Transcutaneous strain of oxygen (TcPO2) was studied in tissues of 111 wounds in 110 patients. The uncomplicated course of the wound process was characterized by rapid normalization of the initially decreased TcPO2 in the wounds closed with sutures or in case of gradual approximation of their margins as well as by a slow elevation when the wounds were healing by second intention. High significance of measuring TcPO2 was shown for diagnosis of acute pyo-inflammatory diseases and wound complications. Great feed-back correlation was found between the degree of disjunction of the wound margins and TcPO2 of its tissues. A hypothesis is put forward on the dependence between the degree of tissue tension and the precapillary sphincter tone allowing an explanation of all the changes in TcPO2 of the wound tissues in the process of its healing.
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Quant Imaging Med Surg
January 2025
Division of Plastic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Background And Objective: Diabetic neuropathy significantly elevates the risk of foot ulceration and lower-limb amputation, underscoring the need for precise assessment of tissue perfusion to optimize management. This narrative review explores the intricate relationship between sympathetic nerves and tissue perfusion in diabetic neuropathy, highlighting the important role of autonomic neuropathy in blood flow dynamics and subsequent compromises in tissue perfusion. The consequences extend to the development of diabetic peripheral neuropathy and related foot complications.
View Article and Find Full Text PDFVasc Med
January 2025
Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Foot ulceration is a significant and growing health problem worldwide, particularly due to rises in diabetes mellitus (DM) and peripheral artery disease. The prediction of ulcer healing remains a major challenge. In patients with foot ulcers, medial arterial calcification (MAC) can be present as a result of concomitant DM or chronic kidney disease and is a prognostic factor for unfavorable outcome.
View Article and Find Full Text PDFVasc Med
December 2024
Vascular & Interventional Specialists of Orange County, Orange, CA, USA.
Background: Preclinical studies have demonstrated that therapeutic ultrasound (TUS) increases perfusion in peripheral artery disease (PAD). This pilot study assessed the safety and effectiveness of a noninvasive TUS device in patients with advanced PAD.
Methods: A phased array of TUS transducers was fabricated on a wearable sleeve, designed to sonicate the posterior and anterior tibial arteries (and their collaterals) at the calf level.
J Clin Med
November 2024
Department of Biomedicine and Prevention, Diabetes-Endocrine Section CTO Hospital, Tor Vergata University of Rome, 00133 Rome, Italy.
Chronic limb-threatening ischemia (CLTI), the most advanced form of peripheral arterial disease (PAD), is the comorbidity primarily responsible for major lower-limb amputations, particularly for diabetic patients. Autologous cell therapy has been the focus of efforts over the past 20 years to create non-interventional therapeutic options for no-option CLTI to improve limb perfusion and wound healing. Among the different available techniques, peripheral blood mononuclear cells (PBMNC) appear to be the most promising autologous cell therapy due to physio-pathological considerations and clinical evidence, which will be discussed in this review.
View Article and Find Full Text PDFActa Diabetol
November 2024
Azienda Ospedaliero Universitaria Careggi and University of Florence, Florence, Italy.
Aim: To assess the efficacy and safety of autologous cell therapy (ACT) in patients with ischemic diabetic foot ulcers (DFU). The present meta-analysis was designed to support the development of the Italian Guidelines for the Treatment of Diabetic Foot Syndrome (DFS).
Methods: A Medline and Embase search were performed up to Feb 1st, 2024 collecting all RCTs including diabetic patients or reporting subgroup analyses on diabetic patients with ischemic foot ulcers comparing ACT with placebo/no therapy/standard of care (SoC), with a duration of at least 26 weeks.
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