SCBD therapy is a cost-effective and clinically efficacious solution in CLI patients with no option of revascularization. It provides adequate limb salvage and ameliorated amputation-free survival while providing relief of rest pain without any intervention.
The SCBD therapy is a cost-effective and clinically effective solution in patients with CLI having no option of revascularization. It provides adequate limb salvage while providing relief of rest pain without any intervention.
Patients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). From January 2003 to June 2009, out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% ± SD 8.8%) compared to DAVF (7.3% ± SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF (P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.
Background
Diabetes is a major health problem that is currently showing an alarming rise in its prevalence, this has recently been estimated at 7.8% in the United States, presenting a > 50% increase over the past 15 years while there exists a large population group in whom diabetes is undiagnosed.
Objective
To evaluate the effectiveness and rate of healing of autologous PRP gel in treatment of diabetic foot ulcers. Compare the effectiveness of PRP gel with standard treatment (normal saline dressings).
Methods
30 patients with non-ischemic DFU were classified into two groups: Group A: Patients with non-ischemic DFU and were treated with a novel modality i.e.: PRP injection in the healing edge and the floor of the targeted ulcer. GroupGroup B B:: Patients with non-ischemic DFU who had usual standard care i.e.: moist dressing with or without collagenase ointment. All cases had a minimal debridement prior to treatment, here in our study the demographic data i.e. Age, sex, medical history were homogenously distributed among both groups. All cases in both groups were non ischemic after successful revascularization either by OR or ER.
Results
The rate of complete healing for ulcers in group A was achieved in six patients (40%) at the fifth week, while five patients (33.33%) were healed completely by the sixth week and only one patient (6.67%) healed in the ninth week. 26.67% (n = 4 cases) in group B showed complete healing rate by eighth week and 40% (n = 6 cases) were healed by ninth week while 33.33% (n = 5 cases) were healed in the tenth week. P value was statistically significant <0.001 between the groups.
Conclusion
Activated platelet rich plasma is a novel modality in treatment of diabetic foot ulcers which is feasible, safe and effective with high rate of limb salvage rate and clinical improvement.
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