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Full-Text Articles in Endocrinology, Diabetes, and Metabolism
Soft Tissue Reconstruction Pyramid In The Diabetic Foot., Claire M Capobianco, John Stapleton, Thomas Zgonis
Soft Tissue Reconstruction Pyramid In The Diabetic Foot., Claire M Capobianco, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
Foot complications and ulceration are well-known sequelae to uncontrolled diabetes. Patients with chronic foot ulcers or wounds resulting from surgical debridement of deep-space infections are at continued risk for development of osteomyelitis and potential amputation. Moreover, these wounds often necessitate multiple outpatient clinic visits, daily dressing care, and prolonged periods of non-weight bearing, all of which have been shown to adversely affect the patient's quality of life. After a prudent period of wound-healing response, the authors believe that early and aggressive soft tissue reconstruction is in the patient's best interest and is crucial for resolution of the chronic nonhealing wound. …
Plastic Surgery Reconstruction Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Roberto H Rodriguez, Valerie A Girard-Powell, Douglas T Cromack
Plastic Surgery Reconstruction Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Roberto H Rodriguez, Valerie A Girard-Powell, Douglas T Cromack
John J Stapleton DPM, FACFAS
Soft tissue reconstruction of the diabetic foot is a challenge for the perioperative team. Primary closure may not be an option and secondary healing may not be reliable. Therefore, surgery is vital and should be coordinated among a well-functioning multidisciplinary team that specializes in caring for patients with diabetes mellitus. Team members must have expertise in reconstructive surgery to ensure adequate wound healing. This article emphasizes the appropriate timing and staging of surgery, discusses the most common plastic surgery techniques, and underscores the importance of a team approach in the management of diabetic foot wounds.
Surgical Management Of Diabetic Foot Infections And Amputations., Thomas Zgonis, John Stapleton, Valerie A Girard-Powell, Ryan T Hagino
Surgical Management Of Diabetic Foot Infections And Amputations., Thomas Zgonis, John Stapleton, Valerie A Girard-Powell, Ryan T Hagino
John J Stapleton DPM, FACFAS
The incidence of diabetes with severe foot infections (eg, necrotizing fasciitis, gas gangrene, ascending cellulitis, infection with systemic toxicity or metabolic instability) has risen significantly during the past decade. Foot infections are a major cause of hospitalization and subsequent lower extremity amputation among patients with diabetes mellitus who have a history of a preexisting ulceration. Surgical management often is required to address severe diabetic foot infections because they can be limb- or life-threatening. Critical limb ischemia, neuropathy, and an immunocompromised host, which often are associated with diabetic foot infections, complicate treatment and are associated with a poorer prognosis.
Addressing Psychosocial Aspects Of Care For Patients With Diabetes Undergoing Limb Salvage Surgery., Thomas S Roukis, John Stapleton, Thomas Zgonis
Addressing Psychosocial Aspects Of Care For Patients With Diabetes Undergoing Limb Salvage Surgery., Thomas S Roukis, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
Surgeons provide a key role in improving the life of patients with diabetes-related foot complications who undergo limb salvage surgery as an alternative to amputation. An integrated multidisciplinary approach is essential to improve the emotional well-being of these patients to avoid potential complications that may prolong their convalescence and further degrade their psychosocial welfare. The authors attempt to increase awareness of critical preoperative risk factors that should be obtained by a thorough comprehensive psychosocial evaluation. In addition, this article discusses how to interact with the patient and his or her family throughout the perioperative period, assisting the patient in managing …