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... Editor Continuing Medical Education Abstract Wound healing proceeds in a ByCornelius M. Donoh... more ... Editor Continuing Medical Education Abstract Wound healing proceeds in a ByCornelius M. Donohue, DPM, Larry R. Goss, DPM, Frederick B. LaVan, MD, Michael S. Weingarten, MD, and Mazen A. Abboud, DPM Objectives 1 ...
International Wound Journal
Journal of the American Podiatric Medical Association, Jul 1, 2004
Regional nerve blocks at the ankle produce sufficient anesthesia to permit most operative procedu... more Regional nerve blocks at the ankle produce sufficient anesthesia to permit most operative procedures on the foot. However, conditions such as anatomical disturbance from previous operations or infection at the operative site may render the application of ankle blocks difficult or inappropriate, respectively. Common alternatives to local foot and ankle blocks include general and spinal anesthesia. General and spinal anesthesia have substantial disadvantages. Skill in airway management, including anti-aspiration maneuvers and airway patency preservation, is required for general anesthesia. Spinal anesthesia demands meticulous sterile technique. Both types require specialized equipment, facilities, and monitors for hemodynamic and respiratory management during the anesthesia, and both increase the risk of postoperative complications, including nausea and vomiting, postdural puncture headache, and prolonged recovery. 1, 2 Incorporation of a combined popliteal fossa nerve block and saphenous nerve block at the knee has certain advantages over general and spinal anesthesia for foot and ankle surgery. This combined block provides an attractive alternative that avoids some of the disadvantages of general and spinal anesthesia. The combined block is performed with a clean, rather than a sterile, technique; requires similar equipment, drugs, and monitoring as an ankle block; and extends surgical anesthesia to include the entire distal lower
International Wound Journal
Early reliable, valid screening, diagnosis, and treatment improve peripheral arterial disease out... more Early reliable, valid screening, diagnosis, and treatment improve peripheral arterial disease outcomes, yet screening and diagnostic practices vary across settings and specialties. A scoping literature review described reliability and validity of peripheral ischaemia diagnosis or screening tools. Clinical studies in the PUBMED database January 1, 1970, to August 13, 2018, were reviewed summarising ranges of reliability and validity of peripheral ischaemia diagnostic and screening tools for patients with non‐neuropathic lower leg ischaemia. Peripheral ischaemia screening and diagnostic practices varied in parameters measured such as timing, frequency, setting, ordering clinicians, degree of invasiveness, costs, definitions, and cut‐off points informing clinical and referral decisions. Traditional ankle/brachial systolic blood pressure index <0.9 was a reliable, valid lower leg ischaemia screening test to trigger specialist referral for detailed diagnosis. For patients with advanced peripheral ischaemia or calcified arteries, toe‐brachial index, claudication, or invasive angiographic imaging techniques that can have complications were reliable, valid screening, and diagnostic tools to inform management decisions. Ankle/brachial index testing is sufficiently reliable and valid for use during routine examinations to improve timing and consistency of peripheral ischaemia screening, triggering prompt specialist referral for more reliable, accurate Doppler, or other diagnosis to inform treatment decisions.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, Sep 1, 2017
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot... more The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open-ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer (n = 19) or a lower extremity amputation (n = 20). Interviews were audio-recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts. Coded data were summarized and examined for patterns. Participants' description of the relationship between diabetes and their foot ulcer or amputation revealed a limited understanding of the disease process. Disruption and loss of independence was expressed whether the person had a foot ulcer or an amputation. Treatment recommendations for foot ulcers were viewed by most as extremely difficult....
... Editor Continuing Medical Education Abstract Wound healing proceeds in a ByCornelius M. Donoh... more ... Editor Continuing Medical Education Abstract Wound healing proceeds in a ByCornelius M. Donohue, DPM, Larry R. Goss, DPM, Frederick B. LaVan, MD, Michael S. Weingarten, MD, and Mazen A. Abboud, DPM Objectives 1 ...
International Wound Journal
Journal of the American Podiatric Medical Association, Jul 1, 2004
Regional nerve blocks at the ankle produce sufficient anesthesia to permit most operative procedu... more Regional nerve blocks at the ankle produce sufficient anesthesia to permit most operative procedures on the foot. However, conditions such as anatomical disturbance from previous operations or infection at the operative site may render the application of ankle blocks difficult or inappropriate, respectively. Common alternatives to local foot and ankle blocks include general and spinal anesthesia. General and spinal anesthesia have substantial disadvantages. Skill in airway management, including anti-aspiration maneuvers and airway patency preservation, is required for general anesthesia. Spinal anesthesia demands meticulous sterile technique. Both types require specialized equipment, facilities, and monitors for hemodynamic and respiratory management during the anesthesia, and both increase the risk of postoperative complications, including nausea and vomiting, postdural puncture headache, and prolonged recovery. 1, 2 Incorporation of a combined popliteal fossa nerve block and saphenous nerve block at the knee has certain advantages over general and spinal anesthesia for foot and ankle surgery. This combined block provides an attractive alternative that avoids some of the disadvantages of general and spinal anesthesia. The combined block is performed with a clean, rather than a sterile, technique; requires similar equipment, drugs, and monitoring as an ankle block; and extends surgical anesthesia to include the entire distal lower
International Wound Journal
Early reliable, valid screening, diagnosis, and treatment improve peripheral arterial disease out... more Early reliable, valid screening, diagnosis, and treatment improve peripheral arterial disease outcomes, yet screening and diagnostic practices vary across settings and specialties. A scoping literature review described reliability and validity of peripheral ischaemia diagnosis or screening tools. Clinical studies in the PUBMED database January 1, 1970, to August 13, 2018, were reviewed summarising ranges of reliability and validity of peripheral ischaemia diagnostic and screening tools for patients with non‐neuropathic lower leg ischaemia. Peripheral ischaemia screening and diagnostic practices varied in parameters measured such as timing, frequency, setting, ordering clinicians, degree of invasiveness, costs, definitions, and cut‐off points informing clinical and referral decisions. Traditional ankle/brachial systolic blood pressure index <0.9 was a reliable, valid lower leg ischaemia screening test to trigger specialist referral for detailed diagnosis. For patients with advanced peripheral ischaemia or calcified arteries, toe‐brachial index, claudication, or invasive angiographic imaging techniques that can have complications were reliable, valid screening, and diagnostic tools to inform management decisions. Ankle/brachial index testing is sufficiently reliable and valid for use during routine examinations to improve timing and consistency of peripheral ischaemia screening, triggering prompt specialist referral for more reliable, accurate Doppler, or other diagnosis to inform treatment decisions.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, Sep 1, 2017
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot... more The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open-ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer (n = 19) or a lower extremity amputation (n = 20). Interviews were audio-recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts. Coded data were summarized and examined for patterns. Participants' description of the relationship between diabetes and their foot ulcer or amputation revealed a limited understanding of the disease process. Disruption and loss of independence was expressed whether the person had a foot ulcer or an amputation. Treatment recommendations for foot ulcers were viewed by most as extremely difficult....