International Journal of Lower Extremity Wounds最新文献

{"title":"M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update","authors":"Joachim Dissemond, Paul Chadwick, Dot Weir, Paulo Alves, Kirsi Isoherranen, José Luis Lázaro Martínez, Terry Swanson, Andrea Gledhill, Matthew Malone","doi":"10.1177/15347346241245159","DOIUrl":"https://doi.org/10.1177/15347346241245159","url":null,"abstract":"Chronic wounds remain a significant clinical challenge both for those affected and for healthcare systems. The treatment is often comprised and complex. All patients should receive wound care that is integrated into a holistic approach involving local management that addresses the underlying etiology and provides for gold standard therapy to support healing, avoid complications and be more cost effective. There have been significant advances in medicine over the last few decades. The development of new technologies and therapeutics for the local treatment of wounds is also constantly increasing. To help standardize clinical practice with regard to the multitude of wound products, the M.O.I.S.T. concept was developed by a multidisciplinary expert group. The M stands for moisture balance, O for oxygen balance, I for infection control, S for supporting strategies, and T for tissue management. Since the M.O.I.S.T. concept, which originated in the German-speaking countries, is now intended to provide healthcare professionals with an adapted instrument to be used in clinical practice, and a recent update to the concept has been undertaken by a group of interdisciplinary experts to align it with international standards. The M.O.I.S.T. concept can now be used internationally both as an educational tool and for the practical implementation of modern local treatment concepts for patients with chronic wounds and can also be used in routine clinical practice.","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":"67 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140595097","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 and Antimicrobial Pattern of Diabetic Foot Ulcers at a Tertiary Care Center in East China.","authors":"Yaping Xie, Ying Xu, Kuang Chen, Can Chen, Jiao Huang, Qiong Chen, Pengfei Shi","doi":"10.1177/15347346211055972","DOIUrl":"10.1177/15347346211055972","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot infections (DFIs) are the most complex and challenging pathological state, characterized by high complexity of management, morbidity, and mortality. Empirical antimicrobial administration is needed before the identification of the causative organisms. Microbiological profile of the diabetic foot patients is the basis of the antibiotic choice for clinicians.</p><p><strong>Methods: </strong>76 patients visiting the Diabetic Foot Center of our Hospital for having ulcers with Wagner 3 to 5 were retrospectively surveyed for the bacterium infected. Antimicrobial susceptibility testing (AST) was implemented and the results were interpreted on the basis of the Clinical and Laboratory Standards Institute (CLSI) guidelines.</p><p><strong>Results: </strong>A total of 92 isolates were obtained, of which 47 strains of gram-negative bacilli (GNB) accounted for 51.1%, 41 strains of gram-positive cocci (GPC) accounted for 44.6%, and 4 strains of fungi accounted for 4.3%. Species of <i>Enterobacteriaceae</i> and <i>Staphylococcus</i> are the two predominant strains. The top 4 most frequently isolated strains were <i>Staphylococcus aureus</i> (22.8%), <i>enterococcus faecalis</i> (9.8%), <i>Pseudomonas aeruginosa</i> (9.8%), <i>Escherichia coli</i> (5.4%). The rate of resistance to methicillin was 33.3% for <i>S. aureus</i>. The rate of extended-spectrum β-lactamases (ESBLs) production among <i>E. coli</i> was 60%. 50% of <i>Klebsiella pneumoniae</i> were resistant to carbapenems. <i>P. aeruginosa</i> showed high sensitivity to commonly used antibiotics. There was one isolate of <i>Acinetobacter</i> spp. resistant to most antimicrobials except tigecycline and aminoglycosides.</p><p><strong>Conclusion: </strong><i>Enterobacteriaceae</i> and <i>Staphylococcus</i> are the two predominant species. The resistance to antibiotics of <i>S. aureus and P. aeruginosa</i> showed optimistic results. However, the high prevalence of CRKP imposed a challenging issue for clinical physicians.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"104-108"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39688312","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":"Overexpression of miR-7-5p Promoted Fracture Healing Through Inhibiting LRP4 and Activating Wnt/β-Catenin Pathway.","authors":"Changtie Liu, Junlin Liu, Hong Chen","doi":"10.1177/15347346231157443","DOIUrl":"10.1177/15347346231157443","url":null,"abstract":"<p><p><i>Background.</i> The bone healing after fracture had a great impact on the patients' life quality. However, how miR-7-5p participated in fracture healing has not been investigated. <i>Methods.</i> For <i>in vitro</i> studies, the pre-osteoblast cell line MC3T3-E1 was obtained. The male C57BL/6 mice were purchased for <i>in vivo</i> experiments, and the fracture model was constructed. Cell proliferation was determined by CCK8 assay, and alkaline phosphatase (ALP) activity was measured by commercial kit. Histological status was evaluated using H&E and TRAP staining. The RNA and protein levels were detected <i>via</i> RT-qPCR and western blotting, respectively. <i>Results.</i> Overexpression of miR-7-5p increased cell viability and ALP activity <i>in vitro</i>. Moreover, <i>in vivo</i> studies consistently indicated that transfection of miR-7-5p improved the histological status and increased the proportion of TRAP-positive cells. Overexpression of miR-7-5p suppressed LRP4 expression while upregulated Wnt/β-catenin pathway. <i>Conclusion.</i> MiR-7-5p decreased LRP4 level and further activated the Wnt/β-catenin signaling, facilitating the process of fracture healing.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"86-91"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9589582","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":"Development and Testing of the Foot Care Scale for Older Japanese Diabetic Patients.","authors":"Sayuri Sable-Morita, Yuki Arai, Sanae Takanashi, Keita Aimoto, Mika Okura, Takahisa Tanikawa, Keisuke Maeda, Haruhiko Tokuda, Hidenori Arai","doi":"10.1177/15347346211045033","DOIUrl":"10.1177/15347346211045033","url":null,"abstract":"<p><p>We aimed to develop and test the reliability and validity of a foot care self-management assessment tool for older Japanese patients with diabetes. In this cross-sectional observational study, which was carried out according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, additional items were developed and selected to reflect older Japanese patients' needs a thorough investigation with experts in diabetes and geriatrics. A total of 200 older patients with diabetes in a foot care outpatient clinic were included in the study to finalize the scale items and verify the scale's reliability and validity. A factor analysis yielded a 4-factor, 9-item scale. Factors 1 to 4 were \"skin condition\" (3 items), \"nail clipping\" (2 items), \"attention to wounds\" (2 items), and \"relationships with others\" (2 items). The Cronbach's α coefficients for the 4 factors were .852, .900, .820, and .571, respectively. The overall scale was 0.797, indicating good internal consistency. Spearman's correlation coefficients for each of the 4 factors with the scale's total score showed good stability; all correlations were significant. In Japan's super-aged society, it is important to focus on foot care practices among older adults and to promote good foot care practices among early older adults so that they can practice self-care at home. Therefore, a scale for comprehensively evaluating foot care in elderly patients with diabetes is needed. The Foot Care Scale for Older Diabetics could be useful as a tool for assessing the ability to self-manage foot care in older Japanese patients with diabetes.</p>","PeriodicalId":49181,"journal":{"name":"International Journal of Lower Extremity Wounds","volume":" ","pages":"140-147"},"PeriodicalIF":1.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39485820","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":"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":"<p><p>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.</p>","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}

{"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":"<p><p>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 (<i>P</i> = .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 (<i>P</i> = 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.</p>","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}

{"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":"<p><p>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.</p>","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}

{"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":"<p><p>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 (<i>P </i>= .001), while staff in higher academic ranks less difficulty (<i>P </i>< .001) in adjustment. There was a small increase in workload, which was higher among respondents researching into COVID-19 (<i>P </i>= .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.</p>","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}

{"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":"<p><p>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 <i>Staphylococcus aureus</i>, <i>Staphylococcus epidermidis</i>, and <i>Streptococcus</i> 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.</p>","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}

{"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":"<p><p>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.</p>","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}