Skin grafting and tissue replacement for treating foot ulcers in people with diabetes.

Background: Foot ulceration is a major problem in people with diabetes and is the leading cause of hospitalisation and limb amputations. Skin grafts and tissue replacements can be used to reconstruct skin defects for people with diabetic foot ulcers in addition to providing them with standard care. Skin substitutes can consist of bioengineered or artificial skin, autografts (taken from the patient), allografts (taken from another person) or xenografts (taken from animals).

Economic outcomes in clinical studies assessing hyperbaric oxygen in the treatment of acute and chronic wounds.

Introduction: Hyperbaric oxygen treatment (HBOT) is used to treat acute and chronic wounds. This systematic review was conducted to summarise and evaluate existing evidence on the costs associated with HBOT in the treatment of wounds.

Methods: We searched multiple electronic databases in March 2015 for cohort studies and randomised clinical trials (RCTs) that reported on the clinical effectiveness and treatment costs of HBOT in the treatment of acute or chronic wounds.

Shared Decision-Making in Cosmetic Medicine and Aesthetic Surgery.

Shared decision-making (SDM) invokes the bidirectional communication between physicians and patients required to involve the patient's preference in the eventual treatment choice. This paper will explain what SDM is, why it is important, and how it is performed in clinical practice. It is an essential part of evidence-based medicine, as it helps determine whether the available evidence on the possible benefits and harms of treatment options match the patient's characteristics and preferences.

Hospital costs of complications after a pancreatoduodenectomy.

Background: A pancreatoduodenectomy (PD) is a highly advanced procedure associated with considerable post-operative complications and substantial costs. In this study the hospital costs associated with complications after PD were assessed.

Methods: A retrospective cohort study was conducted on 100 consecutive patients who underwent a pylorus-preserving (PP)PD between January 2012 and July 2013.

Comparing the Meggitt-Wagner and the University of Texas wound classification systems for diabetic foot ulcers: inter-observer analyses.

Accurate classification of diabetic foot ulcers is essential for inter-clinician communication, assessment of healing tendency and determination of treatment options. The aim of this study was to assess the inter-observer agreement (IOA) of the most commonly used classification systems for diabetic foot ulcers; the Meggitt-Wagner (MW) and the University of Texas (UT) systems. In this study, 95 clinicians judged digital photographs of diabetic foot ulcers in various stages of healing.

Systemic wound care: a meta-review of cochrane systematic reviews.

Wound care is a classic example of a surgical realm with a great variation in care. The diversity in wounds and wound treatments, the limited amount of convincing evidence, and the diverging opinions among doctors and nurses involved in wound care contribute to this undesirable variation in care. For chronic wounds, such as arterial or venous ulcers, pressure sores, and diabetic foot ulcers, but also for acute wounds after surgery or trauma, international and national guidelines provide recommendations on diagnostic procedures and treatment options, but rely mostly on expert opinion.

Is additional hyperbaric oxygen therapy cost-effective for treating ischemic diabetic ulcers? Study protocol for the Dutch DAMOCLES multicenter randomized clinical trial?

Background: The value of hyperbaric oxygen therapy (HBOT) in the treatment of diabetic ulcers is still under debate. Available evidence suggests that HBOT may improve the healing of diabetic ulcers, but it comes from small trials with heterogeneous populations and interventions. The DAMOCLES-trial will assess the (cost-)effectiveness of HBOT for ischemic diabetic ulcers in addition to standard of care.