scholarly journals LEA 10. Use of Home Negative Pressure Wound Therapy in Peripheral Artery Disease and Diabetic Limb Salvage

2018 ◽  
Vol 68 (5) ◽  
pp. e117
Author(s):  
Kai Lim ◽  
Qiantai Hong ◽  
Glenn Wei Leong Tan ◽  
Sadhana Chandrasekar ◽  
Zhiwen Joseph Lo
Keyword(s):  
Limb Salvage ◽  
Peripheral Artery Disease ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Peripheral Artery ◽  
Wound Therapy ◽  
Artery Disease

scholarly journals Use of home negative pressure wound therapy in peripheral artery disease and diabetic limb salvage

2020 ◽  
Vol 17 (3) ◽  
pp. 531-539
Author(s):  
Kai Lim ◽  
Xuxin Lim ◽  
Qiantai Hong ◽  
Enming Yong ◽  
Sadhana Chandrasekar ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Peripheral Artery Disease ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Peripheral Artery ◽  
Wound Therapy ◽  
Artery Disease

scholarly journals Role of genetics in peripheral arterial disease outcomes; significance of limb-salvage quantitative locus-1 genes

2017 ◽  
Vol 243 (2) ◽  
pp. 190-197 ◽  
Author(s):  
Emmanuel Okeke ◽  
Ayotunde O Dokun
Keyword(s):  
Quantitative Trait Locus ◽  
Limb Salvage ◽  
Disease Severity ◽  
Peripheral Artery Disease ◽  
Quantitative Trait ◽  
Molecular Mechanisms ◽  
Limb Ischemia ◽  
Peripheral Artery ◽  
Trait Locus ◽  
Artery Disease

Peripheral artery disease is a major health care problem with significant morbidity and mortality. Humans with peripheral artery disease exhibit two major and differential clinical manifestations – intermittent claudication and critical limb ischemia. Individuals with intermittent claudication or critical limb ischemia have overlapping risk factors and objective measures of blood flow. Hence, we hypothesized that variation in genetic make-up may be an important determinant in the severity of peripheral artery disease. Previous studies have identified polymorphism in genes, contributing to extent of atherosclerosis but much less is known about polymorphisms associated with genes that can influence peripheral artery disease severity. This review outlines some of the progress made up-to-date to unravel the molecular mechanisms underlining differential peripheral artery disease severity. By exploring the recovery phenotype of different mouse strains following experimental peripheral artery disease, our group identified the limb salvage-associated quantitative trait locus 1 on mouse chromosome 7 as the first genetic modifier of perfusion recovery and tissue necrosis phenotypes. Furthermore, a number of genes within LSq-1, such as ADAM12, IL-21Rα, and BAG3 were identified as genetic modifiers of peripheral artery disease severity that function through preservation of endothelial and skeletal muscle cells during ischemia. Taken together, these studies suggest manipulation of limb salvage-associated quantitative trait locus 1 genes show great promise as therapeutic targets in the management of peripheral artery disease. Impact statement Peripheral artery disease (PAD) is a major health care problem with significant morbidity and mortality. Individuals with similar atherosclerosis burden do display different severity of disease. This review outlines some of the progress made up-to-date in unraveling the molecular mechanisms underlining differential PAD severity with a focus on the role of the Limb Salvage-associated Quantitative trait locus 1 (LSq-1), a key locus in adaptation to ischemia in PAD.

Novel home use of mechanical negative pressure wound therapy in diabetic foot ulcers

2021 ◽  
Vol 30 (12) ◽  
pp. 1006-1010
Author(s):  
Xuxin Lim ◽  
Li Zhang ◽  
Qiantai Hong ◽  
Enming Yong ◽  
Shufen Neo ◽  
...  
Keyword(s):  
Wound Healing ◽  
Limb Salvage ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Length Of Hospital Stay ◽  
Wound Therapy ◽  
Primary Wound Closure ◽  
Mean Cost

Objective: Mechanical negative pressure wound therapy is an ultraportable, light weight and disposable single-use device that has been shown to promote wound healing. This study evaluated home use of a mechanically powered negative pressure wound therapy (NPWT) in diabetic foot wounds. Methods: Patients underwent revascularisation and/or debridement or amputation before starting mechanical NPWT. Wound outcomes and images of the wounds were recorded at each follow-up visit by the wound nurse. Patients were followed up until wound closure or end of therapy. Results: A total of 12 patients (each with one wound) were included in the study. Of the 12 wounds, 33.3% (n=4) of wounds achieved primary wound closure while the remaining 66.6% (n=8) of wounds demonstrated a mean wound size reduction of 37.5±0.13%. Of the closed wounds, mean time to healing was 4.75±2.50 weeks. There was 100% limb salvage with no further debridement or amputations, and no 30-day unplanned readmissions. Mean length of hospital stay before starting home NPWT was 9.75±6.31 days. Mean number of NPWT changes was 8.33±2.67 sessions, while mean duration of therapy was 4.0±1.54 weeks. Mean cost of home NWPT therapy was US$1904±731 per patient. Conclusion: The home use of mechanically powered NPWT in diabetic foot wounds demonstrated excellent wound healing rates and 100% limb salvage, with no complications.

552 Limb Salvage: Amputations Prevented with Dehydrated Human Amnion/Chorion Membrane Allografts (dHACM) Used in Combination with Decellularized Human Collagen Matrix (dHCM)

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S124-S125
Author(s):  
Marc R Matthews ◽  
Emily Helmick ◽  
Christopher Mellon ◽  
Danielle Thornburg ◽  
Areta Kowal-Vern ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Surgical Flaps ◽  
Tissue Growth ◽  
Wound Therapy ◽  
Promising Alternative ◽  
Human Amnion ◽  
Limb Injuries ◽  
Human Collagen

Abstract Introduction Burn and traumatic limb injuries with exposed bone/tendon typically require surgical flaps or amputations for healing. Some burn patients are not candidates for these invasive techniques. Placental amniotic membrane has been used as a wound dressing for more than 100 years and may offer an alternative to flaps and/or amputations. Processed dehydrated human amnion/chorion membrane (dHACM), from human placental tissue, contains type 1 human collagen as well as non-viable cells and 285 identified regulatory proteins including growth factors, chemokines, cytokines, metalloproteinases, and other tissue growth and inflammatory mediators. dHACM has been successfully used as a dressing for wound ulcers, burns, donor sites, & surgical debridement. This study reports the use of dHCAM as a limb salvage tool in four patients with severe injuries. Methods This is a retrospective case series of patients suffering severe lower extremity injury with bone/tendon exposure that had applied dHACM/dHCM over or packed (depending on wound depth), then covered with 3% bismuth tribromophenate petrolatum dressing & glycerol/ hydroxyethylcellulose lubricant. Negative pressure wound therapy (NPWT) was initiated; wound re-evaluation occurred in seven days. dHACM/dHCM was reapplied if required (bone still exposed). Results There were 3 males and 1 female with three burns and one NSTI. The mean±sd (median) age was 58±23 (61) years; % total burn surface area 3±3 (2); length of hospital stay 48±30 (40) days; number of tangential excisions & debridements 6.5±1 (6.5); days from admission to product application 49±47 (34) and discharge 24±19 (19) days; negative pressure wound therapy (NPWT) 53±6 (56) days. All four patients continued treatment upon discharge with clinic visits and home NPWT. All recovered with good results and no complications. Treatment may be continued with NPWT therapy at home or in a skilled nursing facility. Patients healed after two to three dHACM/dHCM applications and did not require leg or foot amputations. Conclusions In select limb salvage cases, dHACM/HCM may be a promising alternative to extremity amputations, tissue transfer flaps or other techniques for secondary intention healing of wounds with bone/tendon exposure.

scholarly journals Long-term follow-up of negative pressure wound therapy with instillation: a limb salvage procedure?

2014 ◽  
Vol 13 (5) ◽  
pp. 768-773 ◽  
Author(s):  
Daniele Bollero ◽  
Kiran Degano ◽  
Ezio N Gangemi ◽  
Domenico Aloj ◽  
Valeria Malvasio ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Salvage Procedure ◽  
Wound Therapy ◽  
Limb Salvage Procedure ◽  
Long Term Follow Up

scholarly journals Preliminary evidence using negative pressure wound therapy to achieve limb salvage for the ischemic diabetic foot

2016 ◽  
Vol 3 (12) ◽  
pp. 378
Author(s):  
Joe Chi-Cheng Fang ◽  
Yu-Tsung Chen ◽  
Yin-Shuo Chang ◽  
Jen-Hsiang Shen ◽  
Min-Ling Chen ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Preliminary Evidence ◽  
Wound Therapy
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