Diabetic Foot Limb Salvage in Low-Resource Settings: Challenges and Solutions

Diabetic foot is a common ailment with poor limb salvage rate. The aim of our study was to assess the role of early intervention with adjuncts like negative pressure wound therapy and platelet-rich fibrin in management of these cases in low-resource settings.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Global surgery Source Type: research

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The prospect of an increase in ageing population and incidence of diabetes potentially increases the number of amputees in the future1. Hip fractures in lower limb amputees have been reported sporadically in literature2. Amputees suffer from accelerated bone density loss regardless of their age and are at increased risk of osteoporosis and fragility fractures of the hip2,3. This also increases the risk of other co-morbidities such as pressure ulcers and infection if the treatment is delayed4. Hip fractures amongst lower limb amputees though uncommon, pose a management challenge with regards to the surgical approach and tec...
Source: Injury - Category: Orthopaedics Authors: Source Type: research
CONCLUSIONS: The comprehensive CAP study landscape with structured case report summaries and randomized case-control studies allows the conclusion that CAP is safe, effective, and easy to handle for wound treatment. The utilization of CAP in addition to standard wound treatments is starting to enter routine clinical practice. PMID: 32997219 [PubMed - as supplied by publisher]
Source: Der Hautarzt: Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete - Category: Dermatology Tags: Hautarzt Source Type: research
A variety of skin lesions have been described with Coronavirus infection, also called COVID-19 or SARS-CoV-2, and this post explores whether there is a link between COVID and wounds. Understanding of this disease is still in the early stages, and it is unclear whether these skin lesions are the result of comorbidities or coinfection with other agents, or whether COVID-19 is actually responsible. A search of the world literature reveals the following skin issues with COVID: Acral erythema (redness and swelling of the hands and feet) with vesicles and pustules.  This is similar to chilblains – a condition associa...
Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Tags: Featured Medical Articles Geriatric Medicine Long-Term Care Pressure Injuries & Wound Care bedsore bedsores coronavirus COVID COVID-19 decubiti decubitus ulcer end-of-life care eschar geriatrics gerontology Improving Medical Source Type: blogs
We read the interesting report on the efficacy of incisional negative pressure wound therapy (NPWT) for the prevention of postoperative wound complication such as surgical site infections (SSIs).1 NPWT is effective in promoting wound healing and in removing wound exudate, irrigation fluids, bodily fluids, or infectious materials.2 –6 The procedure may be indicated for use on chronic, acute, traumatic, subacute, and dehisced wounds; diabetic ulcers; pressure ulcers; skin flaps; and grafts. Also, indications for the use of incisional NPWT include prophylaxis of SSI.
Source: Surgery - Category: Surgery Authors: Source Type: research
Authors: Sami DG, Abdellatif A, Azzazy HME Abstract Diabetic wound infections and pressure ulcers pose a significant challenge to healthcare providers worldwide. The current study provides new and innovative wound care products that reduce inflammation, clear infection and improve healing in an animal model of pressure ulcers in diabetic rats. Ointment, hydrogel, and nanofiber dressings were synthesized using 5% turmeric, 1% oregano, and 1% chitosan nanoparticles and tested for antibacterial and cytotoxicity in vitro, and wound healing effects in vivo.Turmeric ethanolic extract showed high antioxidant activity comp...
Source: Drug Development and Industrial Pharmacy - Category: Drugs & Pharmacology Tags: Drug Dev Ind Pharm Source Type: research
ConclusionsMedical and wound care teams can benefit from this combination therapy when dealing with nonhealing necrotic wounds.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
CONCLUSIONS: As shown in this case series, NPWTi-d was a beneficial tool for cleansing the wound bed, thus creating a moist, closed wound environment conducive to healing. Using NPWTi-d supported the formation of a healthy wound bed and contributed to rapid, positive outcomes in this patient population. PMID: 32804665 [PubMed - as supplied by publisher]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
CONCLUSIONS: Venous leg ulcers and other wound etiologies (ie, STWs, PUs, DFUs, and arterial wounds) appear to differ in wound healing outcomes and certain characteristics. These results may be of interest to clinicians, patients, health care policy makers, and insurers. Future research is warranted to compare wound healing outcomes and patient characteristics among different settings. PMID: 32804663 [PubMed - as supplied by publisher]
Source: Wounds - Category: General Medicine Tags: Wounds Source Type: research
Abstract Wound repair and regeneration is a complex orchestrated process, comprising several phases interconnecting various cellular events and triggering multiple intracellular molecular pathways in damaged cells and tissues. In several metabolic disorders including diabetes mellitus, delay in wound healing due to elevated levels of cellular stress poses a key challenge. Several therapeutic wound dressing materials and strategies including hyperbaric oxygen therapy and negative pressure wound therapy have been developed to accelerate repair and restore cellular homeostasis at the wound site. Further, tremendous p...
Source: European Journal of Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Eur J Pharmacol Source Type: research
Minimally invasive distal metatarsal diaphyseal osteotomy (DMDO) is an effective procedure for the treatment of complicated chronic diabetic foot ulcers under the heads of all lateral metatarsal bones (including the fifth). Resistant toe ulcers and recurrent pressure ulcers can be treated effectively by DMDO. For diabetic patients, the main advantages of this method are minimal surgical scars and tissue damage, immediately postoperative weight bearing, absence of osteosynthesis and consequent potential infection of metal fixation, reduction of the previous high plantar pressures by the restoration of a harmonic balanced fo...
Source: Foot and Ankle Clinics - Category: Orthopaedics Authors: Source Type: research
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