Hau Pham - Academia.edu (original) (raw)

Papers by Hau Pham

Research paper thumbnail of Emerging Treatments in Diabetic Wound Care

woundsresearch.com

Emerging Treatments in Diabetic Wound Care. Thu, 9/4/08 - 11:52am; 2 Comments; 24488 reads. Autho... more Emerging Treatments in Diabetic Wound Care. Thu, 9/4/08 - 11:52am; 2 Comments; 24488 reads. Author(s): Thanh Dinh, DPM;1 Hau Pham, DPM;1 Aristidis Veves, MD2. ... In a chronic wound the bacteria have organized to defend themselves in a biofilm and are far harder to kill off ...

Research paper thumbnail of A randomized clinical trial of a human acellular dermal matrix demonstrated superior healing rates for chronic diabetic foot ulcers over conventional care and an active acellular dermal matrix comparator

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, May 24, 2017

This study compared the efficacy and safety of a human acellular dermal matrix (ADM), D-ADM, with... more This study compared the efficacy and safety of a human acellular dermal matrix (ADM), D-ADM, with a conventional care arm and an active comparator human ADM arm, GJ-ADM, for the treatment of chronic diabetic foot ulcers. The study design was a prospective, randomized controlled trial that enrolled 168 diabetic foot ulcer subjects in 13 centers across 9 states. Subjects in the ADM arms received one application but could receive one additional application of ADM if deemed necessary. Screen failures and early withdrawals left 53 subjects in the D-ADM arm, 56 in the conventional care arm, and 23 in the GJ-ADM arm (2:2:1 ratio). Subjects were followed through 24 weeks with major endpoints at Weeks 12, 16, and 24. Single application D-ADM subjects showed significantly greater wound closure rates than conventional care at all three endpoints while all applications D-ADM displayed a significantly higher healing rate than conventional care at Week 16 and Week 24. GJ-ADM did not show a signif...

Research paper thumbnail of The role of endothelial function on the foot. Microcirculation and wound healing in patients with diabetes

Clinics in podiatric medicine and surgery, 1998

Wound healing is defective in patients with diabetes, which may be attributed to many factors. Ou... more Wound healing is defective in patients with diabetes, which may be attributed to many factors. Our data indicate that impairment of the microcirculation is a major factor. Although the exact causes of microvascular impairment are not known, dysfunction of the endothelium has emerged over the last decade as the prominent abnormality related to vascular disease in diabetes. Further studies are required to clarify the causes of endothelial dysfunction and identify potential therapeutic interventions in the future.

Research paper thumbnail of Feature: A Prospective, Randomized, Controlled Double-Blind Study of a Moisturizer for Xerosis of the Feet in Patients with Diabetes

Research paper thumbnail of Microcirculation in the neuropathic diabetic foot remains impaired after successful large vessel revascularization

Research paper thumbnail of Microvascular reactivity in the neuropathic foot remains impaired after successful revascularization

Research paper thumbnail of Original Articles-Epidemiology/Health Services/Psychosocial Research-Screening techniques to identify people at high risk for diabetic foot ulceration: A prospective multicenter trial

Research paper thumbnail of The forefoot/rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration

Research paper thumbnail of Change in foot ulcer area over a 4-week period can predict complete healing in a prospective clinical trial

Research paper thumbnail of Risk factors for the development of foot ulceration: one year prospective follow-up

Research paper thumbnail of Healing rate measurement can predict complete wound healing rate in chronic diabetic foot ulceration

Research paper thumbnail of Living Skin Equivalents for Diabetic Foot Ulcers

Diabetic Foot, The, 2002

ABSTRACT

Research paper thumbnail of A Phase 2, Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial of the Safety and Efficacy of Plasmid Dna Expressing 2 Isoforms of Hepatocyte Growth Factor in Patients with Critical Limb Ischemia

Journal of the American College of Cardiology, 2014

A phAse 2, double-blind, rAndomized, plAcebo-controlled, multicenter triAl oF the sAFety And eFFi... more A phAse 2, double-blind, rAndomized, plAcebo-controlled, multicenter triAl oF the sAFety And eFFicAcy oF plAsmid dnA expressing 2 isoForms oF hepAtocyte growth FActor in pAtients with criticAl limb ischemiA

Research paper thumbnail of Using Living Skin Equivalents for Diabetic Foot Ulceration

The International Journal of Lower Extremity Wounds, 2002

Diabetic foot ulcers are a major clinical challenge with enormous socioeconomic consequence. All ... more Diabetic foot ulcers are a major clinical challenge with enormous socioeconomic consequence. All advances in the understanding and management of this problem are eagerly received by wound specialists. The development of bioengineered skin—living skin equivalent—is an interesting event that could be significant in the management of lower extremity wounds such as the diabetic foot ulcer.

Research paper thumbnail of Role of Neuropathy and High Foot Pressures in Diabetic Foot Ulceration

Diabetes Care, 1998

OBJECTIVE High plantar foot pressures in association with peripheral neuropathy have been ascerta... more OBJECTIVE High plantar foot pressures in association with peripheral neuropathy have been ascertained to be important risk factors for ulceration in the diabetic foot. Most studies investigating these parameters have been limited by their size and the homogeneity of study subjects. The objective of this study was therefore to ascertain the risk of ulceration associated with high foot pressures and peripheral neuropathy in a large and diverse diabetic population. RESEARCH DESIGN AND METHODS We studied a cross-sectional group of 251 diabetic patients of Caucasian (group C) (n = 121), black (group B) (n = 36), and Hispanic (group H) (n = 94) racial origins with an overall age of 58.5 ± 12.5 years (range 20–83). There was an equal distribution of men and women across the entire study population. All patients underwent a complete medical history and lower extremity evaluation for neuropathy and foot pressures. Neuropathic parameters were dichotomized (0/1) into two high-risk variables: p...

Research paper thumbnail of Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial

Diabetes Care, 2000

OBJECTIVE: Diabetic foot ulceration is a preventable long-term complication of diabetes. A multic... more OBJECTIVE: Diabetic foot ulceration is a preventable long-term complication of diabetes. A multicenter prospective follow-up study was conducted to determine which risk factors in foot screening have a high association with the development of foot ulceration. RESEARCH DESIGN AND METHODS: A total of 248 patients from 3 large diabetic foot centers were enrolled in a prospective study. Neuropathy symptom score, neuropathy disability score (NDS), vibration perception threshold (VPT), Semmes-Weinstein monofilaments (SWFs), joint mobility, peak plantar foot pressures, and vascular status were evaluated in all patients at the beginning of the study. Patients were followed-up every 6 months for a mean period of 30 months (range 6-40), and all new foot ulcers were recorded. The sensitivity, specificity, and positive predictive value of each risk factor were evaluated. RESULTS: Foot ulcers developed in 95 feet (19%) or 73 patients (29%) during the study. Patients who developed foot ulcers wer...

Research paper thumbnail of The Forefoot-to-Rearfoot Plantar Pressure Ratio Is Increased in Severe Diabetic Neuropathy and Can Predict Foot Ulceration

Diabetes Care, 2002

OBJECTIVE—We have previously demonstrated that high plantar pressures can predict foot ulceration... more OBJECTIVE—We have previously demonstrated that high plantar pressures can predict foot ulceration in diabetic patients. The aim of the present study was to evaluate both the relationship between forefoot and rearfoot plantar pressure in diabetic patients with different degrees of peripheral neuropathy and their role in ulcer development. RESEARCH DESIGN AND METHODS—Diabetic patients of a 30-month prospective study were classified according to the neuropathy disability score: scores of 0, 1–5, 6–16, and 17–28 are defined as absent (n = 20), mild (n = 66), moderate (n = 95), and severe (n = 57) neuropathy, respectively. The F-Scan mat system was used to measure dynamic plantar pressures. The peak pressures under the forefoot and the rearfoot were selectively measured for each foot, and the forefoot-to-rearfoot ratio (F/R ratio) was calculated. RESULTS—Foot ulcers developed in 73 (19%) feet. The peak pressures were increased in the forefoot of the severe and moderate neuropathic groups...

Research paper thumbnail of A Randomized, Controlled Trial of Promogran (a Collagen/Oxidized Regenerated Cellulose Dressing) vs Standard Treatment in the Management of Diabetic Foot Ulcers

Archives of Surgery, 2002

Hypothesis: Promogran, a wound dressing consisting of collagen and oxidized regenerated cellulose... more Hypothesis: Promogran, a wound dressing consisting of collagen and oxidized regenerated cellulose, is more effective that standard care in treating chronic diabetic plantar ulcers. Design: Randomized, prospective, controlled multicenter trial. Setting: University teaching hospitals and primary care centers. Patients: A total of 276 patients from 11 centers were enrolled in the study. The mean age of the patients was 58.3 years (range, 23-85 years). All patients had at least 1 diabetic foot ulcer. Interventions: Patients were randomized to receive Promogran (n = 138) or moistened gauze (control group; n=138) and a secondary dressing. Dressings were changed when clinically required. The maximum follow-up for each patient was 12 weeks. Main Outcome Measure: Complete healing of the study ulcer (wound). Results: After 12 weeks of treatment, 51 (37.0%) Promogran-treated patients had complete wound closure compared with 39 (28.3%) control patientss, but this difference was not statistically significant (P=.12). The difference in healing between treatment groups achieved borderline significance in the subgroup of patients with wounds of less than 6 months' duration. In patients with ulcers of less than 6 months' duration, 43 (45%) of 95 Promogran-treated patients healed compared with 29 (33%) of 89 controls (P=.056). In the group with wounds of at least 6 months' duration, similar numbers of patients healed in the control (10/49 [20%]) and the Promogran (8/43 [19%]; P=.83) groups. No differences were seen in the safety measurements between groups. Patients and investigators expressed a strong preference for Promogran compared with moistened gauze. Conclusions: Promogran was comparable to moistened gauze in promoting wound healing in diabetic foot ulcers. It showed an additional efficacy for ulcers of less than 6 months' duration that was of marginal statistical significance. Furthermore, Promogran had a safety profile that was similar to that of moistened gauze, with greater user satisfaction. Therefore, Promogran may be a useful adjunct in the management of diabetic foot ulceration, especially in ulcers of less than 6 months' duration.

Research paper thumbnail of Screening techniques to identify the at risk patients for developing diabetic foot ulcers in a prospective multicenter trial

Research paper thumbnail of The Forefoot-to-Rearfoot Plantar Pressure Ratio Is Increased in Severe Diabetic Neuropathy and Can Predict Foot Ulceration

Diabetes Care, 2002

OBJECTIVE -We have previously demonstrated that high plantar pressures can predict foot ulceratio... more OBJECTIVE -We have previously demonstrated that high plantar pressures can predict foot ulceration in diabetic patients. The aim of the present study was to evaluate both the relationship between forefoot and rearfoot plantar pressure in diabetic patients with different degrees of peripheral neuropathy and their role in ulcer development.

Research paper thumbnail of Emerging Treatments in Diabetic Wound Care

woundsresearch.com

Emerging Treatments in Diabetic Wound Care. Thu, 9/4/08 - 11:52am; 2 Comments; 24488 reads. Autho... more Emerging Treatments in Diabetic Wound Care. Thu, 9/4/08 - 11:52am; 2 Comments; 24488 reads. Author(s): Thanh Dinh, DPM;1 Hau Pham, DPM;1 Aristidis Veves, MD2. ... In a chronic wound the bacteria have organized to defend themselves in a biofilm and are far harder to kill off ...

Research paper thumbnail of A randomized clinical trial of a human acellular dermal matrix demonstrated superior healing rates for chronic diabetic foot ulcers over conventional care and an active acellular dermal matrix comparator

Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, May 24, 2017

This study compared the efficacy and safety of a human acellular dermal matrix (ADM), D-ADM, with... more This study compared the efficacy and safety of a human acellular dermal matrix (ADM), D-ADM, with a conventional care arm and an active comparator human ADM arm, GJ-ADM, for the treatment of chronic diabetic foot ulcers. The study design was a prospective, randomized controlled trial that enrolled 168 diabetic foot ulcer subjects in 13 centers across 9 states. Subjects in the ADM arms received one application but could receive one additional application of ADM if deemed necessary. Screen failures and early withdrawals left 53 subjects in the D-ADM arm, 56 in the conventional care arm, and 23 in the GJ-ADM arm (2:2:1 ratio). Subjects were followed through 24 weeks with major endpoints at Weeks 12, 16, and 24. Single application D-ADM subjects showed significantly greater wound closure rates than conventional care at all three endpoints while all applications D-ADM displayed a significantly higher healing rate than conventional care at Week 16 and Week 24. GJ-ADM did not show a signif...

Research paper thumbnail of The role of endothelial function on the foot. Microcirculation and wound healing in patients with diabetes

Clinics in podiatric medicine and surgery, 1998

Wound healing is defective in patients with diabetes, which may be attributed to many factors. Ou... more Wound healing is defective in patients with diabetes, which may be attributed to many factors. Our data indicate that impairment of the microcirculation is a major factor. Although the exact causes of microvascular impairment are not known, dysfunction of the endothelium has emerged over the last decade as the prominent abnormality related to vascular disease in diabetes. Further studies are required to clarify the causes of endothelial dysfunction and identify potential therapeutic interventions in the future.

Research paper thumbnail of Feature: A Prospective, Randomized, Controlled Double-Blind Study of a Moisturizer for Xerosis of the Feet in Patients with Diabetes

Research paper thumbnail of Microcirculation in the neuropathic diabetic foot remains impaired after successful large vessel revascularization

Research paper thumbnail of Microvascular reactivity in the neuropathic foot remains impaired after successful revascularization

Research paper thumbnail of Original Articles-Epidemiology/Health Services/Psychosocial Research-Screening techniques to identify people at high risk for diabetic foot ulceration: A prospective multicenter trial

Research paper thumbnail of The forefoot/rearfoot plantar pressure ratio is increased in severe diabetic neuropathy and can predict foot ulceration

Research paper thumbnail of Change in foot ulcer area over a 4-week period can predict complete healing in a prospective clinical trial

Research paper thumbnail of Risk factors for the development of foot ulceration: one year prospective follow-up

Research paper thumbnail of Healing rate measurement can predict complete wound healing rate in chronic diabetic foot ulceration

Research paper thumbnail of Living Skin Equivalents for Diabetic Foot Ulcers

Diabetic Foot, The, 2002

ABSTRACT

Research paper thumbnail of A Phase 2, Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial of the Safety and Efficacy of Plasmid Dna Expressing 2 Isoforms of Hepatocyte Growth Factor in Patients with Critical Limb Ischemia

Journal of the American College of Cardiology, 2014

A phAse 2, double-blind, rAndomized, plAcebo-controlled, multicenter triAl oF the sAFety And eFFi... more A phAse 2, double-blind, rAndomized, plAcebo-controlled, multicenter triAl oF the sAFety And eFFicAcy oF plAsmid dnA expressing 2 isoForms oF hepAtocyte growth FActor in pAtients with criticAl limb ischemiA

Research paper thumbnail of Using Living Skin Equivalents for Diabetic Foot Ulceration

The International Journal of Lower Extremity Wounds, 2002

Diabetic foot ulcers are a major clinical challenge with enormous socioeconomic consequence. All ... more Diabetic foot ulcers are a major clinical challenge with enormous socioeconomic consequence. All advances in the understanding and management of this problem are eagerly received by wound specialists. The development of bioengineered skin—living skin equivalent—is an interesting event that could be significant in the management of lower extremity wounds such as the diabetic foot ulcer.

Research paper thumbnail of Role of Neuropathy and High Foot Pressures in Diabetic Foot Ulceration

Diabetes Care, 1998

OBJECTIVE High plantar foot pressures in association with peripheral neuropathy have been ascerta... more OBJECTIVE High plantar foot pressures in association with peripheral neuropathy have been ascertained to be important risk factors for ulceration in the diabetic foot. Most studies investigating these parameters have been limited by their size and the homogeneity of study subjects. The objective of this study was therefore to ascertain the risk of ulceration associated with high foot pressures and peripheral neuropathy in a large and diverse diabetic population. RESEARCH DESIGN AND METHODS We studied a cross-sectional group of 251 diabetic patients of Caucasian (group C) (n = 121), black (group B) (n = 36), and Hispanic (group H) (n = 94) racial origins with an overall age of 58.5 ± 12.5 years (range 20–83). There was an equal distribution of men and women across the entire study population. All patients underwent a complete medical history and lower extremity evaluation for neuropathy and foot pressures. Neuropathic parameters were dichotomized (0/1) into two high-risk variables: p...

Research paper thumbnail of Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial

Diabetes Care, 2000

OBJECTIVE: Diabetic foot ulceration is a preventable long-term complication of diabetes. A multic... more OBJECTIVE: Diabetic foot ulceration is a preventable long-term complication of diabetes. A multicenter prospective follow-up study was conducted to determine which risk factors in foot screening have a high association with the development of foot ulceration. RESEARCH DESIGN AND METHODS: A total of 248 patients from 3 large diabetic foot centers were enrolled in a prospective study. Neuropathy symptom score, neuropathy disability score (NDS), vibration perception threshold (VPT), Semmes-Weinstein monofilaments (SWFs), joint mobility, peak plantar foot pressures, and vascular status were evaluated in all patients at the beginning of the study. Patients were followed-up every 6 months for a mean period of 30 months (range 6-40), and all new foot ulcers were recorded. The sensitivity, specificity, and positive predictive value of each risk factor were evaluated. RESULTS: Foot ulcers developed in 95 feet (19%) or 73 patients (29%) during the study. Patients who developed foot ulcers wer...

Research paper thumbnail of The Forefoot-to-Rearfoot Plantar Pressure Ratio Is Increased in Severe Diabetic Neuropathy and Can Predict Foot Ulceration

Diabetes Care, 2002

OBJECTIVE—We have previously demonstrated that high plantar pressures can predict foot ulceration... more OBJECTIVE—We have previously demonstrated that high plantar pressures can predict foot ulceration in diabetic patients. The aim of the present study was to evaluate both the relationship between forefoot and rearfoot plantar pressure in diabetic patients with different degrees of peripheral neuropathy and their role in ulcer development. RESEARCH DESIGN AND METHODS—Diabetic patients of a 30-month prospective study were classified according to the neuropathy disability score: scores of 0, 1–5, 6–16, and 17–28 are defined as absent (n = 20), mild (n = 66), moderate (n = 95), and severe (n = 57) neuropathy, respectively. The F-Scan mat system was used to measure dynamic plantar pressures. The peak pressures under the forefoot and the rearfoot were selectively measured for each foot, and the forefoot-to-rearfoot ratio (F/R ratio) was calculated. RESULTS—Foot ulcers developed in 73 (19%) feet. The peak pressures were increased in the forefoot of the severe and moderate neuropathic groups...

Research paper thumbnail of A Randomized, Controlled Trial of Promogran (a Collagen/Oxidized Regenerated Cellulose Dressing) vs Standard Treatment in the Management of Diabetic Foot Ulcers

Archives of Surgery, 2002

Hypothesis: Promogran, a wound dressing consisting of collagen and oxidized regenerated cellulose... more Hypothesis: Promogran, a wound dressing consisting of collagen and oxidized regenerated cellulose, is more effective that standard care in treating chronic diabetic plantar ulcers. Design: Randomized, prospective, controlled multicenter trial. Setting: University teaching hospitals and primary care centers. Patients: A total of 276 patients from 11 centers were enrolled in the study. The mean age of the patients was 58.3 years (range, 23-85 years). All patients had at least 1 diabetic foot ulcer. Interventions: Patients were randomized to receive Promogran (n = 138) or moistened gauze (control group; n=138) and a secondary dressing. Dressings were changed when clinically required. The maximum follow-up for each patient was 12 weeks. Main Outcome Measure: Complete healing of the study ulcer (wound). Results: After 12 weeks of treatment, 51 (37.0%) Promogran-treated patients had complete wound closure compared with 39 (28.3%) control patientss, but this difference was not statistically significant (P=.12). The difference in healing between treatment groups achieved borderline significance in the subgroup of patients with wounds of less than 6 months' duration. In patients with ulcers of less than 6 months' duration, 43 (45%) of 95 Promogran-treated patients healed compared with 29 (33%) of 89 controls (P=.056). In the group with wounds of at least 6 months' duration, similar numbers of patients healed in the control (10/49 [20%]) and the Promogran (8/43 [19%]; P=.83) groups. No differences were seen in the safety measurements between groups. Patients and investigators expressed a strong preference for Promogran compared with moistened gauze. Conclusions: Promogran was comparable to moistened gauze in promoting wound healing in diabetic foot ulcers. It showed an additional efficacy for ulcers of less than 6 months' duration that was of marginal statistical significance. Furthermore, Promogran had a safety profile that was similar to that of moistened gauze, with greater user satisfaction. Therefore, Promogran may be a useful adjunct in the management of diabetic foot ulceration, especially in ulcers of less than 6 months' duration.

Research paper thumbnail of Screening techniques to identify the at risk patients for developing diabetic foot ulcers in a prospective multicenter trial

Research paper thumbnail of The Forefoot-to-Rearfoot Plantar Pressure Ratio Is Increased in Severe Diabetic Neuropathy and Can Predict Foot Ulceration

Diabetes Care, 2002

OBJECTIVE -We have previously demonstrated that high plantar pressures can predict foot ulceratio... more OBJECTIVE -We have previously demonstrated that high plantar pressures can predict foot ulceration in diabetic patients. The aim of the present study was to evaluate both the relationship between forefoot and rearfoot plantar pressure in diabetic patients with different degrees of peripheral neuropathy and their role in ulcer development.