A case report of a multi-drug resistant bacterial infection in a diabetic patient treated in northeast Brazil.
Authors: Neto RM, Ansaldi MA, da Costa ME, da Silva SO, Luz VH
Abstract
Diabetes mellitus is one of the most critical health conditions around the world, not only in terms of the number of affected people, disability, and premature mortality, but also in regards to the health care costs involved in controlling and treating its complications. Among the most constant ailments the diabetic patient suffers is the diabetic foot, defined as any infection, ulceration, and/or necrosis of deep tissues associated with neurological abnormalities and various degrees of peripheral vascular disease of the lower limbs. D...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Preoperative medical treatment in patients undergoing diabetic foot surgery with a Wagner Grade-3 or higher ulcer: a retrospective analysis of 52 patients.
Authors: Korkmaz M, Erdoğan Y, Balcı M, Senarslan DA, Yılmaz N
Abstract
Diabetic foot ulcers (DFU) are one of the most important complications in people with diabetes mellitus. The present study was aimed to retrospectively review the efficacy of at least 1-week medical treatment before any surgical intervention in patients with Grade-3 and higher DFU according to Wagner's classification. A total of 52 patients (36 males and 16 females) hospitalized and treated between June 2006 and February 2009 and had initially received therapeutic treatment (local wound care, antibiotic therapy and blood glucose reg...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Surgical complications associated with primary closure in patients with diabetic foot osteomyelitis.
DISCUSSION: Primary surgical closure was not associated with a greater number of complications. Patients who received primary surgical closure had faster healing rates and experienced a lower percentage of exudation (p=0.05), edema (p<0.001) and reinfection, factors that determine the delay in wound healing and affect the prognosis of the surgical outcome. Further research with a greater number of patients is required to better define the cases for which primary surgical closure may be indicated at different levels of the diabetic foot.
PMID: 23050062 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
A tale of two soles: sociomechanical and biomechanical considerations in diabetic limb salvage and amputation decision-making in the worst of times.
We describe in detail the similarities and differences in the clinical presentation, extent of infection, etiology, and socioeconomic concerns that ultimately led to divergent clinical decisions regarding the choices of attempting diabetic limb salvage versus primary amputation and prompt rehabilitation.
PMID: 23050063 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
The current role of endovascular intervention in the management of diabetic peripheral arterial disease.
This article will review the basics of application of endovascular intervention in the diabetic patient with arterial disease and provide a broad understanding of the literature behind the decision-making on appropriate therapy.
PMID: 23050064 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Diabetic foot infections with osteomyelitis: efficacy of combined surgical and medical treatment.
In conclusion, combined surgical and medical treatment for diabetic foot osteomyelitis can achieve acceptable limb salvage rate and also reduce the duration of time to healing along with the duration of antibiotic treatment and wound recurrence rate.
PMID: 23050065 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
The use of propeller perforator flaps for diabetic limb salvage: a retrospective review of 25 cases.
CONCLUSIONS: The purpose of this article is to review the use of PPF as an effective method for soft tissue coverage of the diabetic lower extremity and/or foot. In well-controlled diabetic patients that present with at least one permeable artery in the affected lower leg, the use of PPF may provide an alternative option for soft tissue reconstruction of acute and chronic diabetic wounds.
PMID: 23050066 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
From the diabetic foot ulcer and beyond: how do foot infections spread in patients with diabetes?
Authors: Aragón-Sánchez J, Lázaro-Martínez JL, Pulido-Duque J, Maynar M
Abstract
A diabetic foot infection is usually the result of a pre-existing foot ulceration and is the leading cause of lower extremity amputation in patients with diabetes. It is widely accepted that diabetic foot infections may be challenging to treat for several reasons. The devastating effects of hyperglycemia on host defense, ischemia, multi-drug resistant bacteria and spreading of infection through the foot may complicate the course of diabetic foot infections. Understanding the ways in which infections spread through the diab...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Current challenges in imaging of the diabetic foot.
Authors: Sanverdi SE, Ergen BF, Oznur A
Abstract
Although a variety of diagnostic imaging modalities are available for the evaluation of diabetes-related foot complications, the distinction between neuroarthropathy and osteomyelitis is still challenging. The early and accurate diagnosis of diabetic foot complications can help reduce the incidence of infection-related morbidities, the need for and duration of hospitalization, and the incidence of major limb amputation. Conventional radiography, computed tomography, nuclear medicine scintigraphy, magnetic resonance imaging, ultrasonography, and positron emis...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Editorial.
Authors: Zgonis T
PMID: 23050069 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
A comparison of diabetic smokers and non-smokers who undergo lower extremity amputation: a retrospective review of 112 patients.
CONCLUSION: Neither the amputation level nor the amputation itself was enough motivation for the patients to participate in smoking cessation.
PMID: 23082237 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Associated risk factors and management of chronic diabetic foot ulcers exceeding 6 months' duration.
DISCUSSION: Risk factors associated with chronic DFU of>6 months' duration included the presentation of an ulcer with increased size and depth, with associated skin callus and neuroischemia, in a diabetic patient with a history of smoking and increased HbA1c >7%. Off-loading mainly with the use of TCC is an effective method of managing long-standing DFU.
PMID: 23119125 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Pressure pain perception in the diabetic Charcot foot: facts and hypotheses.
CONCLUSION: It is hypothesised that deep dull aching in an acute diabetic Charcot foot may represent faulty posttraumatic hyperalgesia involving cutaneous and skeletal tissues.
PMID: 23705057 [PubMed] (Source: Diabetic Foot and Ankle)
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Etiology, pathophysiology and classifications of the diabetic Charcot foot.
Authors: Papanas N, Maltezos E
Abstract
In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by ...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
Distal amputations for the diabetic foot.
Authors: Nather A, Wong KL
Abstract
Minor amputations in diabetic patients with foot complications have been well studied in the literature but controversy still remains as to what constitutes successful or non-successful limb salvage. In addition, there is a lack of consensus on the definition of a minor or distal amputation and a major or proximal amputation for the diabetic population. In this article, the authors review the existing literature to evaluate the efficacy of minor amputations in this selected group of patients in terms of diabetic limb salvage and also propose several definitions regarding...
Source: Diabetic Foot and Ankle - December 20, 2015 Category: Endocrinology Tags: Diabet Foot Ankle Source Type: research
