The international journal of lower extremity wounds最新文献

{"title":"Effects of Wound Localisation on Balance, Performance, Muscle Strength, and Gait Speed in Individuals with Diabetic Foot Ulcer: A Cross-Sectional Study.","authors":"Tezel Yıldırım Şahan, Simay Akyüz, Binnaz Bozkurt, Buse Kılınç, Gözde Tekin, Büşra Nur Fındık, Derya Çağlar, Betül Erbay, Kerim Bora Yılmaz","doi":"10.1177/15347346251315867","DOIUrl":"https://doi.org/10.1177/15347346251315867","url":null,"abstract":"<p><p>Muscle strength, balance, performance, and gait speed of individuals diagnosed with diabetic foot wound are negatively affected. This study aimed to investigate the effects of wound localisation on balance, performance, muscle strength, and gait speed in individuals with diabetic foot wounds. Individuals (n = 48) with a mean age of 59.35 ± 11.28 years and were divided into two groups according to wound localisation as group 1 (n = 24) with forefoot wounds and group 2 (n = 24) with hindfoot wounds. Four Step Square Test was used for dynamic balance assessment, Timed Up and Go Test for performance, Manual Muscle Tests for muscle strength, and 10 Meter Walk Test for gait speed assessment. When compared in terms of muscle strength, there was a difference only between the injured side Gluteus Medius (p = 0.02), Gastrosoleus (p = 0.00), and Tibialis Anterior (p = 0.03) muscles. Other muscle groups strength, balance, performance, and gait speed were similar (p > 0.05). Loss of muscle strength can lead to serious negative consequences such as deformity and new wound formation if not intervened in time. The effects on balance and performance are similar in different wound localizations.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251315867"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effective Modeling for Management Options in Charcot Neuroarthropathy.","authors":"Andrea Shehaj, Kelly M Dopke, Abdul Wasay Paracha, Kirsten Mansfield, Michaela D Pitcher, Kaitlin Saloky, Christopher Stauch, Erdi Ozdemir, Michael Aynardi","doi":"10.1177/15347346251313652","DOIUrl":"https://doi.org/10.1177/15347346251313652","url":null,"abstract":"<p><p>Charcot neuropathic arthropathy (CN) impacts peripheral lower extremity nerves, leading to joint destruction, and has a significant economic burden on the healthcare system. This economic burden is further exacerbated by the projected increase in diabetes mellitus cases over the coming decades, with a corresponding anticipated rise in CN. This study assesses CN management costs through a single institution retrospective chart review and cost-effectiveness through economic modeling by utilizing a well-established equation to determine the cost-effectiveness of conservative management. This retrospective chart review from a single academic center analyzed costs and outcomes for CN patients undergoing exostectomy, arthrodesis, major amputation, minor amputation, or casting from 2000-2022. This retrospective review analyzed 216 CN patients (average age 58, 54% male). Costs were $57 949 for exostectomy, $149 009 for arthrodesis, $40 313 for major amputation, $55 035 for minor amputation, $125 851 for failed casting, and $8233 for casting. We conducted a break-even analysis that determined that intervention with casting was cost-effective compared to failed casting. Total contact casting is a cost-effective first-line treatment for CN, capable of managing non-advanced cases effectively and reducing the economic burden of surgical intervention. This study provides a critical framework for practitioners to assess cost-effectiveness in various institutional contexts.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251313652"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Recurrence Risk of Diabetic Foot Ulcers After Healing: A 5-Year Retrospective Cohort Study on the Influence of Hemodialysis and Amputation Levels.","authors":"Toyoaki Kitano, Shunsuke Sakakibara, Ikuro Kitano, Yoriko Tsuji, Akira Takekawa, Hiroto Terashi","doi":"10.1177/15347346251315220","DOIUrl":"https://doi.org/10.1177/15347346251315220","url":null,"abstract":"<p><p>This retrospective study aimed to evaluate diabetic foot ulcer (DFU) recurrence rates and associated risk factors, focusing on hemodialysis and specific amputation levels. Patients with diabetes treated for DFU between 2003 and 2019 at a wound-care center in Japan were studied. The primary outcome was DFU recurrence, and the factors evaluated included age, sex, hemodialysis treatment, revascularization type, and amputation level. Among 236 participants (mean age: 65 years; male: 73%; 33% on hemodialysis), DFU recurrence rates were 40.3% and 77.1% at 1 and 5 years, respectively. Hemodialysis was significantly associated with an increased DFU recurrence risk (hazard ratio: 1.92; 95% confidence interval: 1.40-2.64, <i>P</i> < .001). Revascularization did not significantly impact DFU recurrence rates after ulcer healing. Contralateral DFU recurrence was the most frequent, occurring in 45% of cases. Higher DFU recurrence rates were observed at adjacent toes on the same side in patients who underwent great toe amputation and at the treated site in patients who underwent transmetatarsal, Lisfranc, or Chopart amputations. These findings indicate that DFU recurrence poses a higher risk in patients undergoing hemodialysis. Tailored postoperative management focusing on both contralateral and ipsilateral recurrences is essential to minimize recurrence and improve long-term outcomes.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251315220"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overweight yet Undernourished: A Common Juxtaposition in the Specialist Diabetes Foot Service.","authors":"Wrivu Niezel Martin, Hayley Katherine Wigmore, Leanne Caroline Gregory, Cheryl Mei Yee Lum, Joel Willem Johan Lasschuit","doi":"10.1177/15347346241310266","DOIUrl":"https://doi.org/10.1177/15347346241310266","url":null,"abstract":"<p><strong>Aims: </strong>To describe the nutritional status of people with diabetes-related foot complications and explore the association between nutrition and ulceration healing.</p><p><strong>Methods: </strong>This retrospective cohort study included attendees of a diabetes foot service who completed a dietary questionnaire. Diet was compared to guideline recommendations and biochemical measures were recorded. Associations between dietary intake and biochemical measures were analysed using non-parametric tests, and their relationship with being ulcer-free at 12 weeks analysed by binary logistic regression.</p><p><strong>Results: </strong>Of 102 participants, 83% were men, mean age 68 (SD 12), body mass index 28.6 (SD 6.1) kg/m², and 86% had type 2 diabetes. Complications included 154 ulcerations and 7 active Charcot feet. Recommended fruit, vegetable and protein intake was seldom attained. Common insufficiencies were 25-hydroxy-vitamin D (40%), zinc (27%), iron (23%) and vitamin C (21%). Vitamin C was higher in the upper (vs lower) tertile of fruit/vegetable intake (62 [95%CI 33-88] vs 30 [13-46] umol/L, p = 0.04), and zinc higher in those meeting protein requirements (12.3 [95%CI 11.1-12.8] vs 10.6 [9.8-11.5] umol/L, p = 0.04). Haemoglobin was the only predictor of becoming ulcer-free (OR 1.03 [95%CI 1.00-1.06], p = 0.03).</p><p><strong>Conclusion: </strong>Nutritional inadequacies are common in people with diabetes-related foot complications; however, the benefit of assessing nutrition remains uncertain.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241310266"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Foot Amputations: Engagement Still Needed to Improve Outcomes.","authors":"Alfred Gatt, Cynthia Formosa, Nikolaos Papanas","doi":"10.1177/15347346251316041","DOIUrl":"https://doi.org/10.1177/15347346251316041","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346251316041"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanotechnological Advances in Burn Wound Care: Silver Sulfadiazine-Loaded Nanosuspension-Based Chitosan-Incorporated Nanogel for Partial Thickness Burns.","authors":"Harshita Barkat, Md Abul Barkat, Raisuddin Ali, Hazrina Hadi","doi":"10.1177/15347346241309425","DOIUrl":"https://doi.org/10.1177/15347346241309425","url":null,"abstract":"<p><p>Burn lesions damage the skin's outermost defensive layer, allowing pathogenic microbes including <i>Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli</i> to infiltrate. Silver sulfadiazine (SSD) is an effective antibacterial agent approved by U.S. Food and Drug Administration (US-FDA) and is considered as the gold standard for burn wound treatment. Despite the high degree of efficacy of SSD in burn wound management, it possesses some drawbacks, such as poor solubility, low topical bioavailability and skin irritations. The present study endeavors to develop nanosuspension based SSD nanogel for improving the deliverability of SSD and its therapeutic outcomes for the management of partial thickness burn. The SSD nanosuspension was formulated employing controlled nanoprecipitation approach using various surfactants. The formulation was optimized utilizing one-factor-at-a-time approach and to fetch the optimized formulation of 134.6 nm size. The optimized nanosuspension was incorporated into chitosan gel that offer superior drug release potential, and also offered better spreadability (5.21 ± 0.38 g) and extrudability (152.27 ± 0.22 gm) that represents the easy application over the skin and extrusion of gel from the tube. The formulation was well tolerated as shown by skin irritation study and offered a superior burn lesion healing characteristics vis-à-vis the marketed product, even at a lower concentration. Hence, the formulation offers a huge potential in enhancing the clinical outcomes of SSD, especially in the management of partial thickness burn. The developed system with the above mentioned outcomes could be a promising delivery system for partial thickness burn wound management.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241309425"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Significance of Serum VEGF, bFGF, and Wound Tissue EGFR in Diabetic Chronic Refractory Wounds.","authors":"Xuanyu Wang, Huafa Que","doi":"10.1177/15347346241313010","DOIUrl":"https://doi.org/10.1177/15347346241313010","url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetes mellitus (DM) face a higher risk of developing chronic refractory wounds. Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and epidermal growth factor receptor (EGFR) plays an important role in diabetes-related complications. This study aims to analyze the correlation between the 3 indicators and diabetic chronic refractory wounds, in order to establish the diagnostic value of these 3 indicators and provide reference for the treatment.</p><p><strong>Material and methods: </strong>We selected 168 patients, with 84 in healing group and 84 in refractory group. The levels of serum VEGF, bFGF, and wound tissue EGFR were compared before treatment, and the correlation between the 3 indicators and the refractory wounds was analyzed. After the specific treatment in refractory group, the clinical efficacy and wound closure index was recorded, and the correlation between them and the 3 indicators were analyzed.</p><p><strong>Results: </strong>The 3 indicators were all protective factors for diabetic chronic refractory wounds (<i>p </i>< .05). The serum VEGF and bFGF had relatively low diagnostic value for diabetic chronic refractory wounds, while wound tissue EGFR demonstrated higher diagnostic value (<i>p </i>< .05). The 3 indicators had a positive correlation with both the clinical efficacy and the wound closure index (<i>p </i>< .05).</p><p><strong>Conclusion: </strong>Higher levels of serum VEGF, bFGF, and wound tissue EGFR are conducive to reducing the incidence of diabetic chronic refractory wounds. The combined measurement of these indicators holds high diagnostic value for the disease. Moreover, the higher the expression levels of these 3 indicators, the more favorable the clinical outcomes.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241313010"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Histological Assessment of Zinc Oxide Nanoparticles and Low-Power Laser Treatment at 810nm Wavelength on the Recovery of Second-Degree Burn Wounds in Rat Models.","authors":"Zahra Al-Timimi, S F Haddawi, Sajjad Abbas Hadi Nukhailawi","doi":"10.1177/15347346241313009","DOIUrl":"https://doi.org/10.1177/15347346241313009","url":null,"abstract":"<p><p><b>Background:</b> The utilization of zinc oxide nanoparticles is thought to augment wound healing because of their antibacterial characteristics and capacity to stimulate cellular regeneration, especially in instances of minor burn injuries. On the other hand, it has been shown that tissue regeneration is aided by low-power laser therapy via photobiomodulation. Zinc oxide nanoparticles and low-power laser therapy are the two therapeutic modalities that will be compared in this study in order to assess how well they promote healing after burn injury and provide important new information on improved wound care techniques. <b>Methods:</b> For this investigation, thirty male Wistar rats weighing 230 ± 25 grams each were split into three groups. Every rat received general anesthesia before the experiment. A stainless-steel rod was put to the rats' skin after being heated for 20 min in a boiling water bath to cause superficial second-degree burns. The control group functioned as a reference point for comparison and did not receive any treatment intervention. Over the course of a week, zinc oxide nanoparticles were applied topically to the second group. For one week, the third group received daily therapy with a diode laser at a dosage of 10 J/cm.¹ Histological and clinical exams were performed after the therapy period to evaluate the impact of the therapies. <b>Results:</b> The experimental groups that received low-power laser therapy (third group) and zinc oxide nanoparticles (second group) showed a substantial increase in wound contraction in relation to the control group, based on macroscopic observations. One rat from the second group showed notable indications of full wound healing on day 21. The treated rats showed the highest rate of lesion contraction, indicating that wound treatment happened at least 7 days faster in these rats than in the other groups. After 21 days, the third group's epidermis fully epithelized and formed a layer of keratinization. Furthermore, there was enhanced angiogenesis and significant fibroblast proliferation; large-scale fibrosis was also commonly seen. <b>Conclusion:</b> Zinc oxide nanoparticles promoted wound healing and accelerated connective tissue regeneration faster than other groups when applied to second-degree superficial burns. This research implies that the use of zinc oxide nanoparticles may be a therapeutic approach that shows promise for treating burn injuries and improving patient outcomes.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241313009"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Artificial Intelligence in Medical Writing: Balancing Technological Innovation and Human Expertise, with Practical Applications in Lower Extremity Wounds Care.","authors":"Pak Thaichana, Myo Zin Oo, Gabriel Leiden Thorup, Chayatorn Chansakaow, Supapong Arworn, Kittipan Rerkasem","doi":"10.1177/15347346241312814","DOIUrl":"https://doi.org/10.1177/15347346241312814","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is revolutionizing medical writing by enhancing the efficiency and precision of healthcare communication and health research. This review explores the transformative integration of AI in medical writing, highlighting its dual role of enhancing efficiency while maintaining the crucial elements of human expertise. AI technologies, including natural language processing and AI-driven literature review tools, have significantly advanced, facilitating rapid draft generation, literature summarization, and consistency in medical documentation. Key applications include aiding study design, enhancing content drafting, and optimizing literature reviews through specific AI tools. Moreover, this review delves into practical applications of AI in the context of lower extremity wounds, specifically ischemic leg ulcers, demonstrating how AI can streamline the synthesis of relevant literature. While AI presents notable advantages, it also raises ethical concerns, such as potential biases and data privacy issues, highlighting the need for human oversight in the writing process. A proposed future framework suggests that AI could take over routine tasks, allowing medical writers to devote more attention to analytical and ethical aspects. Additionally, there is a strong need for further research on the cost-effectiveness of both clinical trials utilizing AI interventions and the incorporation of AI in medical writing. Ultimately, balancing the integration of AI in medical writing promises to improve both healthcare communication and health research, ensuring the production of high-quality, patient-centric and research-focused content.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241312814"},"PeriodicalIF":0.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Euglycemic Diabetic Ketoacidosis in a Patient with Diabetic Foot Syndrome.","authors":"Massimo Giambalvo, Francesco Giangreco, Elisabetta Iacopi, Letizia Pieruzzi, Chiara Goretti, Alberto Piaggesi","doi":"10.1177/15347346241308120","DOIUrl":"https://doi.org/10.1177/15347346241308120","url":null,"abstract":"<p><p>Euglycemic Diabetic ketoacidosis (E-DKA) is a life-threatening emergency characterized by ketonemia and metabolic acidosis in presence of relatively normal glycemic values. In recent years it has been associated with some predisposing conditions including sodium-glucose transporter 2 inhibitors (SGLT2-i) therapy, widely used in high-risk cardiovascular patients. We report the case of a 78-year-old diabetic woman treated with dapagliflozin, affected by critical limb threatening ischemia and septic osteoarthritis of interphalangeal joint of first right toe. At admission blood exams allowed diagnosis of E-DKA associated to acute kidney failure. The occurrence of the condition was probably due to foot infection acting on a trigger on a SGLT2-i predisposition. We treated the patient according to guidelines' indications achieving the resolution of the metabolic derangement. After the control of acute condition and return of metabolic parameters within the normal range, the patient underwent revascularization procedure and surgical debridement eventually obtaining complete healing of foot lesion.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346241308120"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}