High bacterial loads within chronic wounds increase the risk of infection and complication. Detection and localization of bacterial loads through point-of-care fluorescence (FL) imaging can objectively inform and support bacterial treatment decisions. This single time-point, retrospective analysis describes the treatment decisions made on 1000 chronic wounds (DFUs, VLUs, PIs, surgical wounds, burns, and others) at 211 wound-care facilities across 36 US states.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2022
(1) Background: Systemic antibiotic use in chronic wounds is alarmingly high worldwide. Between 53% to 71% of patients are prescribed at least one course per chronic wound. Systemic antibiotic use should follow antibiotic stewardship guidelines and ought to be reserved for situations where their use is deemed supported by clinical indications.
View Article and Find Full Text PDFThe COVID-19 pandemic, which started in March of 2020, and its associated surges have had an immense impact on the ability of medical staff to perform their daily activities. Thus, we sought to direct patients who had gram-positive Acute Bacterial Skin and Skin Structure Infections (ABSSSI) to our Outpatient Department/Wound Care Center for treatment. We met the challenge of the pandemic by shifting care in the treatment of ABSSSI using a new antibiotic delivery system.
View Article and Find Full Text PDFIntroduction: The healing of venous ulcers is difficult, and several sources indicate a multidisciplinary plan of care as the best approach to the healing of these wounds.
Materials And Methods: Seventy-five patients with suspected venous disease being treated at Northern New Jersey Medical Center were assessed by dedicated interventional radiology physicians as part of Wound Center protocol. Of those patients, 27 required diagnostic testing, such as CT venogram or venography.
Complex lower extremity ulcers with exposed bone, tendon, muscle, and/or joint capsule as well as multiple comorbidities including diabetes, ischemia, and underlying osteomyelitis are difficult to heal and associated with high morbidity and mortality and high rates of amputation. A retrospective review was performed to assess healing of 31 patients presenting with 33 complex foot ulcers with a confirmed histopathological diagnosis of osteomyelitis treated by the same surgeon at a single wound care center by the following treatment regimen: sharp debridement, resection of infected bone when necessary, open cortex, antibiotics, and application of cryopreserved umbilical cord (cUC). The average ulcer size was 15.
View Article and Find Full Text PDFThis study evaluates the results of treating neuropathic diabetes mellitus (DM) foot ulcers with Achilles tendon percutaneous complete tenotomy. To the authors' knowledge this study is the largest of this nature to date. One hundred twenty-seven patients with Wagner Grade 1 to 4 foot ulcers were treated with percutaneous Achilles complete tenotomy between January 2007 and December 2010.
View Article and Find Full Text PDFChronic wounds with exposed bone present a challenge for clinicians. Without intact periosteum, cortical bone is relatively avascular and provides a poor base for wound healing and skin grafting. It has been shown that cortical bone fenestration and decortication can expedite wound healing in exposed calvarial bone.
View Article and Find Full Text PDFDebridement of devitalised tissue is an essential component of the effective treatment of chronic wounds. The Versajet Hydrosurgery System is a new technology that simultaneously cuts and aspirates soft tissue. In this study we compared Versajet with conventional surgical techniques in the debridement of lower extremity ulcers to assess impact on time and resources for debridement.
View Article and Find Full Text PDFWounds of the foot are the most common reason for diabetes-related hospital admissions. In many of these cases, surgical intervention is the best option. This article will review the risk factors for foot wounds in people with diabetes, discuss preventative and surgical strategies, and present surgical management techniques to treat ulceration and chronic infection in these wounds.
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