| 1. |
- Brorson, Håkan
(författare)
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From lymph to fat: liposuction as a treatment for complete reduction of lymphedema.
- 2012
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Ingår i: International Journal of Lower Extremity Wounds. - : SAGE Publications. - 1552-6941 .- 1534-7346. ; 11:1, s. 10-19
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Tidskriftsartikel (refereegranskat)abstract
- There is some controversy regarding liposuction for late-stage lymphedemas. Although it is clear that conservative therapies such as complex decongestive therapy and controlled compression therapy should be tried in the first instance, options for the treatment of late-stage lymphedema that is not responding to treatment is not so clear. Liposuction has been used for many years to treat lipodystrophy. Some results have been far from optimal; however, improvements in technique, patient preparation, and patient follow-up have led to a greater and a wider acceptance of liposuction as a treatment for lymphedema. This article outlines the benefits of using liposuction and presents the evidence to support its use.
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| 2. |
- Derraik, José G. B., et al.
(författare)
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Fundamentals of Data Collection in Clinical Studies : Simple Steps to Avoid "Garbage In, Garbage Out"
- 2021
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Ingår i: International Journal of Lower Extremity Wounds. - : Sage Publications. - 1534-7346 .- 1552-6941. ; 20:3, s. 183-187
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Forskningsöversikt (refereegranskat)abstract
- Many fundamental steps underpin the delivery of high-quality clinical research. In this article, we provide a brief commentary on some important aspects associated with the collection and management of data during clinical studies, which, if overlooked, will lead to poor-quality research. In particular, we discuss the key aspects that should help early career researchers maximize the relevance and impact of their clinical research.
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| 3. |
- Derraik, Jose G. B., et al.
(författare)
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Publishing Without Perishing : A Guide to the Successful Reporting of Clinical Data
- 2019
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Ingår i: International Journal of Lower Extremity Wounds. - : SAGE PUBLICATIONS INC. - 1534-7346 .- 1552-6941. ; 18:3, s. 219-227
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Forskningsöversikt (refereegranskat)abstract
- Many researchers find writing a scientific manuscript a highly discouraging task. This problem may be partly responsible for the fact that approximately half of completed clinical studies worldwide remain unreported or unpublished. Therefore, we aimed to create a user-friendly guide with helpful recommendations, which are complementary to the many existing reporting guidelines for quantitative clinical data. This article has been prepared with clearly defined subheadings, to facilitate quick identification of any specific sections/topics. We encourage the use of the IMRaD model (ie, Introduction, Methods, Results, and Discussion), providing guidance on the key information required, as well as the dos and don'ts. We also comment briefly on feedback and rejection, proposing the I AM approach (Ignore, Address, and Move on).
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| 4. |
- Edmonds, M
(författare)
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Apligraf in the treatment of neuropathic diabetic foot ulcers
- 2009
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Ingår i: The international journal of lower extremity wounds. - : SAGE Publications. - 1534-7346 .- 1552-6941. ; 8:1, s. 11-18
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Tidskriftsartikel (refereegranskat)abstract
- This study compared the efficacy and safety of Apligraf (Organogenesis, Inc., Canton, MA) in combination with standard therapy versus standard therapy alone in the treatment of neuropathic diabetic foot ulcers. Efficacy was assessed by time to complete wound healing (by 12 weeks) and incidence of complete wound closure (at 12 weeks). This was an international multi-center, randomized, controlled study. Patients were eligible for entry into the study if the following criteria were met: type 1 or type 2 diabetes mellitus, age 18 to 80 years, adequate glycemic control, and the presence of a full-thickness neuropathic ulcer for at least 2 weeks prior to the initial screening visit. Following the 2-week screening period, the 2 treatment groups received standard ulcer care consistent with international treatment guidelines that comprised sharp debridement, saline-moistened dressings, and a non—weight bearing regimen. There were 106 subjects screened for enrollment, 82 randomized to the treatment groups, and 72 treated (33 Apligraf subjects and 39 standard therapy subjects) before the study was terminated. Kaplan—Meier curves indicated a trend for shorter time to complete wound healing in the Apligraf group compared with the standard therapy group ( p = .059; log-rank test). The median time to healing was 84 days in the Apligraf group, whereas no median time to healing could be determined for the standard therapy group because <50% of the standard therapy subjects healed. By 12 weeks, 51.5% (17/33) Apligraf subjects had achieved complete wound closure compared with 26.3% (10/38) of standard therapy subjects ( p = .049; Fisher's exact test). Even though the study was halted prematurely, this study suggested that the use of Apligraf resulted in a higher incidence of wound closure by 12 weeks.
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| 5. |
- Löndahl, Magnus
(författare)
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Hyperbaric Oxygen Therapy as Adjunctive Treatment for Diabetic Foot Ulcers.
- 2013
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Ingår i: International Journal of Lower Extremity Wounds. - : SAGE Publications. - 1552-6941 .- 1534-7346.
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Tidskriftsartikel (refereegranskat)abstract
- Hyperbaric oxygen therapy (HBOT) has been suggested to improve healing of hard-to-heal diabetic foot ulcers. Although the wide use of HBOT as a treatment for diabetic foot ulcers has been founded on weak scientific ground, 2 well-designed randomized, double-blind, placebo-controlled studies have in recent years put HBOT on firmer ground as treatment for diabetic patients with chronic foot ulcers. The recognition of inclusion criteria in these studies may help identify a select group of diabetic patients with hard-to-heal ulcers who might benefit from HBOT. In this review, we discuss the rationale behind the use of HBOT, its clinical application, and possible treatment complications.
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| 6. |
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| 7. |
- Rezk, Francis, et al.
(författare)
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Antibiotic Prophylaxis With Trimethoprim/Sulfamethoxazole Instead of Cloxacillin/Cefotaxime Increases Inguinal Surgical Site Infection Rate After Lower Extremity Revascularization
- 2019
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Ingår i: International Journal of Lower Extremity Wounds. - : SAGE Publications. - 1534-7346 .- 1552-6941. ; 18:2, s. 135-142
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Tidskriftsartikel (refereegranskat)abstract
- Due to the consistently high proportion of surgical site infections (SSI) after vascular surgery, a change of prophylactic antibiotic therapy from cloxacillin/cefotaxime to trimethoprim/sulfamethoxazole (TMP-SMX) was conducted in 2016. The study included consecutive patients undergoing lower extremity revascularization due to acute or chronic lower extremity arterial disease. The antibiotic regime was changed in between the two sampling periods (2014 -2016 versus 2016 -2017). The diagnosis of SSI was based on clinical examination and microbiological results, and severity was classified according to the Szilagyi classification. One hundred and twenty-two patients in the cloxacillin/cefotaxime and 67 patients in the TMP-SMX group were included. The SSI rates were 32.0% and 40.3%, respectively (p=0.25). The proportion of women were higher in the TMP-SMX group (32.8% versus 47.8%, respectively, p=0.043). No other differences between the two groups were found regarding patient, vascular surgery procedure characteristics or severity of SSI. Groin infection rate was higher in the TMP-SMX group (15.4% versus 30.5%, respectively, p=0.022). When adjusting for gender, groin infection was more common in the TMP-SMX group (Odds Ratio 2.5, 95% CI 1.1 -5.4). The groin SSI rate was higher after elective surgery in the TMP-SMX group (13.0% versus 27.8%, respectively, p=0.027), and also after adjusting for gender (Odds Ratio 2.6, 95% CI 1.1 -6.2). The change in antibiotic prophylaxis from Cloxacillin/Cefotaxime to TMP-SMX was associated with an increased rate of inguinal SSI in patients undergoing lower extremity revascularization, despite a possible Hawthorne effect.
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| 8. |
- Velickovic, Vladica M., et al.
(författare)
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Superabsorbent Wound Dressing for Management of Patients With Moderate-to-Highly Exuding Chronic Leg Ulcers : An Early Stage Model-Based Benefit–Harm Assessment
- 2023
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Ingår i: International Journal of Lower Extremity Wounds. - : Sage Publications. - 1534-7346 .- 1552-6941. ; 22:2, s. 345-352
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the research is to assess the benefit–harm of superabsorbent polymers wound dressings based on polyacrylate polymers (SAPs) compared with standard of care (SoC) dressing mix for patients with moderate-to-highly exuding hard-to-heal leg ulcers. The SoC dressings mix was composed of other superabsorbents in 29% of cases, antimicrobials 26%, foams 20%, alginates 5%, and other dressings 19% weighted according to their frequency. We have used the decision-analytic modeling method, Markov process, as an adequate analytical solution for medical prognosis. We have combined the systematic literature search to identify the most relevant inputs for the analysis, with available patient-level clinical data concerning benefits of superabsorbent to generate a robust prediction of patient-relevant outcomes, including healing rates and health-related quality of life. Besides, we have qualitatively described adverse events associated with those treatments. Our research indicates that SAPs when compared with SoC dressing mix in a patient with moderate-to-highly excluding leg ulcers are leading to an improved healing rate with an absolute risk difference of 2.20% in 6 months and a relative risk of 1.07 in favor of SAP dressings. The attributable fraction among those exposed to SAP dressings of 6.6%, meaning that 6.6% of the healed ulcers could be attributed to having had the SAP dressing treatment instead of the SoC dressing treatment. Besides, SAP dressings lead to improved quality of life measured as incremental quality-adjusted life weeks (QALWs) of 0.13 QALWs.
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