scholarly journals Foot Ulcers: A Different Technique to Total Contact Casting for Healing Chronic Foot Ulcers

2017 ◽  
Vol 2 (4) ◽  
Keyword(s):  
Standard Method ◽  
Gold Standard ◽  
Foot Ulcers ◽  
Evidence Based ◽  
Diabetic Foot Ulcers ◽  
Patient Mobility ◽  
Gold Standard Method ◽  
Total Contact Cast ◽  
Plantar Pressures ◽  
Total Contact Casting

Total Contact Cast (TCC) is considered the gold standard method for healing diabetic foot ulcers (DFU) [1]. Chronic foot ulcers are a growing concern worldwide. Evidence-based research suggests that TCC is the best method to offload the plantar foot by adequately redistributing plantar pressures related to body mass while still maintaining patient mobility.

Technique for Fabrication of an “Instant Total-Contact Cast” for Treatment of Neuropathic Diabetic Foot Ulcers

2002 ◽  
Vol 92 (7) ◽  
pp. 405-408 ◽  
Author(s):  
David G. Armstrong ◽  
Brian Short ◽  
Eric H. Espensen ◽  
Patricia L. Abu-Rumman ◽  
Brent P. Nixon ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Gold Standard ◽  
Simple Technique ◽  
Patient Adherence ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Pressure Reduction ◽  
Critical Component ◽  
Total Contact Cast ◽  
Equivalent Time

Addressing pressure reduction in the treatment of diabetic foot wounds is a critical component of therapy. The total-contact cast has proven to be the gold standard of treatment because of its ability to reduce pressure and facilitate patient adherence to the off-loading regimen. Removable cast walkers have proven to be as effective as total-contact casts in pressure reduction, but this has not translated into equivalent time to healing. A simple technique to convert the removable cast walker into a device that is not as easily detached from the lower extremity, thereby encouraging the use of this device over a 24-hour period, is presented in this article. The procedure involves wrapping the cast walker with cohesive bandage or plaster of Paris. In the authors’ opinion, this technique addresses many of the disadvantages of the total-contact cast, resulting in an adequate compromise in this aspect of care. (J Am Podiatr Med Assoc 92(7): 405-408, 2002)

The MABAL Shoe, an Alternative Method in Contact Casting for the Treatment of Neuropathic Diabetic Foot Ulcers

2000 ◽  
Vol 21 (4) ◽  
pp. 320-323 ◽  
Author(s):  
Rutger Jan Hissink ◽  
Hendrik Anton Manning ◽  
Jeff G. van Baal
Keyword(s):  
Surface Area ◽  
Diabetic Foot ◽  
Gold Standard ◽  
Healing Time ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Plantar Ulcers ◽  
The Mean ◽  
Total Contact Casting ◽  
Methods Of Treatment

INTRODUCTION: Total Contact Casting (TCC) is considered the gold standard in the treatment of neuropathic diabetic foot ulcers. To overcome some disadvantages of TCC we developed a removable fiberglass combicast shoe - the MABAL shoe. PATIENTS AND METHODS: The MABAL shoe was used to treat 23 plantar ulcers. RESULTS: Before treatment the mean surface area was 2.0 cm 2 (0.5–7.1 cm 2 ). Twenty-one of 23 ulcers healed, with a mean healing time of 34 days (7–75 days). CONCLUSION: The MABAL shoe provides healing of neuropathic diabetic foot ulcers comparable to existing methods of treatment, while offering some potential advantages. The main advantages are mobilization of the ankle, removability of the cast and a less time consuming form of treatment.

The Real-Life Outcome of VACOped Boot in the Management of Diabetic Foot Ulcers

2020 ◽  
pp. 153473462094267
Author(s):  
Wee Teck Lim ◽  
Helen Robinson ◽  
Edward Jude ◽  
Satyan Rajbhandari
Keyword(s):  
Clinical Trials ◽  
Confidence Interval ◽  
Median Duration ◽  
Diabetic Foot ◽  
Gold Standard ◽  
Standard Treatment ◽  
Real Life ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Total Contact Cast

The total contact cast (TCC) is considered the gold standard treatment to off-load diabetic foot ulcers (DFUs); however, the use of TCC can be limited due to various reasons such as underlying infections, ischemia, and patient’s reluctance. Removable cast walkers are used in such cases, and the VACOped boot is one such device. The aim of this study was to analyze the results of the VACOped boot in the treatment of DFUs in real life. Case records of all patients with DFUs treated with a VACOped from 2011 to 2017 were reviewed retrospectively. Eighty-three episodes of ulcerations in 42 subjects were identified, of which 48 (57.8%) healed in a median duration of 17.5 (95% confidence interval = 15-33) weeks with the use of the VACOped and 35 (42.2%) discontinued its use. The median duration of healing with the VACOped of 17.5 weeks appears to be longer, but this cohort included patients with underlying infection and ischemia, which are often excluded in the clinical trials of off-loading. Our data show that the VACOped application is preferred by many patients and seems to be equally effective to other removable cast walkers.

Plantar Pressures, Plantar Forces, and Their Influence on the Pathogenesis of Diabetic Foot Ulcers

2013 ◽  
Vol 103 (4) ◽  
pp. 322-332 ◽  
Author(s):  
Jérôme Patry ◽  
Richard Belley ◽  
Mario Côté ◽  
Marie-Ludivine Chateau-Degat
Keyword(s):  
Shear Stress ◽  
Mechanical Stress ◽  
Diabetic Foot ◽  
Threshold Value ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Plantar Pressures ◽  
Manual Search ◽  
Patients With Diabetes ◽  
Full Text Review

Background: Clinical recommendations for the prevention and healing of diabetic foot ulcers (DFUs) are somewhat clear. However, assessment and quantification of the mechanical stress responsible for DFU remain complex. Different pressure variables have been described in the literature to better understand plantar tissue stress exposure. This article reviews the role of pressure and shear forces in the pathogenesis of plantar DFU. Methods: We performed systematic searches of the PubMed and Embase databases, completed by a manual search of the selected studies. From 535 potentially relevant references, 70 studies were included in the full-text review. Results: Variables of plantar mechanical stress relate to vertical pressure, shear stress, and temporality of loading. At this time, in-shoe peak plantar pressure (PPP) is the only reliable variable that can be used to prevent DFU. Although it is a poor predictor of in-shoe PPP, barefoot PPP seems complementary and may be more suitable when evaluating patients with diabetes mellitus and peripheral neuropathy who seem noncompliant with footwear. An in-shoe PPP threshold value of 200 kPa has been suggested to prevent DFU. Other variables, such as peak pressure gradient and peak maximal subsurface shear stress and its depth, seem to be of additional utility. Conclusions: To better assess the at-risk foot and to prevent ulceration, the practitioner should integrate quantitative models of dynamic foot plantar pressures, such as in-shoe and barefoot PPPs, with the regular clinical screening examination. Prospective studies are needed to evaluate causality between other variables of mechanical stress and DFUs. (J Am Podiatr Med Assoc 103(4): 322–332, 2013)

scholarly journals Rapid Diagnosis of Malaria by Antigen Detection

2009 ◽  
Vol 3 (1) ◽  
pp. 14-16
Author(s):  
Mesbah Uddin Ahmed ◽  
Md Akram Hossain ◽  
AKM Shamsuzzaman ◽  
Md Murshed Alam ◽  
Abdul Hossain Khan ◽  
...  
Keyword(s):  
Thin Films ◽  
Sensitivity And Specificity ◽  
Standard Method ◽  
Gold Standard ◽  
Rapid Diagnosis ◽  
Healthy Controls ◽  
Immunochromatographic Test ◽  
Gold Standard Method ◽  
Malaria Antigen ◽  
Age And Sex

The study was conducted to evaluate the sensitivity and specificity of Immunochromatographic test (ICT) for antigen, using microscopy as the "gold standard" method for diagnosis of malaria. A total of 98 clinically suspected malaria patients and another 30 age and sex-matched healthy controls were included in this study. Thick and thin films were also prepared and examined under microscope as well as Immunochromatographic test (ICT) was performed for malaria antigen. Sensitivity and specificity of ICT for antigen were 93.22% and 94.87% respectively. Keywords: Detection of malaria antigen, Immunochromatographic test   doi: 10.3329/bjmm.v3i1.2965 Bangladesh J Med Microbiol 2009; 03 (01): 14-16

scholarly journals Evaluation of distilled water as buffered water replacement during 3% Giemsa’s solution preparation in Malaria diagnosis

2019 ◽  
Vol 10 (SPL1) ◽  
Author(s):  
Lai Yan Xia ◽  
Hamidah Abu Bakar
Keyword(s):  
Standard Method ◽  
Gold Standard ◽  
Malaria Diagnosis ◽  
Cost Effective ◽  
Peripheral Blood Smear ◽  
Blood Film ◽  
Distilled Water ◽  
Malaria Parasites ◽  
Gold Standard Method ◽  
Modified Method

Malaria is a life-threatening disease which has claimed many lives. Giemsa's stain is the gold standard method in malaria diagnosis. Generally, Giemsa's stain is diluted with buffered water. However, sometimes, it produces poor staining of the blood smears, in which can create a major challenge in detecting and identifying positive malaria parasites in a peripheral blood smear. This can lead to misdiagnosis and mistreatment to a patient. The present study examined the effect of replacing the buffered water to distilled water during the preparation of 3% Giemsa's solution. Blood specimens were collected from selected positive (n=80) and negative (n=300) malaria cases in EDTA tube. The modified method employed distilled water and different concentrations of buffered water for diluting Giemsa’s solution stock. The microscopy observation was performed on each set of blood film stained by both modified and standard Giemsa staining methods by two WHO’s qualified technicians. All Giemsa solutions with different diluents were comparable in detecting malaria parasites in the blood films. There was no difference between distilled water and different concentrations of buffered water. Furthermore, distilled water produced homogeneous staining and clearer background of the blood films, which enables different species of malaria to be identified. The present study demonstrates that the modified staining using distilled water in malaria parasites identification is comparable to the gold standard method. In addition, the modified method is rapid, easily available, cost-effective, and reliable.

The Role of Dynamic Plantar Pressures in Diabetic Foot Ulcers

Diabetes Care ◽  
1997 ◽  
Vol 20 (5) ◽  
pp. 855-858 ◽  
Author(s):  
R. M. Stess ◽  
S. R. Jensen ◽  
R. Mirmiran
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Plantar Pressures

Is TCC-EZ a Suitable Alternative to Gold Standard Total-Contact Casting?

2021 ◽  
Vol 111 (5) ◽  
Author(s):  
Umangi K. Bhatt ◽  
Hui Ying Foo ◽  
Mahalia P. McEvoy ◽  
Sarah J. Tomlinson ◽  
Cara Westphal ◽  
...  
Keyword(s):  
Gold Standard ◽  
Peak Pressure ◽  
Pressure Reduction ◽  
Reduced Pressure ◽  
Suitable Alternative ◽  
Total Contact Cast ◽  
Plantar Pressures ◽  
Signed Rank ◽  
Significant Difference ◽  
Peak Pressures

Background The total-contact cast (TCC) is the gold standard for off-loading diabetic foot ulcers (DFUs) given its nonremovable nature. However, this modality remains underused in clinical settings due to the time and experience required for appropriate application. The TCC-EZ is an alternative off-loading modality marketed as being nonremovable and having faster and easier application. This study aims to investigate the potential of the TCC-EZ to reduce foot plantar pressures. Methods Twelve healthy participants (six males, six females) were fitted with a removable cast walker, TCC, TCC-EZ, and TCC-EZ with accompanying brace removed. These off-loading modalities were tested against a control. Pedar-X technology measured peak plantar pressures in each condition. Statistical analysis of four regions of the foot (rearfoot, midfoot, forefoot, and hallux) was conducted with Friedman and Wilcoxon signed rank tests. Significance was set at P < .05. Results All of the off-loading conditions significantly reduced pressure compared with the control, except the TCC-EZ without the brace in the hallux region. There was no statistically significant difference between TCC-EZ and TCC peak pressure in any foot region. The TCC-EZ without the brace obtained significantly higher peak pressures than with the brace. The removable cast walker produced similar peak pressure reduction in the midfoot and forefoot but significantly higher peak pressures in the rearfoot and hallux. Conclusions The TCC-EZ is a viable alternative to the TCC. However, removal of the TCC-EZ brace results in minimal plantar pressure reduction, which might limit clinical applications of the TCC-EZ.

Can we substitute brush cytology for biopsy in the evaluation of cervical lesions under the guidance of colposcopy?

2005 ◽  
Vol 15 (3) ◽  
pp. 489-492
Author(s):  
Z. Eftekhar ◽  
N. Izadi-Mood ◽  
F. Yarandi ◽  
M. Khodamoradi ◽  
P. Rahimi-Moghaddam
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Standard Method ◽  
Uterine Cervix ◽  
Gold Standard ◽  
Brush Cytology ◽  
Cervical Lesions ◽  
Gold Standard Method ◽  
Special Expertise

In cervical cancer screening, colposcopically directed biopsy is the gold standard method for identifying intraepithelial and occult invasive lesions of the uterine cervix. As biopsy needs special expertise and the procedure is not convenient for the patients, we sought to evaluate colposcopically directed brush cytology as a substitute for biopsy of cervical lesions. We studied a series of 150 women who were referred for colposcopic evaluation. Colposcopically directed brush cytology and biopsy were performed for all patients with abnormal colposcopic findings. A total of 40 samples were excluded due to unsatisfactory report of brush cytology. Of the remaining 110 samples, 34 abnormal pathologies were reported in biopsy evaluations, while only 9 abnormal cytologies were reported in brush cytology specimens. Brush cytology sensitivity and specificity were 26% and 97%, respectively. We conclude that colposcopically directed brush cytology is not a safe substitute for biopsy in the evaluation of cervical lesions.

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