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    1 OF 70

    Growth factors for diabetic foot ulcers: Mixed treatment comparison analysis of randomized clinical trials.
    Br J Clin Pharmacol 2017 Nov 17. Epub 2017 Nov 17.
    Department of Oral Health, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
    Aims: Topical growth factors accelerate wound healing in patients with diabetic foot ulcers (DFU). Due to the absence of head to head comparisons, we carried out Bayesian network meta-analysis to compare the efficacy and safety of growth factors.

    Methods: Using an appropriate search strategy, randomized controlled trials on topical growth factors compared with standard of care in patients with DFU, were included. Read More

    A Series of 210 Peripheral Arterial Disease Below-Knee Amputations and Predictors for Subsequent Above-Knee Amputations.
    Ann Vasc Dis 2017 Sep;10(3)
    Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore.
    Objective: To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods: A retrospective study of 210 BKAs between May 2008 and December 2015. Results: The mean age of the study population was 66 years. Read More

    Antimicrobial Efficacy of Penicillium amestolkiae elv609 Extract Treated Cotton Fabric for Diabetic Wound Care.
    Mycobiology 2017 Sep 30;45(3):178-183. Epub 2017 Sep 30.
    Universiti Kuala Lumpur, Malaysian Institute of Chemical and Bioengineering Technology, 78000 Alor Gajah, Melaka, Malaysia.
    Diabetes mellitus is a chronic disorder which affects millions of population worldwide. Global estimates published in 2010 reported the world diabetic prevalence as 6.4%, affecting 285 million adults. Read More

    Efficacy of intravenous tigecycline in patients with Acinetobacter complex infections: results from 14 Phase III and Phase IV clinical trials.
    Infect Drug Resist 2017 3;10:401-417. Epub 2017 Nov 3.
    Pfizer Inc, Collegeville, PA, USA.
    Background: Acinetobacter infections, especially multidrug-resistant (MDR) Acinetobacter infections, are a global health problem. This study aimed to describe clinical outcomes in patients with confirmed Acinetobacter spp. isolates who were treated with tigecycline in randomized clinical trials. Read More

    Ciprofloxacin-loaded calcium alginate wafers prepared by freeze-drying technique for potential healing of chronic diabetic foot ulcers.
    Drug Deliv Transl Res 2017 Nov 13. Epub 2017 Nov 13.
    Department of Pharmaceutical, Chemical & Environmental Sciences, Faculty of Engineering and Science, University of Greenwich, Medway, Central Ave. Chatham Maritime, Kent, ME4 4TB, UK.
    Calcium alginate (CA) wafer dressings were prepared by lyophilization of hydrogels to deliver ciprofloxacin (CIP) directly to the wound site of infected diabetic foot ulcers (DFUs). The dressings were physically characterized by scanning electron microscopy (SEM), texture analysis (for mechanical and in vitro adhesion properties), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). Further, functional properties essential for wound healing, i. Read More

    A diabetic foot ulcer treated with hydrogel and hyperbaric oxygen therapy: a case study.
    J Wound Care 2017 Nov;26(11):692-695
    Lecturer, Universidade Luterana do Brasil, Rio Grande, Rio Grande do Sul, Brazil.
    This study reports on the case of an elderly patient, with diabetes, and a bullous wound on the left big toe that led to an amputation of the first and second left toes. The amputation was because of deep injury as it was not able to heal with a conventional treatment. After completing the normal treatment and the removal of a bacterial infection in the lesion, the patient underwent a treatment that was based on a hydrogel gel (0. Read More

    Topical oxygen therapy promotes the healing of chronic diabetic foot ulcers: a pilot study.
    J Wound Care 2017 Nov;26(11):652-660
    Consultant Vascular Surgeon, St George's Vascular Unit, St George's Healthcare NHS Trust, Tooting, London, UK.
    Objective: Interventions that can heal or reduce diabetic foot ulcer (DFU) size may reduce the incidence of infection and amputation, and reduce associated social and economic costs. Many chronic wounds exhibit a degree of hypoxia and this leads to a reduction in healing processes including cell division and differentiation, angiogenesis, infection prevention, and collagen production. The aim of this pilot study was to assess the effects of a device supplying continuous oxygen ambulatory therapy on healing in chronic DFUs. Read More

    Tibiotalocalcaneal Arthrodesis With the Hindfoot Arthrodesis Nail: A Prospective Consecutive Series From a Single Institution.
    J Foot Ankle Surg 2017 Nov 9. Epub 2017 Nov 9.
    Consultant, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
    Tibiotalocalcaneal arthrodesis (TTCA) is a salvage procedure. We report a series of 20 patients who underwent TTCA using an intramedullary nail. Of the 20 patients, 7 (35%) had diabetes mellitus. Read More

    Medial forefoot fillet flap for primary closure of transmetatarsal amputation: A series of four cases.
    Foot (Edinb) 2017 Jun 29;33:53-56. Epub 2017 Jun 29.
    Department of Orthopedic Surgery, Rabin Medical Center, 39th Jabutinski St. Petach Tikva 49100, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel. Electronic address:
    Amputation of the forefoot is a salvage procedure for several forefoot acute or chronic infection. A good, sensate and durable skin cover is important for quicker and better rehabilitation. The use of filleted flaps (or "spare parts technique") has been published in the past as a creative technique. Read More

    Compassionate Use of Bacteriophage Therapy for Foot Ulcer Treatment as an Effective Step for Moving Toward Clinical Trials.
    Methods Mol Biol 2018 ;1693:159-170
    VA Northern California, Muir Road, Martinez, CA, 94553, USA.
    We here present detailed descriptions of successful treatment of a series of diabetic toe ulcers using the Eliava BioPreparations' commercial preparation of the very well-studied anti-staphylococcal bacteriophage Sb-1. This chapter outlines what we feel is an appropriate mechanism to speed movement toward full-scale clinical trials with bacteriophage use to treat wound infections and to help address the crisis in antibiotic resistance. Read More

    Bacteriophage Treatment of Infected Diabetic Foot Ulcers.
    Methods Mol Biol 2018 ;1693:151-158
    Institute of Chemical Biology and Fundamental Medicine SB RAS, Laboratory of Molecular Microbiology, Lavrentiev Ave. 8, Novosibirsk, 630090, Russian Federation.
    Diabetic foot ulcers occur as a common complication of diabetes. Healing of the ulcers is largely delayed by the concomitant infection. Antibiotic treatment of infected ulcers is complicated by formation of microbial biofilms , which are often heterogeneous and resistant to antibiotics. Read More

    Antibiotic Resistance in Diabetic Foot Soft Tissue Infections: A Series From Greece.
    Int J Low Extrem Wounds 2017 Nov 1:1534734617737640. Epub 2017 Nov 1.
    1 Democritus University of Thrace, Alexandroupolis, Greece.
    Diabetic foot infections are a common and serious problem for all health systems worldwide. The aim of this study was to examine the resistance to antibiotics of microorganisms isolated from infected soft tissues of diabetic foot ulcers, using tissue cultures. We included 113 consecutive patients (70 men, 43 women) with a mean age of 66. Read More

    Minimally Invasive Distal Metatarsal Diaphyseal Osteotomy (DMDO) for Chronic Plantar Diabetic Foot Ulcers.
    Foot Ankle Int 2017 Nov 1:1071100717735640. Epub 2017 Nov 1.
    1 Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy.
    Background: The aims of this prospective study were first to evaluate the safety and effectiveness of minimally invasive distal metatarsal diaphyseal osteotomies (DMDOs) for treating a consecutive series of diabetic patients with chronic plantar diabetic foot ulcers (CPDFUs) and second to assess their clinical-functional and radiographic outcomes.

    Methods: A consecutive series of patients affected by diabetes mellitus with CPDFUs, not responsive to previous nonoperative management, underwent DMDO. The CPDFUs were evaluated using the University of Texas Diabetic Wound Classification System (UTDWC). Read More

    Comparative Assessment of Tedizolid Pharmacokinetics and Tissue Penetration Between Diabetic Patients with Wound Infections and Healthy Volunteers via In Vivo Microdialysis.
    Antimicrob Agents Chemother 2017 Nov 6. Epub 2017 Nov 6.
    Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA
    Herein, we present pharmacokinetic and tissue penetration data for oral tedizolid in hospitalized patients with diabetic foot infections (DFI) compared with healthy volunteers. Participants received oral tedizolid phosphate 200mg every 24 hours for 3 doses to achieve steady-state. A microdialysis catheter was inserted into the subcutaneous tissue near the margin of the wound for patients or into thigh tissue of volunteers. Read More

    Viability of permanent PMMA spacer with combined free fasciocutaneous tissue transfer for failed charcot reconstruction: A 38 month prospective case report.
    Int J Surg Case Rep 2017 Oct 4;41:174-179. Epub 2017 Oct 4.
    Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC, USA. Electronic address:
    Introduction: Charcot Neuroarthropathy is a complex lower extremity pathology which predisposes the afflicted limb to ulcerations, osteomyelitis, and risk of major amputation. Charcot Neuroarthropathy often requires osseous reconstruction, which can be complicated with osteomyelitis and hardware infection. When soft tissue and osseous deficits must be concomitantly addressed, the use of PMMA spacers can be combined with free tissue transfers. Read More

    Multiple limb salvage attempts for diabetic foot infections: is it worth it?
    Bone Joint J 2017 Nov;99-B(11):1502-1507
    National University Hospital, 1E Kent Ridge Road, Singapore.
    Aims: Limb salvage for diabetic foot infections often require multiple procedures. Some patients will eventually end up with below knee amputation (BKA) when all limb salvage attempts fail. We seek to study the patients' ability to return to normal life, functional status, prosthesis usage and perspectives on multiple limb salvage procedures that culminated in BKA to review if they would undertake a similar path if their situation was repeated. Read More

    Updating the Diabetic Foot Treatment Algorithm: Recommendations on Treatment Using Advanced Medicine and Therapies.
    Wounds 2017 Oct 20. Epub 2017 Oct 20.
    Dr. William M. School College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, Center for Lower Extremity Ambulatory Research (CLEAR), North Chicago, IL.
    Objective: Since the last diabetic foot ulcer (DFU) treatment algorithm was published in 2002, new options for diagnostic testing and treatments have been developed. This study seeks to update the DFU treatment algorithm to include new options available in diagnostic testing and treatment.

    Materials And Methods: A computerized literature search of peer-reviewed articles published between January 2003 and January 2016 was conducted using MEDLINE (PubMed), EMBASE, and the Cochrane Library. Read More

    Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study.
    Diabet Med 2017 Oct 30. Epub 2017 Oct 30.
    Schoool of Healthcare, University of Leeds, Leeds, UK.
    Aims: To determine clinical outcomes and explore prognostic factors related to ulcer healing in people with a clinically infected diabetic foot ulcer.

    Methods: This multicentre, prospective, observational study reviewed participants' data at 12 months after culture of a diabetic foot ulcer requiring antibiotic therapy. From participants' notes, we obtained information on the incidence of wound healing, ulcer recurrence, lower extremity amputation, lower extremity revascularization and death. Read More

    Virulence genes fliC, toxA and phzS are common among Pseudomonas aeruginosa isolates from diabetic foot infections.
    Infect Dis (Lond) 2017 Oct 27:1-7. Epub 2017 Oct 27.
    b REDPROM Research Center , University of Adnan Menderes , Aydın , Turkey.
    Background: Outcomes of antibiotic treatment of diabetic foot infections (DFIs) may depend not only on the antimicrobial susceptibility of the aetiologic agents, but also their ability to produce virulence factors. This study aimed to use polymerase chain reaction (PCR) with specific primers to investigate the presence of virulence genes among isolates of Pseudomonas aeruginosa isolates cultured from specimens from diabetic foot and other infections.

    Methods: We examined 63 P. Read More

    Split-Thickness Skin Grafts to the Foot and Ankle of Diabetic Patients.
    J Am Podiatr Med Assoc 2017 Sep;107(5):365-368
    Background: There is an increased prevalence of foot ulceration in patients with diabetes, leading to hospitalization. Early wound closure is necessary to prevent further infections and, ultimately, lower-limb amputations. There is no current evidence stating that an elevated preoperative hemoglobin A1c (HbA1c) level is a contraindication to skin grafting. Read More

    Bacterial Profile and Antibiotic Resistance in Patients with Diabetic Foot Ulcer in Guangzhou, Southern China: Focus on the Differences among Different Wagner's Grades, IDSA/IWGDF Grades, and Ulcer Types.
    Int J Endocrinol 2017 11;2017:8694903. Epub 2017 Jul 11.
    Department of Clinical Laboratory, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
    Objective: To understand the bacterial profile and antibiotic resistance patterns in diabetic foot infection (DFI) in different Wagner's grades, IDSA/IWGDF grades, and different ulcer types in Guangzhou, in order to provide more detailed suggestion to the clinician about the empirical antibiotic choice.

    Methods: 207 bacteria were collected from 117 DFIs in Sun Yat-sen Memorial Hospital from Jan.1, 2010, to Dec. Read More

    A novel approach for quantification of contour irregularities of diabetic foot ulcers and its association with ischemic heart disease.
    Conf Proc IEEE Eng Med Biol Soc 2017 Jul;2017:1437-1440
    Diabetic Foot Ulcer (DFU) is a common and global health problem in patients suffering from Diabetes. Delayed healing of these ulcers lead to serious problems, such as infection and amputation, apart from the problems faced in carrying out daily activities. This work has hypothesized the change in irregularity of wound contour may be linked to patient's clinical conditions. Read More

    Osteomyelitis of the lower extremity: pathophysiology, imaging, and classification, with an emphasis on diabetic foot infection.
    Emerg Radiol 2017 Oct 20. Epub 2017 Oct 20.
    Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
    Osteomyelitis is inflammation of the bone caused by an infectious organism, and is a difficult clinical problem. The pathophysiology, imaging, and classification of osteomyelitis are challenging, varying with the age of the patient (child versus adult), the chronicity of the infection (acute versus chronic), and the route of spread (hematogenous versus contiguous focus), as well as the immune and vascular status of the patient and affected region. The two most common classification schemes are those of Lew and Waldvogel, and Cierny and Mader. Read More

    Wound-Healing Peptides for Treatment of Chronic Diabetic Foot Ulcers and Other Infected Skin Injuries.
    Molecules 2017 Oct 18;22(10). Epub 2017 Oct 18.
    LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Rua do Campo Alegre 687, P-4169-007 Porto, Portugal.
    As the incidence of diabetes continues to increase in the western world, the prevalence of chronic wounds related to this condition continues to be a major focus of wound care research. Additionally, over 50% of chronic wounds exhibit signs and symptoms that are consistent with localized bacterial biofilms underlying severe infections that contribute to tissue destruction, delayed wound-healing and other serious complications. Most current biomedical approaches for advanced wound care aim at providing antimicrobial protection to the open wound together with a matrix scaffold (often collagen-based) to boost reestablishment of the skin tissue. Read More

    [A multidisciplinary approach in diabetic foot disease is mandatory].
    Ned Tijdschr Geneeskd 2017 ;161(0):D1755
    Ziekenhuisgroep Twente, afd. Heelkunde, Almelo/Hengelo.
    The history of two patients (66- and 53-year-old males) with diabetes and peripheral neuropathy illustrates the variety of clinical presentations and pitfalls in treatment of diabetic foot ulcers. Peripheral arterial disease and mechanical stress as a consequence of peripheral neuropathy are important risk factors for developing an ulcer and eventually loss of a limb. Revascularisation of the limb should be considered in the presence of critical limb ischaemia or in the presence of mild to severe ischaemia in combination with a deep infection. Read More

    Is surgical debridement necessary in the diabetic foot treated with photodynamic therapy?
    Diabet Foot Ankle 2017 19;8(1):1373552. Epub 2017 Sep 19.
    Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
    Background: Diabetic patients are susceptible to developing foot ulcers with serious complications such as osteomyelitis and amputations. Treatment approaches are still empirical and the benefit of usual procedures such as surgical debridement has not been properly evaluated. Photodynamic Therapy (PDT) is a non-invasive and highly efficient method for the treatment of the diabetic foot, being able to eradicate the infection and to stimulate healing, decreasing considerably the amputation risk. Read More

    Treatment of diabetic foot ulcers with Therapeutic Magnetic Resonance (TMR®) improves the quality of granulation tissue.
    Eur J Histochem 2017 Aug 7;61(3):2800. Epub 2017 Aug 7.
    University of Padua.
    Diabetic foot ulcers (DFUs) often result in severely adverse outcomes, such as serious infections, hospitalization, and lower extremity amputations. In last few years, to improve the outcome of DFUs, clinicians and researchers put their attention on the application of low intensity pulsating electro-magnetic fields through Therapeutic Magnetic Resonance (TMR®). In our study, patients with DFUs have been divided into two groups: The Sham Group treated with non-functioning TMR® device, and the Active Group treated with a functioning device. Read More

    Calcitriol promotes proangiogenic molecules in keratinocytes in a diabetic foot ulcer model.
    J Steroid Biochem Mol Biol 2017 Nov 16;174:303-311. Epub 2017 Oct 16.
    Unidad de Investigación Biomédica-Zacatecas, IMSS, Mexico. Electronic address:
    Foot ulceration is one of the most common and complex sequelae of diabetes mellitus, generally posing a therapeutic challenge due to poor healing responses and high rates of complications, including peripheral vascular disease, ischemia and infections. Calcitriol, the most active vitamin D metabolite, induces antimicrobial peptides production in keratinocytes from diabetic foot ulcers (DFU); however, little is known about its effects on angiogenic factors in this pathology. Herein we aimed at studying whether calcitriol induces angiogenic molecules in keratinocytes under normoxic and hypoxic conditions, and if these molecules are able to improve cell migration in vitro. Read More

    Hybrid Fixation for Ankle Fusion in Diabetic Charcot Arthropathy.
    Foot Ankle Int 2017 Oct 1:1071100717735074. Epub 2017 Oct 1.
    1 Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Eldakahlia, Egypt.
    Background: Ankle fusion is difficult to achieve in the diabetic Charcot ankle Brodsky type 3a because of the poor quality of the bone and the inability to achieve a stable biomechanical construct. The aim of this study was to report the outcome of ankle fusion using a combination of an intramedullary nail and a circular external fixator in patients with diabetic Charcot arthropathy.

    Methods: We prospectively studied 24 patients with diabetic Charcot arthropathy of the ankle who were treated by fusion of the tibiotalar joint using a combined retrograde intramedullary nail and Ilizarov external fixator. Read More

    Procalcitonin as a diagnostic and prognostic marker in diabetic foot infection. A current literature review.
    Rom J Intern Med 2017 Oct 11. Epub 2017 Oct 11.
    .
    Diabetic foot ulcers (DFUs) are a very common cause of mortality and morbidity. The distinction between infected and non-infected DFU remains a very challenging task for clinicians in everyday practice. Even when infection is documented, the spectrum of diabetic foot infection is wide, ranging from cellulitis and soft tissue infection to osteomyelitis. Read More

    Unplanned 30-day readmission in patients with diabetic foot wounds treated in a multidisciplinary setting.
    J Vasc Surg 2017 Oct 7. Epub 2017 Oct 7.
    Diabetic Foot and Wound Service, The Johns Hopkins Hospital, Baltimore, Md; Division of Vascular Surgery and Endovascular Therapy, The Johns Hopkins Hospital, Baltimore, Md; Johns Hopkins Surgery Center for Outcomes Research, The Johns Hopkins Hospital, Baltimore, Md. Electronic address:
    Objective: Readmission rates are known to be high for vascular surgery patients in general, but there are limited data describing the risk of surgical and nonsurgical readmission among patients with diabetic foot ulcers (DFUs). Our aim was to identify factors associated with unplanned readmission in DFU patients treated in a multidisciplinary setting.

    Methods: We studied a single-center cohort of patients enrolled in a multidisciplinary diabetic foot service (July 2012-June 2017). Read More

    The LeucoPatch® system in the management of hard-to-heal diabetic foot ulcers: study protocol for a randomised controlled trial.
    Trials 2017 Oct 10;18(1):469. Epub 2017 Oct 10.
    Magnus Löndahl, Skåne University Hospital, Lund, Sweden.
    Background: Diabetic foot ulcers are a common and severe complication of diabetes mellitus. Standard treatment includes debridement, offloading, management of infection and revascularisation where appropriate, although healing times may be long. The LeucoPatch® device is used to generate an autologous platelet-rich fibrin and leucocyte wound dressing produced from the patient's own venous blood by centrifugation, but without the addition of any reagents. Read More

    Clinical and pharmacokinetic drug evaluation of delafloxacin for the treatment of acute bacterial skin and skin structure infections.
    Expert Opin Drug Metab Toxicol 2017 Nov 14;13(11):1193-1200. Epub 2017 Oct 14.
    b Department of Medicine , Institute of Clinical Pharmacology, 'Santa Maria della Misericordia' University Hospital, ASUIUD , Udine , Italy.
    Introduction: In the era of multi-drug resistant pathogens, the adequate treatment of skin and skin structure infections remains a challenge for clinicians. Delafloxacin, with its broad spectrum against Gram-positive, Gram-negative and anaerobic organisms, represents a new therapeutic option in this setting, especially when coverage of methicillin-resistant Staphylococcus aureus is required in the empirical or targeted approach. Areas covered: In this drug evaluation, the Authors have reviewed the pharmacokinetic and pharmacodynamic characteristics of delafloxacin. Read More

    Microbiota of Chronic Diabetic Wounds: Ecology, Impact, and Potential for Innovative Treatment Strategies.
    Front Microbiol 2017 21;8:1791. Epub 2017 Sep 21.
    Center for Neuroscience and Cell Biology, University of CoimbraCoimbra, Portugal.
    World Health Organization considered diabetes as one of the 20th century epidemics, estimating that over 10% of the world population is diabetic or at high risk. Self-assessment studies indicate that diabetic patients consider chronic wounds to affect their quality of life more dramatically than vision loss or renal failure. In addition to being the main reason for diabetic patients' hospitalization, the economic burden of diabetic chronic wounds is close to 1% of United Kingdom and United States health systems budgets, which exceeds the funds allocated to the treatment of some types of cancer in both countries. Read More

    Use of Tigecycline for Diabetic Foot Infections.
    Wounds 2017 Sep 26. Epub 2017 Sep 26.
    Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey.
    Objective: The aim of this study is to evaluate tigecycline for diabetic foot infections (DFIs).

    Materials And Methods: In this prospective observational study, the investigators included patients who had consultation with the Diabetic Foot Council of Ege University Faculty of Medicine (Izmir, Turkey) between March 2013 and July 2015 and who used tigecycline during their treatment. Treatment success was assessed by design-specific criteria for each evaluation. Read More

    Foot and ankle reconstruction with vertically designed deep inferior epigastric perforator flap.
    Microsurgery 2017 Oct 3. Epub 2017 Oct 3.
    Department of Plastic Reconstructive and Aesthetic Surgery, Selcuk University, Konya, Turkey.
    Introduction: The deep inferior epigastric perforator (DIEP) flap is one of the most commonly utilized flaps of reconstructive surgery. Although the horizontal flap design is the most commonly used, this flap can be vertically designed to avoid drawbacks such as excessive tissue dissection, relatively reduced flap perfusion, and scarification of the contralateral flap opportunity. The aim of this report is to present our case series for foot and ankle reconstruction with vertical designed DIEP flap. Read More

    Complications during the treatment of diabetic foot osteomyelitis.
    Diabetes Res Clin Pract 2017 Jun 13. Epub 2017 Jun 13.
    Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
    Aim: To identify complications of medical treatment in patients with diabetic foot osteomyelitis (DFO).

    Methods: We reviewed 143 records of consecutive patients admitted with DFO, confirmed by bone histopathology or culture. Complications monitored included acute kidney injuries (AKI), development of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE), gastrointestinal complications, and venous catheter related complications during a 12 months follow-up period. Read More

    The impact of team based interprofessional comprehensive assessments on the diagnosis and management of diabetic foot ulcers: A retrospective cohort study.
    PLoS One 2017 26;12(9):e0185251. Epub 2017 Sep 26.
    Toronto Regional Wound Healing Clinic, Mississauga, Canada.
    Background: Diabetic foot ulcers (DFU) are increasingly prevalent, and associated with significant morbidity, mortality, and cost. An interprofessional approach to DFU management is critical given the etiological complexity involved. This study aimed to assess the impact of an interprofessional team approach on DFU diagnosis and management for a cohort of patients receiving treatment in an Ontario Canada home care setting. Read More

    Osteomyelitis of the foot: non-surgical management, SPECT/CT scanning and minimising the duration of antibiotic use.
    Diabetologia 2017 Dec 21;60(12):2337-2340. Epub 2017 Sep 21.
    Foot Ulcer Trials Unit, Department of Diabetes and Endocrinology, Nottingham University Hospitals Trust, City Hospital Campus, Nottingham, NG5 1PB, UK.
    In a paper in this issue of Diabetologia (DOI: https://doi.org/10.1007/s00125-017-4417-x ), Vouillarmet and colleagues have explored the use of single-photon emission computed tomography (SPECT)/computed tomography (CT) to define remission during non-surgical management of osteomyelitis of the foot. Read More

    Growth factors in the pathogenesis of diabetic foot ulcers.
    Front Biosci (Landmark Ed) 2018 Jan 1;23:310-317. Epub 2018 Jan 1.
    Institute of Medical Sciences, Xiangya Hospital, Central South University, Changsha, China.
    Foot ulcers affect 15% of patients with diabetes, resulting in a great health burden. The occurrence and development of diabetic foot ulcers is associated with neuropathy, peripheral arterial disease, and infection. Several growth factors are involved in these processes, including epidermal growth factor, vascular endothelial growth factor, transforming growth factor-beta, fibroblast growth factor, and erythropoietin, which could promote wound healing of patients with diabetes. Read More

    Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico.
    Diabet Foot Ankle 2017 6;8(1):1367210. Epub 2017 Sep 6.
    Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.
    Background: The objective of this study was to determine the clinical and surgical characteristics of diabetic foot ulcers in a tertiary level hospital in Mexico. Methods: We performed a longitudinal, descriptive study from July, 2012 to August, 2015 on a sample composed of 100 patients with type 2 diabetes mellitus and infected diabetic foot ulcers. We analyzed socio-demographic variables, comorbidities, characteristics of ulcers, and the applied treatment. Read More

    Procalcitonin levels and other biochemical parameters in patients with or without diabetic foot complications.
    J Res Med Sci 2017 16;22:95. Epub 2017 Aug 16.
    National Center of Diabetes, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq.
    Background: Diagnosis of infection in diabetic foot ulcer (DFU) is not always simple. The analytic precision of procalcitonin (PCT) was evaluated to clarify the use of PCT for distinguish the presence of infection in DFU in comparison to other inflammatory markers.

    Materials And Methods: This study comprised 88 subjects distributed into four groups: 16 nondiabetic healthy subjects (group control), 17 patients with type 2 diabetes mellitus without foot Complication (group DM), 25 patients with noninfected diabetic foot (group NIDF), and 30 patients with infected diabetic foot (group IDF). Read More

    Pharmacokinetics and Tissue Penetration of Ceftolozane/Tazobactam in Diabetic Patients with Lower Limb Infections and Healthy Adult Volunteers.
    Antimicrob Agents Chemother 2017 Sep 11. Epub 2017 Sep 11.
    Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA
    Ceftolozane/tazobactam displays potent activity against gram-negative bacteria that can cause diabetic foot infections (DFI), making it an attractive treatment option when few alternatives exist. The pharmacokinetics and tissue penetration of ceftolozane/tazobactam 1.5g q8h in patients (n=10) with DFI were compared with healthy volunteers (n=6) using in vivo microdialysis. Read More

    Diabetic foot infection: Antibiotic therapy and good practice recommendations.
    Int J Clin Pract 2017 Oct 11;71(10). Epub 2017 Sep 11.
    Ninewells Hospital, Dundee, UK.
    Background: Healthcare events related to diabetic foot disease carry a burden of morbidity, mortality and economic cost. Prompt identification of clinical infection with appropriate tissue sampling limits use of broad spectrum empirical antibiotics and improves antibiotic stewardship. Staphylococcus aureus remains the commonest infecting organism and high-dose flucloxacillin remains the empirical antibiotic of choice for antibiotic naïve patients. Read More

    Severity of drug resistance and co-existence of Enterococcus faecalis in diabetic foot ulcer infections.
    Folia Microbiol (Praha) 2017 Sep 9. Epub 2017 Sep 9.
    Department of Biotechnology, School of Life Sciences, Manipal University, Manipal, 576104, India.
    The genes encoding aminoglycoside resistance in Enterococcus faecalis may promote collateral aminoglycoside resistance in polymicrobial wounds. We studied a total of 100 diabetic foot ulcer samples for infection and found 60 samples to be polymicrobial, 5 to be monomicrobial, and 35 samples to be culture negative. A total of 65 E. Read More

    SURGICAL INFECTIONS AT A REGIONAL HOSPITAL IN GAUTENG: REASONS FOR DELAY TO CARE AND PROFILE OF PATHOLOGY.
    S Afr J Surg 2017 Jun;55(2):67
    Edenvale General Hospital, Johannesburg.
    Background: Infection is a common cause for the admission of surgical patients who were initially seen and managed at the primary health care level. Delay to care significantly increases the health care burden of surgical sepsis on affected individuals, the health system and society.

    Method: A prospective descriptive study was performed by means of a confidential questionnaire presented to qualifying patients between February 2014 and October 2016. Read More

    Importance of education in the prevention of diabetic foot syndrome.
    Neuro Endocrinol Lett 2017 Aug 5;38(4):255-256. Epub 2017 Aug 5.
    Faculty of Health and Social Studies, South Bohemian University, Ceske Budejovice, Czech Republic.
    To the Editor, Diabetic foot syndrome (DFS) is defined by the WHO as ulceration or destruction of foot tissue in diabetic patients associated with neuropathy, with different degrees of the disease existing and frequently also with infection. The statistics are frightening: more than million amputations are annually carried out worldwide due to diabetic foot (Foster and Lauver 2014) and these amputations represent as far as 70% of all non-traumatic amputations. In 2013, 861 647 patients were treated for diabetes mellitus in Czech Republic, including 44 657 patients with diabetic foot syndrome and 11 168 patients had to experience the amputation of lower limb due to this condition. Read More

    Clinical and microbiological profile of diabetic foot ulcer patients in a tertiary care hospital.
    Diabetes Metab Syndr 2017 Aug 26. Epub 2017 Aug 26.
    Department of Medicine, Yenepoya University, Deralakatte, Mangalore, India. Electronic address:
    Aim: To evaluate the clinical and microbiological profile of diabetic foot ulcer patients admitted to a tertiary care hospital.

    Methodology: This study recruited 120 diabetic foot ulcer patients of all grade. Their medical records were evaluated retrospectively. Read More

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