A5007364645- Diabetic Foot Ulcer Assessment and Management
- Wound Healing and Treatments
- Pressure Ulcer Prevention and Management
- Streptococcal Infections and Treatments
- Peripheral Artery Disease Management
- Orthopedic Infections and Treatments
- Skin Diseases and Diabetes
- Surgical site infection prevention
- Foot and Ankle Surgery
- Diagnosis and Treatment of Venous Diseases
- Tendon Structure and Treatment
- Prosthetics and Rehabilitation Robotics
- Laser Applications in Dentistry and Medicine
- Surgical Sutures and Adhesives
- Balance, Gait, and Falls Prevention
- Reconstructive Surgery and Microvascular Techniques
- Hematological disorders and diagnostics
- Lower Extremity Biomechanics and Pathologies
- Adipokines, Inflammation, and Metabolic Diseases
- Orthopedic Surgery and Rehabilitation
- Cerebrovascular and Carotid Artery Diseases
- Rabies epidemiology and control
- Stroke Rehabilitation and Recovery
- Botulinum Toxin and Related Neurological Disorders
- Frailty in Older Adults
The University of Texas Health Science Center at San Antonio
1996-2025
The University of Texas Southwestern Medical Center
2016-2025
Southwestern Medical Center
2012-2024
Marble Arch Medical Centre
2023-2024
University of Pittsburgh
2003-2023
Parkland Memorial Hospital
2010-2023
Yahoo (United Kingdom)
2020
Galveston College
2020
Texas Plastic Surgery
2005-2019
Clinical Orthopaedics and Related Research
2019
To validate a wound classification instrument that includes assessment of depth, infection, and ischemia based on the eventual outcome wound.We evaluated medical records 360 diabetic patients presenting for care foot wounds at multidisciplinary tertiary clinic. As per protocol, all had standardized evaluation to assess sensory neuropathy, vascular insufficiency, infection. Patients were assessed 6 months after their initial see whether an amputation been performed.There was significant...
OBJECTIVE: To determine the frequency and constellations of anatomic, pathophysiologic, environmental factors involved in development incident diabetic foot ulcers patients with diabetes no history from Manchester, U.K., Seattle, Washington, research settings. RESEARCH DESIGN AND METHODS: The Rothman model causation was applied to ulcer condition. presence structural deformities, peripheral neuropathy, ischemia, infection, edema, callus formation determined for individuals Manchester...
It is now 10 years since the last technical review on preventative foot care was published (1), which followed by an American Diabetes Association (ADA) position statement preventive in diabetes (2). Many studies have been proposing a range of tests that might usefully identify patients at risk ulceration, creating confusion among practitioners as to screening should be adopted clinical practice. A task force therefore assembled ADA address and concisely summarize recent literature this area...
To prospectively determine risk factors for foot infection in a cohort of people with diabetes.We evaluated then followed 1,666 consecutive diabetic patients enrolled managed care-based outpatient clinic 2-year longitudinal outcomes study. At enrollment, underwent standardized general medical examination and detailed assessment were educated about proper care. They rescreened at scheduled intervals also seen promptly if they developed any problem.During the evaluation period, 151 (9.1%) 199...
Abstract The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines prevention and management of diabetic foot disease since 1999. This guideline is diagnosis treatment infection in persons with diabetes updates 2015 IWGDF guideline. On basis patient, intervention, comparison, outcomes (PICOs) developed by committee, conjunction internal external reviewers consultants, systematic reviews committee conducted (new) (updated from 2015), we offer 27...
OBJECTIVE—To compare the effectiveness of total-contact casts (TCCs), removable cast walkers (RCWs), and half-shoes to heal neuropathic foot ulcerations in individuals with diabetes. RESEARCH DESIGN AND METHODS—In this prospective clinical trial, 63 patients superficial noninfected, nonischemic diabetic plantar ulcers were randomized one three off-loading modalities: TCC, half-shoe, or RCW. Outcomes assessed at wound healing 12 weeks, whichever came first. Primary outcome measures included...
Recommendations Classification/diagnosis Diabetic foot infection must be diagnosed clinically, based on the presence of local or systemic signs symptoms inflammation (strong; low). Assess severity any diabetic using Infectious Diseases Society America/International Working Group Foot classification scheme moderate). Osteomyelitis For an infected open wound, perform a probe‐to‐bone test; in patient at low risk for osteomyelitis, negative test largely rules out diagnosis, while high‐risk...
OBJECTIVE—To report the incidence of diabetes-related lower-extremity complications in a cohort patients enrolled diabetes disease management program. RESEARCH DESIGN AND METHODS—We evaluated screening results and clinical outcomes for first 1,666 program period 24 months (50.3% men, aged 69.1 ± 11.1 years). RESULTS—The ulceration, infection, amputation, bypass was 68.4, 36.5, 5.9, 7.7 per 1,000 persons with year. Amputation higher Mexican Americans than non-Hispanic whites (7.4/1,000 vs....
High plantar foot pressures in association with peripheral neuropathy have been ascertained to be important risk factors for ulceration the diabetic foot. Most studies investigating these parameters limited by their size and homogeneity of study subjects. The objective this was therefore ascertain associated high a large diverse population.We studied cross-sectional group 251 patients Caucasian (group C) (n=121), black B) (n=36), Hispanic H) (n=94) racial origins an overall age 58.5+/-12.5...
To evaluate the sensitivity and specificity of 3 sensory perception testing instruments to screen for risk diabetic foot ulceration.This case-control study prospectively measured degree peripheral neuropathy in patients with without ulcers. We enrolled 115 age-matched (40% male) a ratio approximately 1:3 (30 cases 85 controls) from tertiary care specialty clinic. Cases were defined as individuals who had an existing ulceration or history recently (< 4 weeks) healed ulceration. Controls...
The purpose of this study was to evaluate the effectiveness a temperature monitoring instrument reduce incidence foot ulcers in individuals with diabetes who have high risk for lower extremity complications.In physician-blinded, randomized, 15-month, multicenter trial, 173 subjects previous history diabetic ulceration were assigned standard therapy, structured examination, or enhanced therapy groups. Each group received therapeutic footwear, education, and regular care. Subjects examination...
Abstract The International Working Group on the Diabetic Foot (IWGDF) has published evidence‐based guidelines prevention and management of diabetic foot disease since 1999. This guideline is ulceration in persons with diabetes updates 2015 IWGDF guideline. We followed GRADE methodology to devise clinical questions critically important outcomes PICO format, conduct a systematic review medical‐scientific literature, write recommendations their rationale. are based quality evidence found...
In this longitudinal study of 1666 persons with diabetes, there was an observed trend toward increased risk for amputation (chi(2) test trend, 108.0; P<.001), higher-level 113.3; and lower extremity-related hospitalization 118.6; P<.001) increasing infection severity. The Infectious Diseases Society America's foot classification system may be a useful tool grading infections.
OBJECTIVE—To evaluate the effectiveness of at-home infrared temperature monitoring as a preventative tool in individuals at high risk for diabetes-related lower-extremity ulceration and amputation. RESEARCH DESIGN AND METHODS—Eighty-five patients who fit diabetic foot category 2 or 3 (neuropathy deformity previous history partial amputation) were randomized into standard therapy group (n = 41) an enhanced 44). Standard consisted therapeutic footwear, education, regular evaluation by...
Recommendations To identify a person with diabetes at risk for foot ulceration, examine the feet annually to seek evidence signs or symptoms of peripheral neuropathy and artery disease. (GRADE strength recommendation: strong; Quality evidence: low) In who has neuropathy, screen history ulceration lower‐extremity amputation, disease, deformity, pre‐ulcerative on foot, poor hygiene ill‐fitting inadequate footwear. (Strong; Low) Treat any sign patient diabetes. This includes removing callus,...
Individuals with diabetes mellitus are at an increased risk of developing a diabetic foot ulcer (DFU). This study evaluated the safety and efficacy Integra Dermal Regeneration Template (IDRT) for treatment nonhealing DFUs. The Foot Ulcer New Replacement Study was multicenter, randomized, controlled, parallel group clinical trial conducted under Investigational Device Exemption. Thirty-two sites enrolled randomized 307 subjects least one DFU. Consented patients were entered into 14-day run-in...
Abstract In a randomised, controlled study, we compared the efficacy of Grafix ® , human viable wound matrix (hVWM) ( N = 50), to standard care n 47) heal diabetic foot ulcers (DFUs). The primary endpoint was proportion patients with complete closure by 12 weeks. Secondary endpoints included time closure, adverse events and in crossover phase. who achieved significantly higher received (62%) controls (21%, P 0·0001). median healing 42 days 69·5 0·019). There were fewer (44% versus 66%,...