Examination of the lower limb in high risk patients

Santos, Derek; Carline, Tom

doi:10.1016/s0965-206x(00)80037-6

Cited by 5 publications

(3 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The attributable cost of caring for a primary healing foot ulcer for 3 years after the initial diagnosis can amount to over $26 000 (2). The survival rate of patients who develop diabetic foot ulcers is reduced by about 15%, and at 5 years, these patients have approximately a 50% survival rate usually after arterial interventions and amputations (3,4).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

Jesús¹,

Medina²,

Troche³

et al. 2007

International Wound Journal

View full text Add to dashboard Cite

The use of antiseptics in wound care is often controversial and there is definitely a need for a non toxic, highly disinfective agent. This study assessed the efficacy of a neutral pH superoxidised aqueous solution (NpHSS) for infection control, odour reduction and surrounding skin and tissue damage on infected diabetic foot ulcerations. From November 2003 to March 2004, 45 patients with type 2 diabetes were randomised into a single-blind clinical trial comparing NpHSS (intervention group; n = 21) versus conventional disinfectant (control group; n = 16). All patients received comprehensive care including surgical debridement as appropriate, moist wound care, intensive glucose control and broad spectrum antibiotics. Treatment groups were matched in terms of sex, age (61.9 +/- 11.9 versus 67.8 +/- 11.6), years of diabetes duration (16.4 +/- 8.1 versus 17 +/- 10.2), obesity, HgAlc (7.1 +/- 2 versus 6.7 +/- 1.8), initial fasting glycaemia (163 +/- 59 versus 152 +/- 65.8 mg/dl), ulcer duration/week (13.7 +/- 24 versus 15.1 +/- 16.3), B/A Index (0.9 +/- 0.5 versus 1.14 +/- 0.7), depth and extent of infection/periwound cellulitis (groups B and C of the Tampico Hospital Classification) as well as aetiology (P = 0.647). Odour reduction was achieved in all NpHSS patients (100% versus 25%; P < 0.01) and surrounding cellulitis diminished (P < 0.001) in 17 patients (80.9% versus 43.7%). Nineteen patients in the NpHSS group showed advancement to granulating tissue stage (90.4% versus 62.5%; P = 0.05) with significantly less tissue toxicity (94% versus 31.2%; P < 0.01). A non toxic, NpHSS, as part of a comprehensive care regimen, may be more efficacious in infection control, odour and erythema reduction than conventional disinfectants in treatment of diabetic foot infections.

show abstract

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

Jesús¹,

Medina²,

Troche³

et al. 2007

International Wound Journal

View full text Add to dashboard Cite

show abstract

“…Los pacientes evolucionan con claudicación intermitente y, posteriormente, con dolor de reposo asociado a alteraciones de la sensibilidad 10,11 . Pueden presentar alteraciones tróficas de las extremidades, engrosamiento de las uñas, xerosis, edema, linfangitis, pulsos disminuidos, piel fría, eritema, palidez o cianosis.…”

Section: Caso 3: Microangiopatía Diabéticaunclassified

Necrosis cutánea: un desafío para el médico

et al. 2014

Rev. méd. Chile

View full text Add to dashboard Cite

Skin necrosis must be considered as a syndrome, because it is a clinical manifestation of different diseases. An early diagnosis is very important toa necrosis cutánea debe ser considerada como un síndrome, pues es la manifestación cutánea de diversas entidades clínicas. El diagnóstico precoz y la pronta identificación de la etiología son claves para un tratamiento oportuno y mejorar la sobrevida del paciente.Se recolectaron los casos más demostrativos de necrosis cutánea en pacientes hospitalizados. Se registró la historia clínica, se tomaron fotografías y en algunos casos se realizaron biopsias de las lesiones. Casos clínicosEn la Tabla 1 se presentan los casos clínicos más demostrativos de necrosis cutánea en pacientes hospitalizados en nuestra institución. Se detalla sexo del paciente, edad, antecedentes mórbidos, fármacos utilizados, clínica con la que se presentaron al momento de la consulta y el estudio de anatomía patológica (AP). Finalmente, se describe el diagnóstico y se menciona el tratamiento que se realizó. Caso 1: Necrosis por cumarínicosSe ha descrito necrosis cutánea asociada al uso de warfarina, reportándose una prevalencia entre 0,01 y 0,1% de los pacientes tratados. Aunque el mecanismo no está aclarado, se describe un efecto procoagulante transitorio por una rápida caída de los niveles de proteína C 1,2 . El cuadro clínico se manifiesta como edema y eritema de inicio súbito, asociado a dolor o parestesias. En 90% de los casos, la aparición de necrosis cutánea se produce de 3 a 6 días de iniciado el tratamiento, aunque se han descrito casos que se han desarrollado semanas o meses después 3 . El estudio histopatológico revela trombosis y depósitos de fibrina en las vénulas postcapilares sin inflamación 4,5 . El tratamiento es la suspensión del fármaco, transfusión de plasma fresco congelado y aporte de vitamina K endovenosa. Caso 2: Loxoscelismo cutáneo necróticoEl loxoscelismo es el cuadro clínico secundario a la mordedura de araña del género Loxosceles laeta, el cual presenta una forma limitada a la piel y otra sistémica (loxoscelismo cutáneo visceral), la que

show abstract

“…The patients on intensive visits also had a lower 2-year rate of foot ulceration, 2.4% compared with 3.5%. The implications of a reduction in amputation rate may extend beyond improving the quality of life, as the mortality rate at 3 years after amputation is estimated to be as high as 50% [60,61]. Although this observation most likely reflects comorbidities in patients with advanced DSP, it may be hypothesized that more intensive clinical follow-up may improve outcomes in those with diabetes complicated to this degree.…”

Section: Current Evidence-based Interventionsmentioning

confidence: 99%

Diagnosis and management of diabetic neuropathy

Perkins¹,

Bril

2002

Curr Diab Rep

View full text Add to dashboard Cite

Diabetic sensorimotor polyneuropathy (DSP) remains the most common microvascular complication of both type I and type 2 diabetes, and poses a unique set of management challenges in the prevention of foot complications. Although different quantitative tests are available, the preliminary diagnosis of DSP can be reliably made using simple and rapid screening tests in the family physician's office or in the diabetes clinic. The Semmes-Weinstein 10-g monofilament examination is a popular, simple clinical modality for the prediction of early DSP, foot ulceration, and amputation, and, in turn, a predictor of mortality in patients with diabetes. The management of DSP is centered on optimal glycemic control, diligent foot care, and pain control as a means of preventing the progression of DSP and reducing the morbidity associated with foot complications.

show abstract

Examination of the lower limb in high risk patients

Cited by 5 publications

References 41 publications

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

Necrosis cutánea: un desafío para el médico

Diagnosis and management of diabetic neuropathy

Contact Info

Product

Resources

About