Improvement in Healing With Aggressive Edema Reduction After Debridement of Foot Infection in Persons With Diabetes

Armstrong, David G.

doi:10.1001/archsurg.135.12.1405

Cited by 69 publications

(46 citation statements)

References 24 publications

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“…65 Two RCTs have shown that compression therapy with the use of intermittent pneumatic compression (IPC) is effective in reducing healing time for DFU in addition to reducing lymphedema. 66,67 The mechanism of action of IPC is believed to include enhancement of fibrinolysis and venous outflow, thereby reducing edema. 67,68 IPC simulates the effect of walking and weight-bearing on the venous system by the intermittent compressiondecompression cycle.…”

Section: Decongestion Therapymentioning

confidence: 99%

“…66,67 The mechanism of action of IPC is believed to include enhancement of fibrinolysis and venous outflow, thereby reducing edema. 67,68 IPC simulates the effect of walking and weight-bearing on the venous system by the intermittent compressiondecompression cycle. However, compression therapy is limited in the presence of peripheral vascular disease.…”

Section: Decongestion Therapymentioning

confidence: 99%

See 1 more Smart Citation

Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

Kanapathy¹,

Portou²,

Tsui³

et al. 2015

CWCMR

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Diabetic foot ulcers (DFUs) are complex, chronic, and progressive wounds, and have a significant impact on morbidity, mortality, and quality of life. A particular aspect of DFU that has not been reviewed extensively thus far is its management in conjunction with peripheral limb edema. Peripheral limb edema is a feature of diabetes that has been identified as a significant risk factor for amputation in patients with DFU. Three major etiological factors in development of lymphedema with concurrent DFU are diabetic microangiopathy, failure of autonomic regulation, and recurrent infection. This review outlines the pathophysiology of lymphedema formation in patients with DFU and highlights the cellular and immune components of impaired wound healing in lymphedematous DFU. We then discuss the principles of management of DFU in conjunction with lymphedema.

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Section: Decongestion Therapymentioning

confidence: 99%

Section: Decongestion Therapymentioning

confidence: 99%

Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

Kanapathy¹,

Portou²,

Tsui³

et al. 2015

CWCMR

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show abstract

“…The single RCT on post-operative wounds suggested a significant benefit of compression therapy [43].…”

Section: Compressionmentioning

confidence: 99%

A systematic review of the effectiveness of interventions to enhance the healing of chronic ulcers of the foot in diabetes

Hinchliffe

Valk

Apelqvist

et al. 2008

Diabetes Metab. Res. Rev.

204

132

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SummaryThe outcome of management of diabetic foot ulcers is poor and there is uncertainty concerning optimal approaches to management. We have undertaken a systematic review to identify interventions for which there is evidence of effectiveness. A search was made for reports of the effectiveness of interventions assessed in terms of healing, ulcer area or amputation in controlled clinical studies published prior to December 2006. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Selected studies fell into the following categories: sharp debridement and larvae; antiseptics and dressings; chronic wound resection; hyperbaric oxygen (HBO); reduction of tissue oedema; skin grafts; electrical and magnetic stimulation and ultrasound. Heterogeneity of studies prevented pooled analysis of results. Of the 2251 papers identified, 60 were selected for grading following full text review. Some evidence was found to support hydrogels as desloughing agents and to suggest that a systemic (HBO) therapy may be effective. Topical negative pressure (TNP) may promote healing of post-operative wounds, and resection of neuropathic plantar ulcers may be beneficial. More information was needed to confirm the effectiveness and cost-effectiveness of these and other interventions. No data were found to justify the use of any other topically applied product or dressing, including those with antiseptic properties. Further evidence to substantiate the effect of interventions designed to enhance the healing of chronic ulcers is urgently needed. Until such evidence is available from robust trials, there is limited justification for the use of more expensive treatments and dressings.

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“…36 Edema of the legs can delay wound healing; controlling edema with leg elevation, compression stockings, or a pneumatic pedal compression device enhances the healing process. 37 Evidence of resolution of infection includes formation of granulation tissue, absence of necrotic tissue, and closing of the wound. If osteomyelitis is present, signs of healing include a drop in ESR and loss of increased uptake on nuclear scan.…”

Section: Wound Managementmentioning

confidence: 99%

Total Hip Infections

2003

Musculoskeletal Infections

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Improvement in Healing With Aggressive Edema Reduction After Debridement of Foot Infection in Persons With Diabetes

Cited by 69 publications

References 24 publications

Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

A systematic review of the effectiveness of interventions to enhance the healing of chronic ulcers of the foot in diabetes

Total Hip Infections

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