Surgical Management of Diabetic Foot Infections and Amputations

Zgonis, Thomas; Stapleton, John J.; Girard-Powell, Valerie A.; Hagino, Ryan T.

doi:10.1016/j.aorn.2008.02.014

Cited by 40 publications

(29 citation statements)

References 46 publications

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“…Therefore, PR is mainly used for the evaluation of major structural changes (6, 9, 10). When soft tissue gas is present, the proximal joint next to the infected area must be included in the PR to assess the extent of the infection (11). …”

Section: Overview Of Imaging Modalitiesmentioning

confidence: 99%

Current challenges in imaging of the diabetic foot

Sanverdi

Ergen

Öznur

2012

Diabetic Foot & Ankle

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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 emission tomography are the main procedures currently in use for the evaluation of diabetes-related foot complications. However, each of these modalities does not provide enough information alone and a multimodal approach should be used for an accurate diagnosis. The present study is a review of the current concepts in imaging of diabetes-related foot complications and an analysis of the advantages and disadvantages of each method.

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Section: Overview Of Imaging Modalitiesmentioning

confidence: 99%

Current challenges in imaging of the diabetic foot

Sanverdi

Ergen

Öznur

2012

Diabetic Foot & Ankle

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“…[1] Eighty-five percent of lower limb amputations in diabetes patients results from DFU, [2–4] which is commonly seen with the following 3 conditions: peripheral neuropathy, vasculopathy, and immunopathy. [5] After 10 years, about half of the patients with diabetes develop peripheral artery disease (PAD). [6] Patients with PAD can be asymptomatic or have symptoms such as intermittent claudication and rest pain, as well as ischemia ulcer and foot gangrene.…”

Section: Introductionmentioning

confidence: 99%

A quantitative real-time assessment of Buerger exercise on dorsal foot peripheral skin circulation in patients with diabetes foot

et al. 2016

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Buerger exercise can improve the peripheral circulation of lower extremities. However, the evidence and a quantitative assessment of skin perfusion immediately after this exercise in patients with diabetes feet are still rare.We recruited 30 patients with unilateral or bilateral diabetic ulcerated feet in Chang Gung Memorial Hospital, Chia-Yi Branch, from October 2012 to December 2013. Real-time dorsal foot skin perfusion pressures (SPPs) before and after Buerger exercise were measured and analyzed. In addition, the severity of ischemia and the presence of ulcers before exercise were also stratified.A total of 30 patients with a mean age of 63.4 ± 13.7 years old were enrolled in this study. Their mean duration of diabetes was 13.6 ± 8.2 years. Among them, 26 patients had unilateral and 4 patients had bilateral diabetes foot ulcers. Of the 34 wounded feet, 23 (68%) and 9 (27%) feet were classified as Wagner class II and III, respectively. The real-time SPP measurement indicated that Buerger exercise significantly increased the level of SPP by more than 10 mm Hg (n = 46, 58.3 vs 70.0 mm Hg, P < 0.001). In terms of pre-exercise dorsal foot circulation condition, the results showed that Buerger exercise increased the level of SPP in severe ischemia (n = 5, 22.1 vs 37.3 mm Hg, P = 0.043), moderate ischemia (n = 14, 42.2 vs 64.4 mm Hg, P = 0.001), and borderline–normal (n = 7, 52.9 vs 65.4 mm Hg, P = 0.028) groups, respectively. However, the 20 feet with SPP levels more than 60 mm Hg were not improved significantly after exercise (n = 20, 58.3 vs 71.5 mm Hg, P = 0.239). As to the presence of ulcers, Buerger exercise increased the level of SPP in either unwounded feet (n = 12, 58.5 vs 66.0 mm Hg, P = 0.012) or wounded feet (n = 34, 58.3 vs 71.5 mm Hg, P < 0.001). The majority of the ulcers was either completely healed (9/34 = 27%) or still improving (14/34 = 41%).This study quantitatively demonstrates the evidence of dorsal foot peripheral circulation improvement after Buerger exercise in patients with diabetes.

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“…Most foot ulceration ultimately turns into diabetic gangrene especially if left untreated, contributing to approximately 80% of lower limb amputations [10–16]. More than 50% of diabetic wounds can exponentially increase the risk of below-knee amputation [17–19], which significantly enhances mortality in addition to contributing to a poor quality of life with enormous social, psychological, and economic consequences [13, 20–23]. The majority of diabetic foot ulcerations involve the toes [24].…”

Section: Introductionmentioning

confidence: 99%

Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds

Alam

Islam

Gan

et al. 2014

Evidence-Based Complementary and Alternative Medicine

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Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey's antibacterial activity on diabetic wound-related microorganisms and honey's clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims.

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Surgical Management of Diabetic Foot Infections and Amputations

Cited by 40 publications

References 46 publications

Current challenges in imaging of the diabetic foot

Current challenges in imaging of the diabetic foot

A quantitative real-time assessment of Buerger exercise on dorsal foot peripheral skin circulation in patients with diabetes foot

Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds

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