scholarly journals Analysis of Lower Leg Ulcer Pathogens Using 16S rRNA Gene Based Method

2019 ◽  
pp. 1-18
Author(s):  
Elendu C. Onwuchekwa ◽  
Oliver Onu-Osi ◽  
Uzochukwu G. Ekeleme ◽  
Okonudo, I. Diana
Keyword(s):  
Rural Communities ◽  
Lower Leg ◽  
Leg Ulcer ◽  
Microbial Pathogens ◽  
Aureus Strain ◽  
Rrna Gene ◽  
Leg Ulcers ◽  
Microbial Identification ◽  
Microbiological Methods

The study was carried out to determine the bacterial pathogens associated with lower leg ulcers in Ebonyi State from July, 2016 to July of 2017, using wound swabs from eligible patients with lower leg ulcers. The swabs were processed and analysed using standard microbiological methods, isolated microbial pathogens were identified by employing standard biochemical test, microbial identification tests and standard molecular methods for DNA extraction. Pressure ulcers 450 (37.2%) was found to be the most commonly infected, closely followed by diabetic foot ulcers 300 (24.8%) and non-healing surgical ulcers 210 (17.4%). Staphylococcus aureus strain ATCC 12600 (12.0%, 6.7% and 16.7%) was the most predominant in venous, diabetic and non-healing surgical ulcers respectively, while pressure ulcer had Pseudomonas aeruginosa strain M37351 (8.2%). Out of 1500 specimens examined, 1210 (80.7%) showed positive microbial growth, while 290 (19.3%) were not infected. Age group of 31-40 years had the highest prevalence rate of 20.7%, followed by 41-50 years (20.5%) while the least was 0-10 years (0.1%). The males were mostly affected than females. This study has revealed a high index of microbial involvement in lower leg ulcer in Ebonyi State. We recommend a multidisciplinary approach to leg ulcer management and specific intervention strategies, not only to treat but also to reduce and subsequently prevent their spread in rural communities. This results and findings will hopefully help to create awareness on the imperative to improve the quality of the treatment regime employed. Thus, each health institution should carry out a survey to determine the common microbial wound pathogens among their patients.

Updated leg ulcer pathway: improving healing times and reducing costs

2019 ◽  
Vol 28 (20) ◽  
pp. S21-S26
Author(s):  
Leanne Atkin ◽  
Alison Schofield ◽  
Anita Kilroy-Findley
Keyword(s):  
Quality Of Life ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Nursing Time ◽  
Venous Leg Ulcers ◽  
Reduced Costs ◽  
Reducing Costs

Regardless of the amount of literature and evidence on leg ulcer management, there are still significant variations in treatment. Implementing a standardised leg ulcer pathway to ensure patients are appropriately and timely assessed could help reduce nursing time and overall costs, while improving healing outcomes and patients' quality of life. Such a pathway was introduced in Lincolnshire and Leicestershire, UK, to treat venous leg ulcers (VLUs). The results showed improved healing times, reduced costs and fewer nurse visits, among other findings.

Clinical interventions for venous leg ulcers: Proposals to improve the quality of clinical leg ulcer research

2016 ◽  
Vol 24 (5) ◽  
pp. 767-774 ◽  
Author(s):  
Gerald S. Lazarus ◽  
Robert S. Kirsner ◽  
Jonathan Zenilman ◽  
M. Frances Valle ◽  
David J. Margolis ◽  
...  
Keyword(s):  
Leg Ulcer ◽  
Leg Ulcers ◽  
Clinical Interventions ◽  
Venous Leg Ulcers

A comparison of inpatients with leg ulceration using published randomised controlled trials

2020 ◽  
Vol 29 (5) ◽  
pp. S14-S18
Author(s):  
Yaping Lian ◽  
Philip Stather ◽  
Manj Gohel
Keyword(s):  
Demographic Data ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Community Settings ◽  
Electronic Patient Records ◽  
Large Teaching Hospital ◽  
Significant Burden ◽  
Acute Hospitals ◽  
Randomised Controlled

Background: Leg ulcers are a significant burden and reduce patients' quality of life. In recent years, a plethora of information has been issued regarding leg ulcer management and ‘the demographics of patients affected in the community. However, little is known about the leg ulcer population and how these patients should be managed in acute hospitals. Aim: To compare the demographic data of inpatients with leg ulcers referred to the tissue viability service in a large teaching hospital with data on leg ulcer populations in acute and community settings. Methods: Inpatient demographic data were retrospectively obtained from electronic patient records. A literature search identified studies regarding leg ulcer populations in acute and community settings. Results: The patient population in acute settings is around 10 years older than that in community settings, with much greater levels of comorbidity and higher mortality rates. Conclusion: An improved understanding of inpatients with leg ulcers would allow investigations and interventions to be targeted better, enabling evidence-based, patient-centred referral and care pathways. Further research is required to understand the aetiology and outcomes of leg ulcers for the inpatient population.

scholarly journals Whole-exome sequencing indicates FLG2 variant associated with leg ulcers in Brazilian sickle cell anemia patients

2019 ◽  
Vol 244 (11) ◽  
pp. 932-939 ◽  
Author(s):  
Gabriela Queila de Carvalho-Siqueira ◽  
Galina Ananina ◽  
Bruno Batista de Souza ◽  
Murilo Guimarães Borges ◽  
Mirta Tomie Ito ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Whole Exome ◽  
Extreme Phenotypes

Although sickle cell anemia results from homozygosity for a single mutation at position 7 of the β-globin chain, the clinical aspects of this condition are very heterogeneous. Complications include leg ulcers, which have a negative impact on patients’ quality of life and are related to the severity of the disease. Nevertheless, the complex pathogenesis of this complication has yet to be elucidated. To identify novel genes associated with leg ulcers in sickle cell anemia, we performed whole-exome sequencing of extreme phenotypes in a sample of Brazilian sickle cell anemia patients and validated our findings in another sample. Our discovery cohort consisted of 40 unrelated sickle cell anemia patients selected based on extreme phenotypes: 20 patients without leg ulcers, aged from 40 to 61 years, and 20 with chronic leg ulcers. DNA was extracted from peripheral blood leukocytes and used for whole-exome sequencing. After the bioinformatics analysis, eight variants were selected for validation by Sanger sequencing and TaqMan® genotyping in 293 sickle cell anemia patients (153 without leg ulcers) from two different locations in Brazil. After the validation, Fisher’s exact test revealed a statistically significant difference in a stop codon variant (rs12568784 G/T) in the FLG2 gene between the GT and GG genotypes ( P = 0.035). We highlight the importance of rs12568784 in leg ulcer development as this variant of the FLG2 gene results in impairment of the skin barrier, predisposing the individual to inflammation and infection. Additionally, we suggest that the remaining seven variants and the genes in which they occur could be strong candidates for leg ulcers in sickle cell anemia. Impact statement To our knowledge, the present study is the first to use whole-exome sequencing based on extreme phenotypes to identify new candidate genes associated with leg ulcers in sickle cell anemia patients. There are few studies about this complication; the pathogenesis remains complex and has yet to be fully elucidated. We identified interesting associations in genes never related with this complication to our knowledge, especially the variant in the FLG2 gene. The knowledge of variants related with leg ulcer in sickle cell anemia may lead to a better comprehension of the disease’s etiology, allowing prevention and early treatment options in risk genotypes while improving quality of life for these patients.

Validation of the disease-specific quality of life Wuerzburg Wound Score in patients with chronic leg ulcer

VASA ◽  
2014 ◽  
Vol 43 (5) ◽  
pp. 372-379 ◽  
Author(s):  
Michael Engelhardt ◽  
Eva Spech ◽  
Hermann Diener ◽  
Hermann Faller ◽  
Matthias Augustin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Construct Validity ◽  
Nottingham Health Profile ◽  
Leg Ulcer ◽  
Life Questionnaire ◽  
Leg Ulcers ◽  
Sf 36 ◽  
Arterial Ulcer ◽  
Disease Specific

Background: Aim of the study was to validate a newly developed disease-specific quality of life questionnaire (Wuerzburg Wound Score, WWS) in patients with chronic arterial or venous leg ulcers. Patients and methods: In this prospective study 115 patients with vascular disease associated leg ulcer (54 arterial ulcer, 61 venous ulcer) were studied (mean age 66 ± 11 years, 51 % male). All patients completed the WWS at baseline, and after four and 12 weeks. To assess construct validity additionally all patients completed the generic QoL-questionnaires Short Form-36 (SF-36) and Nottingham Health Profile (NHP). Construct validity and responsiveness of the WWS were tested. Results: WWS showed acceptable construct validity versus SF-36 (r = 0.5 - 0.78; P < 0.001) and NHP (r = 0.36 - 0.68; P < 0.001). Responsiveness of the WWS was superior to SF-36 (P < 0.05) and NHP (P = 0.01). Generic as well as disease-specific QoL were more impaired in patients with arterial ulcer. Conclusions: The WWS is a valid measure of disease-specific QoL in patients with leg ulcers and it is more sensitive than the generic instruments in detecting changes of wound healing over time. Further assessment of the psychometric properties of the WWS with larger patient samples is required before the test can be recommended for use in clinical practice.

Community Leg Ulcer Clinics: Effect on Quality of Life

1994 ◽  
Vol 9 (2) ◽  
pp. 83-86 ◽  
Author(s):  
P. J. Franks ◽  
C. J. Moffatt ◽  
M. Connolly ◽  
N. Bosanquet ◽  
M. Oldroyd ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systems Of Care ◽  
Well Being ◽  
Leg Ulcer ◽  
Daily Activities ◽  
Leg Ulcers ◽  
Compression Bandaging ◽  
Health Centres ◽  
Rapid Healing

Objective: To investigate changes in the quality of life of patients with leg ulcers being treated in community leg ulcer clinics. Design: Patients were interviewed using a standard questionnaire, and then reinterviewed after 12 weeks of compression bandaging to observe changes. Setting: Community ulcer clinics held in health centres within Riverside Health District. Patients: All new patients presenting to community leg ulcer clinics up to 6 months from the start of a clinic and treated with four-layer compression bandaging. Main outcome measures: Changes in quality of life, interference in daily activities caused by leg ulceration and general health after 12 weeks of treatment. Results: Treatment over 12 weeks resulted in a mean reduction in anxiety (2.79 v 1.73, p < 0.001), depression (2.61 v 1.89, p < 0.001), hostility (1.59 v 1.00, p < 0.001) and cognition (1.29 v 0.87, p = 0.015). Pain significantly improved following treatment (χ2 trend = 103.7, 1d.f., p < 0.001). Changes in depression and hostility were related to complete ulcer healing. Conclusions: There were clear changes in quality of life following 12 weeks in a community leg ulcer clinic, which were related to the healing of the ulcer. Systems of care that offer rapid healing and improve patients' well-being must be considered when planning an effective leg ulcer service.

Causes and the way of treatment of patients with chronic leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (05) ◽  
pp. 211-218 ◽  
Author(s):  
C. Wax ◽  
A. Körber ◽  
J. Dissemond ◽  
J. Klode
Keyword(s):  
Treatment Period ◽  
General Practitioners ◽  
Peripheral Arterial Occlusive Disease ◽  
Mean Value ◽  
Arterial Occlusive Disease ◽  
Leg Ulcer ◽  
Leg Ulcers ◽  
Patient Will ◽  
Peripheral Arterial ◽  
Chronic Leg Ulcers

SummaryChronic leg ulcer may have various causes, which are currently not centrally recorded in Germany. It is also unclear who treats patients with chronic leg ulcers in Germany and how the basic implementation of diagnosis and treatment of these patients looks like. Patients, methods: Therefore, we started a survey of 1000 general practitioners and practising specialists in dermatology, surgery and phlebology in five different regions of Germany. We carried out the genesis of a total of 6275 patients from 62 different practising therapists, 33 specialists in dermatology, surgery or phlebology and 29 general practitioners. Results: In 66.1% of all patients we found a venous leg ulcer, in 9.1% a leg ulcer from peripheral arterial occlusive disease, and in 8.5% a mixture of both. Thus there suffered a total of 83.8% of patients on chronic venous insufficiency or peripheral arterial occlusive disease as a major factor in the genesis of the chronic leg ulcer. However, even the rarely diagnosed entities such as exogenous factors, vasculitis, pyoderma gangrenosum or infectious diseases are occur in summation in 16.2% of all patients and should therefore be known and excluded. In addition, the treatment periods and referral routes of patients with chronic leg ulcer should be identified. The analysis showed that the vast majority (86.8%) of patients with chronic ulcers who were investigated by us is treated by specialists. The treatment duration of general practitioners is 6.3 weeks (mean value) before the patient will be referred to a specialist. This treatment period is significantly shorter compared to the treatment period of the specialists, who treat their patients 14.1 weeks (mean value) before the patient will be referred to another specialist or to a clinic. Conclusion: Our results show the current aspects of aetiology and the way of treatment of patients with chronic leg ulcers in Germany.

A lower leg ulcer caused by an intravenous injection: Report of a case.

1989 ◽  
Vol 51 (1) ◽  
pp. 27-31
Author(s):  
Kikuko HARA ◽  
Noriko IWASE ◽  
Yumiko SEZAI ◽  
Takashi NAGASHIMA
Keyword(s):  
Intravenous Injection ◽  
Lower Leg ◽  
Leg Ulcer
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