External Fixators as an Adjunct to Wound Healing

Clemens, Mark W.; Parikh, Pranay M.; Hall, Melanie M.; Attinger, Christopher E.

doi:10.1016/j.fcl.2007.12.001

Cited by 23 publications

(11 citation statements)

References 16 publications

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“…1 Current advances in wound research have led to solutions that have markedly improved patient care. [2][3][4][5][6][7][8] Experimental observations have helped formulate guidelines of care providing the basis for uniform care across the United States. [9][10][11][12][13] Strengthening of wound healing research, in light of the rapidly growing threat, deserves a higher level of prioritization.…”

Section: Chronic Woundsmentioning

confidence: 99%

Human skin wounds: A major and snowballing threat to public health and the economy

Sen

Gordillo

Roy

et al. 2009

Wound Repair Regeneration

2,446

1,984

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In the United States, chronic wounds affect around 6.5 million patients. It is claimed that an excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is growing rapidly due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from “highly branded” diseases such as diabetes and obesity. This seems to have overshadowed the significance of wounds per se as a major health problem. For example, NIH’s Research Portfolio Online Reporting Tool (RePORT; http://report.nih.gov/), directed at providing access to estimates of funding for various disease conditions do list several rare diseases but does not list wounds. According to the latest data from the National Center for Health Statistics, 40 million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also in homeland preparedness against natural disasters as well as against terrorism attacks. An additional burden of wound healing is the problem of skin scarring, a $12 billion annual market. Current research advances in the field have led to solutions that have been effective in improving patient care. The immense economic and social impact of wounds in our society calls for allocation of a higher level of attention and resources to understand biological mechanisms underlying cutaneous wound complications. Investment in the detailed scrutiny of wounds presented clinically as well as in pre-clinical models seems prudent.

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Section: Chronic Woundsmentioning

confidence: 99%

Human skin wounds: A major and snowballing threat to public health and the economy

Sen

Gordillo

Roy

et al. 2009

Wound Repair Regeneration

2,446

1,984

View full text Add to dashboard Cite

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“…During the post-operative follow-up, there were 6 complications (50%) (4 pin site infections) and 2 rescue treatment failures, which required a major amputation (13%). 45 Dalla Paola et al reported, in a prospective study, the results using a circular external fixator (Fig. 4) designed for offloading of hindfoot lesions complicated by osteomyelitis, in a cohort of 18 diabetic patients in their unit.…”

Section: Discussionmentioning

confidence: 99%

Surgical OFF-LOADING of the diabetic foot

Paola

Carone

Valente

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Diabetic foot ulcer treatment is a challenge for the healthcare world. Widespread infection and the presence of critical ischemia (especially with end-stage renal disease) can lead to major amputation rather than amenable to conservative treatment. Surgical strategies of the diabetic foot have been changing over the past 10 years and are now focused on reconstructive treatment and limb salvage. These goals were achieved, thanks to an evolution of distal revascularization techniques and a distinct approach, which integrates various methods focused on limb salvage. Podoplastic techniques of the diabetic foot are focused on infection clearance, the surgical treatment of corrective deformities, soft tissue coverage and limb ischemia correction along with the management of diabetes and the comorbidities that compromise tissue repair processes. The reconstructive techniques used in diabetic foot treatment owe their effectiveness in part to the results of technological improvements such as the circular external fixator as a tool for stabilization and surgical site protection. In the last decade, many studies have shown that circular external fixation should be considered as the most useful method to protect the reconstructive surgical site in limb salvage of the diabetic foot. The objective of this review is to highlight the role of surgical offloading using circular external fixation as an adjunct to the podoplastic diabetic foot reconstruction procedures.

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“…The initial search identified 53 eligible studies. 4-56 After applying the inclusion and exclusion criteria, 28 studies were excluded. Nine studies were excluded because they were performed on foot wounds in patients without diabetes mellitus *.…”

Section: Resultsmentioning

confidence: 99%

Use of Local Flaps for Soft-Tissue Closure in Diabetic Foot Wounds: A Systematic Review

Ramanujam¹,

Zgonis²

2018

Foot & Ankle Specialist

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“A systematic review was undertaken to assess the outcomes of local random flaps in diabetic foot wound closure. The review was conducted using the following databases: Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Excerpta Medica dataBASE, Google Scholar, MEDLINE, Ovid, and PubMed. Search terms were local random flap, diabetes, foot, wound, ulceration, neuropathy, tissue transfer, V-Y, bilobed, monolobed, rotational, advancement, transpositional, rhomboid, and Limberg. English language studies, studies published from 1997 to 2017, patients with diabetes mellitus treated for foot wounds, use of local random flaps, follow-up period of 6 months or more postoperatively, documentation of healing rates, complications, and need for revisional surgery were included. Isolated literature reviews and descriptions of only surgical technique and/or cadaveric studies were excluded. The initial search identified 53 eligible studies with 28 being excluded. The remaining 25 studies used for data extraction had a total of 512 patients in which 199 of these underwent 204 local random flap procedures. Average follow-up for the flaps was approximately >2 years, and successful wound closure at last follow-up was demonstrated in 75.5% of the studied population. Studies were found to be of generally low quality, with the majority composed of retrospective case series. Based on current available evidence found in this systematic review, local random flaps demonstrated a relatively high success rate when utilized for the definitive closure of diabetic foot wounds. However, because of a lack of high-quality evidence and substantial heterogeneity among the studies, the results should be interpreted with caution. Levels of Evidence: Level III: Systematic review

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External Fixators as an Adjunct to Wound Healing

Cited by 23 publications

References 16 publications

Human skin wounds: A major and snowballing threat to public health and the economy

Human skin wounds: A major and snowballing threat to public health and the economy

Surgical OFF-LOADING of the diabetic foot

Use of Local Flaps for Soft-Tissue Closure in Diabetic Foot Wounds: A Systematic Review

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