LEA 9. Revascularization and Growth Factor Injection: It Is Effective for Healing of Foot Ulcers

Diabetic foot ulcer (DFU) is a major health problem and remains a major cause of amputation across the world. Critical assessment of the relationship between peripheral artery disease, revascularization, and healing of DFU was performed. A new therapy has been claimed to prevent major amputations in advanced DFU. The intralesional injection of recombinant human epidermal growth factor (EGF) should often lead to satisfactory outcomes. The purpose of our study was to demonstrate the advantage of the combination of revascularization and EGF local infiltration in accelerating healing of DFU.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research

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Publication date: November 2019Source: The Journal of Foot and Ankle Surgery, Volume 58, Issue 6Author(s): Nicole K. Cates, Kaihua Wang, Jered M. Stowers, Christopher E. Attinger, Paul J. Kim, John S. SteinbergAbstractHeel ulcers have a significant impact on lower-extremity morbidity and confer high risk of major amputations. Treating these ulcers is difficult because of poor tissue coverage and the bony os calcis, often leading to proximal amputation. This case series shows the vertical contour calcanectomy (VCC) as a surgical alternative in functional limb salvage. Sixteen feet (14 patients) with recalcitrant heel wounds...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Publication date: November 2019Source: The Journal of Foot and Ankle Surgery, Volume 58, Issue 6Author(s): Nicole K. Cates, Tammer Elmarsafi, Taylor J. Bunka, Elliot T. Walters, Cameron M. Akbari, Caitlin Zarick, Karen K. Evans, John S. Steinberg, Christopher E. Attinger, Paul J. KimAbstractPostreconstructive outcomes were compared in diabetic patients with Charcot neuroarthropathy (CN) who had peripheral arterial disease (PAD) diagnosed with angiography versus patients who were diagnosed clinically. A retrospective review was performed of patients with diabetic CN requiring reconstruction secondary to ulceration and/or ac...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Diabetic foot ulcer is a common complication of diabetes. The lifetime prevalance of diabetic foot ulcers has been estimated to between 19 and 34% in diabetic patients [1]. In addition, the annual incidence rates of diabetic foot ulcers in the global population of diabetic patients has been reported to be 6.3 percent [2]. Diabetic foot ulcers frequently lead to lower extremity amputations, approximately 75% of which are performed in diabetic patients due to a combination of peripheral neuropathy, peripheral vascular disease, poor glycemic control, and superimposing infections [3].
Source: Diabetes Research and Clinical Practice - Category: Endocrinology Authors: Source Type: research
Foot and ankle complications of diabetes result in significant morbidity, mortality, and health care expenditure. Diabetes may result in foot deformity, neuropathy, and peripheral artery disease with risk of callus, foot ulcer, infection, and subsequent amputation. Appropriate patient education, medical management, and use of therapeutic footwear can prevent many diabetic foot complications. Nurse practitioners are key members of foot care teams in both primary and specialty care. The nurse practitioner managing a patient ’s diabetes is an appropriate provider to certify the need for diabetic shoes and should be auth...
Source: The Journal for Nurse Practitioners - Category: Nursing Authors: Tags: Featured Article Source Type: research
ConclusionCholerae should be included in the differential diagnosis of any bacteremic skin and soft tissue infections especially in elderly, comorbid and immune-compromised patients. Well-timed, proper antibiotic and surgical treatments are important in management of the infection to decrease morbidity and mortality.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Abstract There are>12 million patients with peripheral artery disease in the United States. The most severe form of peripheral artery disease is critical limb ischemia (CLI). The diagnosis and management of CLI is often challenging. Ethnic differences in comorbidities and presentation of CLI exist. Compared with white patients, black and Hispanic patients have higher prevalence rates of diabetes mellitus and chronic renal disease and are more likely to present with gangrene, whereas white patients are more likely to present with ulcers and rest pain. A thorough evaluation of limb perfusion is important in the d...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Diabetes is one of the most common metabolic disorders in the world, and its prevalence in adults has showed a trend of significant increase in the last few decades [1,2]. Major complications of diabetes mellitus include diabetic foot disease and this problem is an important cause of morbidity. Diabetic foot disease is typically defined to include ulcers or infections in the foot of a person with diabetes [3 –5]. Important risk factors for the development of diabetic foot disease include neuropathy, peripheral vascular disease and poor glycemic control [6].
Source: Primary Care Diabetes - Category: Primary Care Authors: Tags: Original research Source Type: research
AbstractPurpose of ReviewThis paper provides a concise update on the management of peripheral artery disease (PAD).Recent FindingsPAD continues to denote a population at high risk for mortality but represents a threat for limb loss only when associated with foot ulcers, gangrene, or infections. Performing either angiogram or non-invasive testing for all patients with foot ulcers, gangrene, or foot infections will help increase the detection of PAD, and refined revascularization strategies may help optimize wound healing in this patient group. Structured exercise programs are becoming available to more patients with claudic...
Source: Current Diabetes Reports - Category: Endocrinology Source Type: research
This article describes two case studies with successful wound healing as a result of using this clinical method during hemodialysis sessions. PMID: 31199100 [PubMed - in process]
Source: Nephrology Nursing Journal - Category: Nursing Authors: Tags: Nephrol Nurs J Source Type: research
This study aimed to compare the effect of high-intensity interval training (HIIT) with moderate-intensity continuous training (MCT) on endothelial function, oxidative stress and clinical fitness in patients with type 1 diabetes. Thirty-six type 1 diabetic patients (mean age 23.5 ± 6 years) were randomized into 3 groups: HIIT, MCT, and a non-exercising group (CON). Exercise was performed in a stationary cycle ergometers during 40 min, 3 times/week, for 8 weeks at 50–85% maximal heart rate (HRmax) in HIIT and 50% HRmax in MCT. Endothelial function was measured by flow-mediated dilation (FMD) [endothelium-depende...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
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