Neuropathic foot ulcers, a serious complication of impaired pedal sensation, are the most common complication of diabetes mellitus leading to hospitalization. One of the goals in treating neuropathic ulcers is to reduce or eliminate pressure from the ulcer site to prevent further breakdown and allow healing. These treatments must address several forms of stress-vertical pressure, shearing force, and tissue strain. This paper reviews several techniques for off-weighting plantar ulcers and describes and recommends the felt-to-foam contact padding technique used at the Northern California Center for the Diabetic and Insensitive Foot and the California College of Podiatric Medicine.
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Arch Bone Jt Surg
January 2024
Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Flail foot is a condition characterized by a significant weakness in ankle dorsiflexion, resulting in limited or no active mobility in the ankle. To address this issue, we described a novel approach called tenodesis, which has been developed for ankle joint stabilization. This technique utilizes the patient's tendons to minimize potential complications.
View Article and Find Full Text PDFJ Tissue Viability
January 2025
Discipline of Podiatric Medicine, School of Health Sciences, University of Galway, Galway, H91 TK33, Ireland.
Background: Diabetic foot ulcers (DFUs) are a prevalent complication of diabetes. Individuals with DFUs can experience wound-related pain, which could be nociceptive and/or neuropathic in origin, which adversely affects health-related quality of life (HRQoL).
Aim: To determine the prevalence and characteristics of DFU-related pain and its impact on HRQoL in community-dwelling individuals with active DFUs.
Adv Skin Wound Care
January 2025
At Mayo Clinic, Rochester, Minnesota, United States, Paul T. Gomez, BS, is Summer Research Fellow, Regenerative Sciences Track, Mayo Clinic Graduate School of Biomedical Sciences; Saranya P. Wyles, MD, PhD, is Consultant, Department of Dermatology; and Karen L. Andrews, MD, is Director, Vascular Ulcer and Wound Healing Clinic/Gonda Vascular Center, and Consultant, Department of Physical Medicine and Rehabilitation. At Mayo Clinic, Jacksonville, Florida, Jennifer R. Arthurs is APRN, Center for Regenerative Medicine; and Alison J. Bruce, MB, ChB, is Consultant, Department of Dermatology.
Background: Chronic nonhealing neuropathic foot ulcers affect approximately 15% to 30% of patients with diabetes mellitus and are associated with significant morbidity and mortality. Although current strategies to address these chronic wounds include a multifactorial approach, clinical outcomes remain poor and warrant improvement. Platelet-rich plasma (PRP), derived from autologous or allogeneic blood, is an emerging regenerative product that aims to serve as an adjuvant to standard diabetic foot ulcer (DFU) treatment.
View Article and Find Full Text PDFMedicina (Kaunas)
December 2024
Department of Physical Therapy for Neurology and Neurosurgery, Faculty of Physical Therapy, Cairo University, Cairo 12613, Egypt.
Patients with diabetes polyneuropathy are at a heightened risk for developing foot ulcers, often due to dynamic plantar foot pressure patterns that lead to increased pressure and shear forces in specific foot areas. This study aimed to evaluate the effects of foot insoles on peak pressure and the pressure-time integral in patients with polyneuropathy diabetic foot ulcers over a twelve-week period followed by an eight-week follow up. : This was a prospective, randomized, double-blinded, controlled clinical trial involving 60 patients aged between 50 and 65 years of both genders.
View Article and Find Full Text PDFPain Ther
February 2025
Department of Medicine, Nephrology Division, University of Verona, Verona, Italy.
Introduction: Pain is one of the most frequently reported symptoms in hemodialyzed (HD) patients, with prevalence rates between 33% and 82%. Risk factors for chronic pain in HD patients are older age, long-lasting dialysis history, several concomitant diseases, malnutrition, and others. However, chronic pain assessment in HD patients is rarely performed by specialists in pain medicine, with relevant consequences in terms of diagnostic and treatment accuracy.
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