing in a Rat Wound Model With Antioxidant, Vascular, and Histopathological Parameters.","authors":"A Nilhan Atsü Md,&nbsp;Zeynep Tosuner Md,&nbsp;Tayfun Bilgiç Md","doi":"10.1177/15347346211040593","DOIUrl":"10.1177/15347346211040593","url":null,"abstract":"<p><p>The study aimed to evaluate the efficiency of pomegranate (<i>Punica granatum</i>) seed oil in wound healing in excised rats. Sixteen female young Wistar Albino Rats weighing approximately 300 to 320 g were randomly divided into 2 groups as the treatment (=pomegranate seed oil group) and control groups in this experiment. Six different wounds 1 cm apart from the midline and each other were formed with a 6 mm punch biopsy instrument. Three wounds were left open (open wound group) whereas 3 wounds were sutured with 4/0 vicryl (closed wound group). <i>Punica granatum</i> seed oil treatment was administered topically to the treatment group, both to open and closed wounds, once a day for 14 days. Parameters for healing were evaluated. Histopathologic examination was performed for the investigation of inflammation, neovascularization, granulation, and fibroblast generation in addition to serologic (enzyme-linked immunosorbent assay) evaluation of rat malondialchehyche, rat glutathione peroxidase, and rat superoxide dismutase. PeriScan PIM 3 System Laser Doppler Blood Perfusion Imager was used for the calculation of blood perfusion. There was a statistically significant difference between inflammation and neovascularization levels and group type on the 14th day in open wounds(<i>P</i> < .05). On the 21st day, the granulation tissue level in the closed wound group was found to be higher in the pomegranate group (<i>P</i> = 0.000).The results showed that PSE oil is partially effective, although it is not effective in every parameter examined, in the treatment of excised wounds in rats and may be suitable for clinical treatment in humans but large controlled studies are needed.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"661-671"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39371524","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":"Free Vacularized Fibula Flap for Septic Bone Defects of the Lower Limb.","authors":"Iván Copete González,&nbsp;Nieves Vanaclocha,&nbsp;Alberto Sánchez-García,&nbsp;Alessandro Thione,&nbsp;Alberto Pérez-García","doi":"10.1177/15347346211049881","DOIUrl":"10.1177/15347346211049881","url":null,"abstract":"<p><p>Free fibula flap (FFF) is one of the reconstructive techniques to treat bone defects, although in septic conditions there are some limitations that have made it less popular. We present our experience with FFF for the reconstruction of lower limb infectious bone defects. From September 2015 to January 2020, 10 patients underwent reconstruction with FFF without rigid internal fixation of septic bone defects of the lower extremities. Demographic, clinical, and operative data were retrospectively collected. All the flaps survived and consolidated. The only major complication was a stress fracture of a fibula that required osteosynthesis. Median time to consolidation and full weight-bearing was 2.5 and 9.8 months, respectively. Bipedal gating was achieved in all the patients, 7 of them without walking aids. Despite it has some limitations and technical difficulties, in our experience FFF is an effective and reliable option in the reconstruction of septic bone defects of the lower limb.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"748-752"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39485816","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":"Chronic Wound Management: New Knowledge Still Required for This Constant Challenge.","authors":"Miltos K Lazarides, Kittipan Rerkasem, Nikolaos Papanas","doi":"10.1177/15347346231194417","DOIUrl":"10.1177/15347346231194417","url":null,"abstract":"Chronic wounds remain a substantial cause of morbidity and a health challenge.1 They are de fi ned as wounds failing to proceed through the normal phases of wound healing in an orderly and timely manner or in which the repair process fails to restore anatomic and functional integrity after 3 months. 1,2 Their etiology is diverse, including peripheral arterial disease, diabetic neuropathic ulcers, chronic venous insuf fi - ciency, decubitus ulcers, vasculitis, pyoderma gangreno-sum, infectious diseases","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"633-634"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9969273","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":"Microbiological Pattern, Antimicrobial Resistance and Prevalence of MDR/XDR Organisms in Patients With Diabetic Foot Infection in an Indian Tertiary Care Hospital.","authors":"Idris Dawaiwala, Snehal Awaghade, Pranjali Kolhatkar, Sunita Pawar, Supriya Barsode","doi":"10.1177/15347346211038090","DOIUrl":"10.1177/15347346211038090","url":null,"abstract":"<p><p>Foot infections are the most prevalent problem in persons with diabetes. The burden of multidrug resistant (MDR) microorganisms in diabetic foot infections (DFIs) is rising day by day. Given that, the present study aims to determine the variety of microorganisms isolated from the diabetic foot ulcers (DFUs), and their antibiotic sensitivity pattern. This prospective observational study was conducted for 1 year at Bharati Hospital and Research Centre, Pune, India. Clinically infected patients with DFU admitted to the surgery ward were included in this study. The specimen for microbiological studies is obtained from the wound swabs, soft tissue, and bone tissue as a part of routine clinical care. All demographic, clinical data, microbial culture results were collected, and evaluated for each case. Antimicrobial susceptibility testing to different agents was carried out using the VITEK-2^® machine. A total of 110 microorganisms were isolated from 76 specimens, with an average of 1.4 organisms per lesion. <i>Staphylococcus aureus</i> (n = 27, 24.5%) and <i>Escherichia coli</i> (n = 17, 15.4%) were the most prevalent Gram-positive and Gram-negative organisms isolated, respectively. MDR organisms constituted up to 52 (47.2%), while 6 (5.4%) of the samples were extensively drug resistant (XDR). Methicillin-resistant <i>S aureus</i> (MRSA) accounted for up to 19 (70.3%) of the <i>S aureus</i> isolates, likewise extended-spectrum beta-lactamase producing microorganisms constituted 16 (14.5%) of total isolates in this study. Oxacillin and benzyl penicillin exhibited least susceptibility against Gram-positive bacteria, among Gram-negative organisms; cefuroxime, ceftriaxone, and ciprofloxacin were least sensitive. As most of the <i>S aureus</i> isolate in our study was MRSA, empirical antimicrobial therapy may include coverage for MRSA in a patient with risk factors associated with this pathogen. A crucial observation is the presence of XDR strains of <i>Proteus mirabilis</i> in DFIs, which is resistant to almost all the antimicrobials, tested. Appropriate antimicrobial selection may reduce the morbidity and the emergence of MDR organisms in DFIs.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"695-703"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39303832","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":"Undifferentiated Pleomorphic Sarcoma of a Chronic Burn Scar of the Knee With Lymph Node Metastasis.","authors":"Jong Yun Choi,&nbsp;Won Jin Cha,&nbsp;Jeeyoon Kim,&nbsp;Ee Room Jung,&nbsp;Sung No Jung,&nbsp;Bommie Florence Seo","doi":"10.1177/15347346211060125","DOIUrl":"10.1177/15347346211060125","url":null,"abstract":"<p><p>Malignant transformation of chronic burn scars are usually toward cutaneous lineages, including squamous cell carcinoma, basal cell carcinoma, and malignant melanoma. Sarcomas are less common. Undifferentiated pleomorphic sarcoma(UPS) is a subtype of soft tissue sarcoma with storiform-pleomorphic cells of uncertain origin, and has sparingly been reported to arise from burn scars. The majority are localized lesions probably due to the spatial distance of mesenchymal cells from the epithelium. The authors describe a rare case of UPS of the chronic burn scar of his knee with ipsilateral femoral and external iliac lymph node metastasis.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"767-773"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39901988","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 of Mobiderm^® Bandage in Compression Therapy for Venous Ulcers: A Prospective Case Series.","authors":"Harikrishna K R Nair,&nbsp;Xian Lew,&nbsp;Kong Yen Liew,&nbsp;Siti Aishah Kamis,&nbsp;Nik Muhamad Hakimi Nik Kub,&nbsp;Ahmad Muhaimin Zakaria,&nbsp;Muhd Arif Akmal Mohd Sulong","doi":"10.1177/15347346211058273","DOIUrl":"10.1177/15347346211058273","url":null,"abstract":"<p><p><b>Background:</b> Venous leg ulcers severely affect patients' quality of life due to its high morbidity and recurrent nature. Currently, compression therapy is the first-line treatment for venous leg ulcers. <b>Aim:</b> This study sought to evaluate the efficacy of the Mobiderm® technology developed by Thuasne in a prospective case series of venous leg ulcers. <b>Methods:</b> Nine patients (<i>N</i>  =  9) with venous leg ulcers were enrolled into this case series. Mobiderm® bandage was applied on to the affected limbs of the patients in the multi-component bandages system. The bandages were changed as frequent as the patients had their wound dressing for their standard treatment in a 12-week duration. Wound size and calf circumference were measured at week 0 and week 12. Paired sample t-test was used to compare the mean values of wound size and calf circumference pre- and post-treatment. <b>Results:</b> Reductions in wound size and calf circumference were observed in all nine patients (100%). Five patients were evaluable at week 12. The wound sizes significantly reduced by 27.2% to 53.2% (<i>p</i>  =  0.02), and the calf circumferences significantly reduced by 3.2% to 26.0% (<i>p</i>  =  0.02) after 12 weeks (<i>N</i>  =  5). Safety was unremarkable, with no occurrence of treatment-emergent-related adverse event. <b>Conclusion:</b> Mobiderm® bandage was reported to be effective in promoting wound healing and reducing swelling, suggesting it to be integrated in the compression therapy for the management of venous leg ulcers.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"759-766"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39913235","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":"Nonhealing Leg Ulcer as the Presentation of Sarcoidosis: A Case Report.","authors":"Nawaf J Shatnawi, Nabil A Al-Zoubi, Lujain A Al-Bakkar, Laith M Gharaibeh, Shadi Hamouri","doi":"10.1177/15347346211037850","DOIUrl":"10.1177/15347346211037850","url":null,"abstract":"Chronic leg ulcers (CLUs) are common, with increasing prevalence in the elderly population. Circulatory dysfunctions are responsible for 90% to 95% of all causes, while 5% to 10% of CLUs are associated with underlying chronic systemic disorders. Sarcoidosis is a complex multisystemic disease characterized by noncaseating granulomas affecting mainly the pulmonary system, with cutaneous manifestation in 25% to 30% of cases. However, ulcerative sarcoidosis (US) is a rare form of cutaneous sarcoidosis. Pyoderma gangrenosum (PG) is an uncommon, chronic inflammatory noninfectious skin disease affecting different body parts. The ulcerative form of PG is rarely reported in association with sarcoidosis. We aim to report a 44-year-old female patient with a history of hypertension and varicose veins, presenting with a CLU for more than 18 months. Ulcer tissue biopsy showed noncaseating granuloma with abscess formation suggestive of sarcoidosis; however, PG could not be ruled out. Mediastinal lymph node biopsy was consistent with sarcoidosis. The leg ulcer had complete healing within 4 months by local wound management, negative pressure wound therapy, and split-thickness skin grafting without immunosuppressive treatment to achieve wound healing.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"742-747"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39296901","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":"Effect of MicroRNA-146a Modified Adipose-Derived Stem Cell Exosomes on Rat Back Wound Healing.","authors":"Gangquan Chen Md,&nbsp;Yaling Wu Md,&nbsp;Lijin Zou Md,&nbsp;Yuanlin Zeng Md","doi":"10.1177/15347346211038092","DOIUrl":"10.1177/15347346211038092","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effect of MicroRNA-146a modified adipose-derived stem cell exosomes on the proliferation and migration of fibroblasts and the therapeutic effect on wound healing. <b>Methods:</b> Culture and identification of human adipose-derived stem cells (hASCs), miRNA-146a minic vector was constructed and transfected into hASCs, the exosomes of the empty group and overexpression group were extracted, identified, and quantitatively analyzed after 24 h of successful transfection. The exosomes were added into National Institute of Health Mouse Embryonic Fibroblasts (NIH/3T3) and cultured for 48 h, the proliferation and migration ability of NIH/3T3 fibroblasts was detected. The expression of serpin family H member 1 (SERPINH1) and phosphorylated extracellular regulated protein kinase (p-ERK) was detected by Western blot. The model of back wound was established. The exosomes were injected into 4 different sites with the shape of \"cross\" around the wound, and the scar diameter of the skin defect was measured at 3, 7, and 11 days, the skin of the defect was taken on the 14th day. platelet endothelial cell adhesion molecule-1 (CD31) was detected by immunofluorescence staining to evaluate angiogenesis, and Western blot was used to detect the expression of SERPINH1 and p-ERK. <b>Results:</b> The miR-146a mimic-exosome promoted the proliferation and migration of fibroblasts, and the expression of SERPINH1 and p-ERK2 was up-regulated. After the rats were treated with exosomes, the wound area decreased rapidly, neovascularization was promoted, and the expression of SERPINH1 and p-ERK2 was up-regulated. <b>Conclusions:</b> MicroRNA-146a modified adipose stem cell exosomes could regulate the expression of SERPINH1 and p-ERK, promote the migration and proliferation of fibroblasts, and neovascularization to promote the wound healing of rat back.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"704-712"},"PeriodicalIF":1.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39366623","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}