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Full-Text Articles in Medicine and Health Sciences
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 Treatment Of Charcot Neuropathy., Thomas Zgonis, John Stapleton, Luke C Jeffries, Valerie A Girard-Powell, Lynanne J Foster
Surgical Treatment Of Charcot Neuropathy., Thomas Zgonis, John Stapleton, Luke C Jeffries, Valerie A Girard-Powell, Lynanne J Foster
John J Stapleton DPM, FACFAS
Charcot neuroarthropathy, a chronic progressive destruction of joint integrity, is believed to result from a disturbance in pain and proprioceptive sensation. It is most commonly treated in patients with uncontrolled diabetes mellitus and dense peripheral neuropathy. Prevention, early diagnosis, and early treatment are key to a patient's successful outcome. Educating the patient is paramount to avoid further complications and subsequent amputations. This article describes the pathophysiology, staging, surgical treatment, and natural course of Charcot neuroarthropathy.
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.
Concomitant Osteomyelitis And Avascular Necrosis Of The Talus Treated With Talectomy And Tibiocalcaneal Arthrodesis, John Stapleton, Thomas Zgonis
Concomitant Osteomyelitis And Avascular Necrosis Of The Talus Treated With Talectomy And Tibiocalcaneal Arthrodesis, John Stapleton, Thomas Zgonis
John J Stapleton DPM, FACFAS
The goal with Lisfranc fracture-dislocations is to regain joint congruity and reestablish midfoot stability to avoid debilitating posttraumatic arthrosis and chronic pain in the sensate patient. In the diabetic population, dense peripheral neuropathy and/or vascular disease are equally important and may alter the surgical approach to traumatic tarsometatarsal injuries. The initial diagnosis in the diabetic population may be delayed due to subtle radiographic findings and/or patient unawareness of trauma in the insensate foot. Failure to initiate treatment in the early stages of acute diabetic neuropathic Lisfranc injuries can predispose the patient to midfoot instability, potential ulceration, infection, and Charcot neuroarthropathy.