ABSTRACT
The current epidemic of diabetes has created a high demand for skilled wound-care professionals. Wound-care treatment begins with an appreciation of the cause of the ulceration and an adherence to the fundamental pillars of wound care. Also critical in the wound management paradigm is the optimization of the wound environment to facilitate the progression through the stages of healing. This can be accomplished through the use of different topical therapies and wound dressings to generate a favorable condition conducive to healing. This article summarizes the updated literature and best practices related to this topic.
Subject(s)
Bandages , Diabetic Foot/therapy , Negative-Pressure Wound Therapy , Wound Healing , Biofilms , HumansABSTRACT
In 1912, the Illinois College of Chiropody and Orthopedics was founded, and is today known as the Dr. William M. Scholl College of Podiatric Medicine. It has been an integral part of Rosalind Franklin University of Medicine and Science in North Chicago, Illinois since 2001. Through the ensuing decades, Scholl College alumni have been instrumental in moving the profession forward.
Subject(s)
Interprofessional Relations , Organizational Innovation , Podiatry/education , Schools, Medical/organization & administration , Chicago , Curriculum , Education, Medical/history , History, 20th Century , History, 21st Century , Humans , Podiatry/historyABSTRACT
BACKGROUND: Fusobacterium necrophorum is a common agent of disease in humans, but the occurrence of primary infections outside the head and neck area is extremely rare. While infection with Fusobacterium necrophorum has a rather benign course above the thorax, the organism is capable of producing very severe disease when located in unusual sites, including various forms of septic thrombophlebitis. No infections of the leg have been documented before; thus, antibiotic coverage for Fusobacterium is currently not recommended in this area. CASE PRESENTATION: A 50-year-old homeless African-American man presented complaining of severe pain in his right lower extremity. A clinical workup was consistent with emphysematous pyomyositis and compartment syndrome; he received limb-saving surgical intervention. The offending organism was identified as Fusobacterium necrophorum, and the antibiotic coverage was adjusted accordingly. CONCLUSIONS: Bacteria typically involved in necrotizing infections of the lower extremity include Group A ß-hemolytic Streptococcus, Clostridium perfringens, and common anaerobic bacteria (Bacteroides, Peptococcus, and Peptostreptococcus). This case report presents a case of gas gangrene of the leg caused by Fusobacterium necrophorum, the first such case reported. Fusobacterium should now be included in the differential diagnosis of necrotizing fasciitis of the extremities.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Compartment Syndromes/microbiology , Fasciitis, Necrotizing/therapy , Fusobacterium Infections/therapy , Limb Salvage , Lower Extremity , Pyomyositis/therapy , Black or African American , Compartment Syndromes/physiopathology , Compartment Syndromes/therapy , Debridement , Fasciitis, Necrotizing/microbiology , Fasciitis, Necrotizing/physiopathology , Fusobacterium Infections/microbiology , Fusobacterium Infections/physiopathology , Fusobacterium necrophorum/isolation & purification , Ill-Housed Persons , Humans , Lower Extremity/physiopathology , Male , Middle Aged , Pyomyositis/microbiology , Pyomyositis/physiopathology , Treatment OutcomeABSTRACT
In recent years, total ankle replacement has become a reasonable option for many patients with end-stage ankle arthrosis. In order to be successful, total ankle replacement requires a relatively balanced alignment of the foot in relation to the leg. Such alignment is traditionally achieved surgically by means of stabilization of the hindfoot in conjunction with relocation osteotomy of the calcaneus and/or tibia. In this report, we describe the unconventional combination of total ankle replacement in an adult patient with concomitant paralysis that was addressed by means of tendon transfer.
Subject(s)
Ankle Joint/surgery , Arthroplasty, Replacement, Ankle/methods , Foot/innervation , Gait Disorders, Neurologic/surgery , Osteoarthritis/surgery , Paralysis/surgery , Tendon Transfer/methods , Aged , Follow-Up Studies , Gait Disorders, Neurologic/complications , Humans , Male , Osteoarthritis/complications , Osteoarthritis/diagnosis , Paralysis/complications , Severity of Illness IndexABSTRACT
Complications associated with digital and lesser metatarsal surgical procedures have been well documented in the literature. These complications may stem from systemic medical, structural, biologic, biomechanical, or iatrogenic causes. The surgeon must be cognizant of all potential complications, including ways to prevent them from occurring and how to manage them when they do occur. This article discusses preventative measures through the preoperative evaluation of the patient, and examines the subsets of complications that may occur after lesser ray surgery that pose a particular management challenge, as well as special complications specific to particular operative techniques.