Modalities of Soft-Tissue Coverage in Diabetic Foot Ulcers

Akhtar, Shamim; Ahmad, Imran; Khan, Ahmad; Khurram, Mohammed Fahud

doi:10.1097/01.asw.0000460889.44609.0c

Cited by 12 publications

(14 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25,37 One study was excluded because further review revealed that the flaps mentioned did not meet the definition of a local random flap. 5 The remaining 25 studies that were scrutinized for data extraction shown in Table 1 had a total of 512 patients in whom 204 local random flaps were performed on 199 patients with diabetes mellitus to achieve definitive foot wound closure. Table 2 provides an overall description of the studies in our systematic review.…”

Section: Resultsmentioning

confidence: 99%

“…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%

“…25,37 One study was excluded because further review revealed that the flaps mentioned did not meet the definition of a local random flap. 5…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

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

Ramanujam¹,

Zgonis²

2018

Foot & Ankle Specialist

View full text Add to dashboard Cite

“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

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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

Ramanujam¹,

Zgonis²

2018

Foot & Ankle Specialist

View full text Add to dashboard Cite

show abstract

“…The mainstay of treatment in diabetic lower extremity wounds has been negative-pressure wound therapy, skin grafts, or free flaps. 1…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategies: Necrotizing Fasciitis of the Foot and Ankle Treated With Dermal Regeneration Matrix for Limb Salvage

et al. 2020

View full text Add to dashboard Cite

Although necrotizing fasciitis is a life-threatening entity that needs expeditious treatment, cases involving the lower extremity are less commonly encountered than in the upper extremity. Surgical intervention is often required and likely lead to amputation (below-knee or above-knee) vs debridement in the lower extremity. Coverage options in the foot and ankle after serial debridements can present many challenges for limb salvage. Patients are often left with large soft tissue defects requiring coverage with a subsequent increase in relative morbidity. Treatment options for coverage in these cases include negative-pressure wound therapy, split-thickness skin grafting, free flap coverage, or higher-level amputation. In the diabetic population, who present with a lower extremity necrotizing infection, limb salvage is often a challenge given the multiple comorbidities associated with these patients including peripheral vascular disease, immunocompromised state, and neuropathy. Optimal treatment strategies for these necrotizing infections in the foot and ankle remain uncertain. We offer a technique tip for utilization of a dermal regeneration matrix to allow coverage of large soft tissue defect with exposed tendon and/or bone without the need for free flap coverage or higher-level amputation, thus allowing for an additional limb salvage option. Level of Evidence: Level V, expert opinion.

show abstract

“…A multidisciplinary approach and medical advances in the past two decades have improved the ability to reconstruct complicated and infected diabetic lower extremities. Feet that once would have been amputated can now be managed by salvage procedures, with similar or even better functional outcomes compared to diabetic patients who undergo amputation [ 12 , 13 ]. In this scenario, it is fundamental to consider the option of a surgical reconstruction, rather than an amputation, when treating diabetic patients with complicated and infected DFUs [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Diabetic limb salvage procedure with bone allograft and free flap transfer: a case report

Godoy‐Santos

Amodio

Pires

et al. 2017

Diabetic Foot & Ankle

View full text Add to dashboard Cite

The aim of this case report was to describe a successful diabetic limb salvage procedure in the treatment of an infected diabetic foot ulcer through a multidisciplinary team approach and complex surgical reconstruction involving a femoral head bone allograft and musculocutaneous latissimus dorsi free flap. The decision to proceed with aggressive staged efforts at diabetic limb salvage should be made only after careful consultation with the patient, his or her family, and the rest of the multidisciplinary healthcare team.

show abstract

Modalities of Soft-Tissue Coverage in Diabetic Foot Ulcers

Abstract: From the results of this study, the authors conclude that radical debridement and soft-tissue cover in the form of a skin graft/flap is an effective method of managing DFUs.

Cited by 12 publications

References 33 publications

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

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

Surgical Strategies: Necrotizing Fasciitis of the Foot and Ankle Treated With Dermal Regeneration Matrix for Limb Salvage

Diabetic limb salvage procedure with bone allograft and free flap transfer: a case report

Contact Info

Product

Resources

About