Literature Review

Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

A major concern in managing patients with diabetes is their susceptibility to acquiring ulcers in their feet. If these patients are not careful, these ulcers may become infected and eventually lead to additional sequelae, ending in lower extremity amputation. The focus of this study was to determine the major factors of lower extremity amputation in the diabetic foot, in hopes that clinicians may be able to reduce the rate of amputations more effectively.

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Temple University School of Podiatric Medicine's picture

Staphylococcus aureus is a primary cause of post-operative surgical site infection. S. aureus produces hyaluronidase, which degrades hyaluronic acid (HA). HA is important in wound healing because it prevents bacterial proliferation and provides anti-inflammatory properties. Although early bactericidal antibiotic treatment is important for wound infection, systemic antibiotics often do not prove to be entirely beneficial for wound penetration. Therefore, newer treatment methods that are not at risk of antibiotic resistance are necessary.

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Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

Within the last decade, the rise of diabetes in the U.S. population has been matched with a rise in diabetic foot ulcers requiring amputations. Because many of these diabetic foot ulcers develop secondary to poor wound healing and susceptibility to infection after surgery, some important risk factors have been evaluated. Stress, among other factors, has been shown not only to affect the psychological state of a patient, but also biologically to impair immunity and induce an inflammatory microenvironment within patients.

Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

Twenty-five percent of all diabetic patients will develop a diabetic foot ulcer (DFU), the major reason for hospitalizations in diabetic patients. The current standard of care (SOC) for DFUs consists of debridement, glycemic control, antimicrobial therapy, and imaging. DFUs often become infected, and with improper healing they require more advanced care and possibly lower extremity amputation. This study evaluated the usefulness of a perfusion-decellularized porcine hepatic-derived wound matrix (PDPHD-WM) in treating difficult-to-heal ulcers, or DFUs of greater than three months’ duration that had been treated with at least one other advanced method.

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Wounds with exposed bone and tendon are a major concern for physicians due to the significant morbidity that they can cause. The primary focus of this study is to determine the efficacy and safety of a biologically active, cryopreserved human skin allograft for the treatment of wounds of this nature.

Aletha Tippett MD's picture
study on statins

by Aletha Tippett MD

Oh, what a shock to see a study published on atorvastatin treatment in the adult patients at risk of diabetic foot infection in a recent issue of Wounds.1 The conclusion of this study was that taking atorvastatin for at least three months reduced the risk of diabetic foot infections (DFI). The authors also theorized that statins could prevent infection in patients with diabetes.

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Wound Care Journal Club Review

Wounds tend to follow a certain algorithm when healing, which can be summed down to three distinct phases: hemostasic/inflammatory, proliferative, and remodeling. Chronic wounds are characterized as wounds that do not follow this pattern and fail to heal within 8 weeks. They tend to occur in patients that have uncontrolled comorbidities causing the healing cycle to get "stuck" in the inflammatory phase. There are roughly 6.5 million cases of chronic wounds noted annually in the United States. Thus, the need for better products that may induce quicker healing are highly sought after.

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Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

One fourth of the approximately 22.3 million patients with diabetes in the United States are expected to develop a diabetic foot ulcer (DFU) at some point during their lives, and it is estimated to affect 1-8% of diabetics annually. DFUs have shown to be challenging to treat, and often result in extended hospital stays, increased risk of infection, and subsequent amputation in certain patients. A major concern regarding amputees is a 5-year mortality rate that rivals that of patients with colon cancer. In addition, DFUs contribute heavily to the financial load of payers, with an estimated annual medical cost of up to $13 billion.

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Temple University School of Podiatric Medicine's picture
Wound Care Journal Club Review

Chronic wounds and ulcerations induced by complications associated with diabetes mellitus have proven to be a burden to the patients themselves, as well as the healthcare system as a whole. This burden has required physicians to not only find interventions that work better, but are also more cost effective. In the population with diabetes, 1 out of 4 will have an ulceration of the lower extremity at some point in their life. It’s also important to state that these foot ulcers can lead to some form of amputation in 20% of these patients. Standard wound care typically involves moist dressings, debridement, wound offloading, infection control, and in some cases, advanced therapies. The authors of this study looked into two of these advanced therapies, bioengineered skin substitutes (BSS) and dehydrated human amnion/chorion membranes (dHACM.) The primary objective of the study was to see which worked best, as compared to standard wound care (SWC), while the secondary objective was to see which had the lowest costs.