Lower Extremity Ulcers

2014 ◽  
Author(s):  
Robert D. Galiano ◽  
Richard F. Neville
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Leg Ulcer ◽  
Venous Stasis ◽  
Compression Stockings ◽  
Management Options ◽  
Staging Systems ◽  
Anterior Tibial

Acknowledging and addressing common features of lower extremity ulcers will allow the surgeon to heal the vast majority of leg ulcers, either surgically or nonsurgically. The involvement of a surgeon interested in lower extremity preservation ensures the patient is offered a comprehensive set of management options. The authors discuss chronic and problem wounds, incidence and epidemiology, anatomic considerations, clinical evaluation and investigative studies, and general and specific management of the main types of leg ulcer (arterial, diabetic, venous, and inflammatory). Tables describe types and causes of lower extremity ulcers, common characteristics, members of the multidisciplinary team, conditions that interfere with healing, angiosomes of the foot, components of a leg ulcer that must be removed by débridement, benefits of hyperbaric oxygen and well-performed débridement, commonly used local pedicled flaps, staging systems for diabetic foot ulcer, and classes of compression stockings. Figures illustrate angiosomes of the anterior tibial, dorsalis pedis, peroneal, posterior tibial, lateral plantar, and medial plantar arteries; interplay between bacterial levels; types of wound dressing; ulcer locations as an indication of etiology; and management of arterial insufficiency ulcers, diabetic foot ulcers, and venous stasis ulcers. This review contains 11 figures, 11 tables, and 138 references.

Lower Extremity Ulcers

2014 ◽  
Author(s):  
Robert D. Galiano ◽  
Richard F. Neville
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Leg Ulcer ◽  
Venous Stasis ◽  
Compression Stockings ◽  
Management Options ◽  
Staging Systems ◽  
Anterior Tibial

Acknowledging and addressing common features of lower extremity ulcers will allow the surgeon to heal the vast majority of leg ulcers, either surgically or nonsurgically. The involvement of a surgeon interested in lower extremity preservation ensures the patient is offered a comprehensive set of management options. The authors discuss chronic and problem wounds, incidence and epidemiology, anatomic considerations, clinical evaluation and investigative studies, and general and specific management of the main types of leg ulcer (arterial, diabetic, venous, and inflammatory). Tables describe types and causes of lower extremity ulcers, common characteristics, members of the multidisciplinary team, conditions that interfere with healing, angiosomes of the foot, components of a leg ulcer that must be removed by débridement, benefits of hyperbaric oxygen and well-performed débridement, commonly used local pedicled flaps, staging systems for diabetic foot ulcer, and classes of compression stockings. Figures illustrate angiosomes of the anterior tibial, dorsalis pedis, peroneal, posterior tibial, lateral plantar, and medial plantar arteries; interplay between bacterial levels; types of wound dressing; ulcer locations as an indication of etiology; and management of arterial insufficiency ulcers, diabetic foot ulcers, and venous stasis ulcers. This review contains 11 figures, 11 tables, and 138 references.

Lower-extremity arterial revascularization: Is there any evidence for diabetic foot ulcer-healing?

2016 ◽  
Vol 42 (1) ◽  
pp. 4-15 ◽  
Author(s):  
J. Vouillarmet ◽  
O. Bourron ◽  
J. Gaudric ◽  
P. Lermusiaux ◽  
A. Millon ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Ulcer Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Revascularization

scholarly journals Lower-Extremity Amputation Risk After Charcot Arthropathy and Diabetic Foot Ulcer

Diabetes Care ◽  
2009 ◽  
Vol 33 (1) ◽  
pp. 98-100 ◽  
Author(s):  
M.-W. Sohn ◽  
R. M. Stuck ◽  
M. Pinzur ◽  
T. A. Lee ◽  
E. Budiman-Mak
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Extremity Amputation ◽  
Charcot Arthropathy ◽  
Extremity Amputation

Influence of bioengineered skin substitutes on diabetic foot ulcer and venous leg ulcer outcomes

2008 ◽  
Vol 17 (12) ◽  
pp. 517-527 ◽  
Author(s):  
C. Barber ◽  
A. Watt ◽  
C. Pham ◽  
K. Humphreys ◽  
A. Penington ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Leg Ulcer ◽  
Skin Substitutes ◽  
Venous Leg Ulcer ◽  
Bioengineered Skin

scholarly journals Predictors of Lower-Extremity Amputation in Patients With an Infected Diabetic Foot Ulcer

Diabetes Care ◽  
2015 ◽  
Vol 38 (5) ◽  
pp. 852-857 ◽  
Author(s):  
Kristy Pickwell ◽  
Volkert Siersma ◽  
Marleen Kars ◽  
Jan Apelqvist ◽  
Karel Bakker ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Extremity Amputation ◽  
Extremity Amputation

The Economic Value of Specialized Lower-Extremity Medical Care by Podiatric Physicians in the Treatment of Diabetic Foot Ulcers

2011 ◽  
Vol 101 (2) ◽  
pp. 93-115 ◽  
Author(s):  
Ginger S. Carls ◽  
Teresa B. Gibson ◽  
Vickie R. Driver ◽  
James S. Wrobel ◽  
Matthew G. Garoufalis ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Medical Care ◽  
Diabetic Foot ◽  
Net Present Value ◽  
Economic Value ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Patients At Risk

Background: We sought to examine the economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers by evaluating cost outcomes for patients with diabetic foot ulcer who did and did not receive care from a podiatric physician in the year before the onset of a foot ulcer. Methods: We analyzed the economic value among commercially insured patients and Medicare-eligible patients with employer-sponsored supplemental medical benefits using the MarketScan Databases. The analysis consisted of two parts. In part I, we examined cost or savings per patient associated with care by podiatric physicians using propensity score matching and regression techniques; in part II, we extrapolated cost or savings to populations. Results: Matched and regression-adjusted results indicated that patients who visited a podiatric physician had $13,474 lower costs in commercial plans and $3,624 lower costs in Medicare plans during 2-year follow-up (P < .01 for both). A positive net present value of increasing the share of patients at risk for diabetic foot ulcer by 1% was found, with a range of $1.2 to $17.7 million for employer-sponsored plans and $1.0 to $12.7 million for Medicare plans. Conclusions: These findings suggest that podiatric medical care can reduce the disease and economic burdens of diabetes. (J Am Podiatr Med Assoc 101(2): 93–115, 2011)

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