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Erschienen in: Current Cardiology Reports 4/2013

01.04.2013 | Peripheral Vascular Disease (M Shishehbor, Section Editor)

The ABC’s of Wound Care

verfasst von: Kelly Bumpus, Michael A. Maier

Erschienen in: Current Cardiology Reports | Ausgabe 4/2013

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Abstract

Non-healing wounds represent a challenging problem for physicians and patients alike. Although treatment strategies are aimed at specific causes, there are basic management principles that apply to all wounds. The purpose of this article is to review these core management principles as they apply to lower extremity wounds. Key points include a multidisciplinary approach and individualized plans of care as per specific patient needs. A comprehensive treatment plan will lead to faster healing and improved outcomes.
Literatur
1.
Zurück zum Zitat Olin JW, Beusterien KM, Childs MB, Seavey C, McHugh L, Griffiths RI. Medical costs of treating venous stasis ulcers: evidence from a retrospective cohort study. Vasc Med. 1999;4:1–7.PubMed Olin JW, Beusterien KM, Childs MB, Seavey C, McHugh L, Griffiths RI. Medical costs of treating venous stasis ulcers: evidence from a retrospective cohort study. Vasc Med. 1999;4:1–7.PubMed
2.
Zurück zum Zitat Cawley MI. Vasculitis and ulceration in rheumatic diseases of the foot. Baillieres Clin Rheumatol. 1987;1:315–33.PubMedCrossRef Cawley MI. Vasculitis and ulceration in rheumatic diseases of the foot. Baillieres Clin Rheumatol. 1987;1:315–33.PubMedCrossRef
3.
Zurück zum Zitat Meyer V, Kerk N, Meyer S, Goerge TJ. Differential diagnosis and therapy of leg ulcers. Dtsch Dermatol Ges. 2011;9:1035–51. Meyer V, Kerk N, Meyer S, Goerge TJ. Differential diagnosis and therapy of leg ulcers. Dtsch Dermatol Ges. 2011;9:1035–51.
4.
Zurück zum Zitat Tang JC, Vivas A, Rey A, Kirsner RS, Romanelli P. Atypical ulcers: wound biopsy results from a university wound pathology service. Ostomy Wound Manage. 2012;58:20–2. 24, 26–9.PubMed Tang JC, Vivas A, Rey A, Kirsner RS, Romanelli P. Atypical ulcers: wound biopsy results from a university wound pathology service. Ostomy Wound Manage. 2012;58:20–2. 24, 26–9.PubMed
5.
Zurück zum Zitat Dormandy JA, Rutherford RB. Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg. 2000;31(1 Pt 2):S1–S296.PubMed Dormandy JA, Rutherford RB. Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). J Vasc Surg. 2000;31(1 Pt 2):S1–S296.PubMed
6.
Zurück zum Zitat Rosero EB, Kane K, Clagett GP, Timaran CH. A systematic review of the limitations and approaches to improve detection and management of peripheral arterial disease in Hispanics. J Vasc Surg. 2010;51(4 Suppl):27S–35S.PubMedCrossRef Rosero EB, Kane K, Clagett GP, Timaran CH. A systematic review of the limitations and approaches to improve detection and management of peripheral arterial disease in Hispanics. J Vasc Surg. 2010;51(4 Suppl):27S–35S.PubMedCrossRef
7.
Zurück zum Zitat Aboyans V, Ho E, Denenberg JO, et al. The association between elevated ankle systolic pressures and peripheral occlusive arterial disease in diabetic and nondiabetic subjects. J Vasc Surg. 2008;48:1197–203.PubMedCrossRef Aboyans V, Ho E, Denenberg JO, et al. The association between elevated ankle systolic pressures and peripheral occlusive arterial disease in diabetic and nondiabetic subjects. J Vasc Surg. 2008;48:1197–203.PubMedCrossRef
8.
Zurück zum Zitat Apelqvist J, Elgzyri T, Larsson J, Löndahl M, Nyberg P, Thörne J. Factors related to outcome of neuroischemic/ischemic foot ulcer in diabetic patients. J Vasc Surg. 2011;53:1582–8.PubMedCrossRef Apelqvist J, Elgzyri T, Larsson J, Löndahl M, Nyberg P, Thörne J. Factors related to outcome of neuroischemic/ischemic foot ulcer in diabetic patients. J Vasc Surg. 2011;53:1582–8.PubMedCrossRef
9.
Zurück zum Zitat Budoff MJ, Achenbach S, Blumenthal RS, Carr JJ, Goldin JG, Greenland P, et al. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation. 2006;114:1761–91.PubMedCrossRef Budoff MJ, Achenbach S, Blumenthal RS, Carr JJ, Goldin JG, Greenland P, et al. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation. 2006;114:1761–91.PubMedCrossRef
10.
Zurück zum Zitat "Diabetes In America," 2nd Ed. National Diabetes Data Group, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. NIH Publication No. 95–1468, 1995. Diabetes Atlas, 3rd ed. International Diabetes Federation, 2006. "Diabetes In America," 2nd Ed. National Diabetes Data Group, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. NIH Publication No. 95–1468, 1995. Diabetes Atlas, 3rd ed. International Diabetes Federation, 2006.
11.
Zurück zum Zitat Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987;40:113–41.PubMedCrossRef Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987;40:113–41.PubMedCrossRef
12.
Zurück zum Zitat Alexandrescu V, Söderström M, Venermo M. Angiosome theory: fact or fiction? Scand J Surg. 2012;101:125–31.PubMed Alexandrescu V, Söderström M, Venermo M. Angiosome theory: fact or fiction? Scand J Surg. 2012;101:125–31.PubMed
13.
Zurück zum Zitat Attinger CE, Evans KK, Bulan E, Blume P, Cooper P. Angiosomes of the foot and ankle and clinical implications for limb salvage: reconstruction, incisions, and revascularization. Plast Reconstr Surg. 2006;117(7 Suppl):261S–93S.PubMed Attinger CE, Evans KK, Bulan E, Blume P, Cooper P. Angiosomes of the foot and ankle and clinical implications for limb salvage: reconstruction, incisions, and revascularization. Plast Reconstr Surg. 2006;117(7 Suppl):261S–93S.PubMed
14.
Zurück zum Zitat Varela C, Acin F, Haro JD, et al. The role of foot collateral vessels on ulcer healing and limb salvage after successful endovascular and surgical distal procedures according to an angiosome model. Vasc Endovasc Surg. 2010;44:654–60.CrossRef Varela C, Acin F, Haro JD, et al. The role of foot collateral vessels on ulcer healing and limb salvage after successful endovascular and surgical distal procedures according to an angiosome model. Vasc Endovasc Surg. 2010;44:654–60.CrossRef
15.
Zurück zum Zitat • Neville RF, Attinger CE, Bulan EJ, Ducic I, Thomassen M, Sidawy AN. Revascularization of a specific angiosome for limb salvage: does the target artery matter? Ann Vasc Surg. 2009;23:367–73. This article offers statistically significant differences in ulcer healing rate when the angiosome corresponding to ulcer location is revascularized, compared with a boundary angiosome, supporting the significance of the theory. PubMedCrossRef • Neville RF, Attinger CE, Bulan EJ, Ducic I, Thomassen M, Sidawy AN. Revascularization of a specific angiosome for limb salvage: does the target artery matter? Ann Vasc Surg. 2009;23:367–73. This article offers statistically significant differences in ulcer healing rate when the angiosome corresponding to ulcer location is revascularized, compared with a boundary angiosome, supporting the significance of the theory. PubMedCrossRef
16.
Zurück zum Zitat Pineda C, Espinosa R, Pena A. Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy. Semin Plast Surg. 2009;23:80–9.PubMedCrossRef Pineda C, Espinosa R, Pena A. Radiographic imaging in osteomyelitis: the role of plain radiography, computed tomography, ultrasonography, magnetic resonance imaging, and scintigraphy. Semin Plast Surg. 2009;23:80–9.PubMedCrossRef
17.
Zurück zum Zitat Mutluoglu M, Uzun G, Turhan V, Gorenek L, Ay H, Lipsky BA. How reliable are cultures of specimens from superficial swabs compared with those of deep tissue in patients with diabetic foot ulcers? J Diabetes Complications. 2012;26:225–9.PubMedCrossRef Mutluoglu M, Uzun G, Turhan V, Gorenek L, Ay H, Lipsky BA. How reliable are cultures of specimens from superficial swabs compared with those of deep tissue in patients with diabetic foot ulcers? J Diabetes Complications. 2012;26:225–9.PubMedCrossRef
18.
Zurück zum Zitat Peters EJ, Lipsky BA, Berendt AR, Embil JM, Lavery LA, Senneville E, et al. A systematic review of the effectiveness of interventions in the management of infection in the diabetic foot. Diabetes Metab Res Rev. 2012;28 Suppl 1:142–62.PubMedCrossRef Peters EJ, Lipsky BA, Berendt AR, Embil JM, Lavery LA, Senneville E, et al. A systematic review of the effectiveness of interventions in the management of infection in the diabetic foot. Diabetes Metab Res Rev. 2012;28 Suppl 1:142–62.PubMedCrossRef
19.
Zurück zum Zitat Ely JW et al. Approach to leg edema of unclear etiology. J Am Board Fam Med. 2006;19:148–60.PubMedCrossRef Ely JW et al. Approach to leg edema of unclear etiology. J Am Board Fam Med. 2006;19:148–60.PubMedCrossRef
20.
Zurück zum Zitat Young JR. The swollen leg. Clinical significance and differential diagnosis. Cardiol Clin. 1991;9:443–56.PubMed Young JR. The swollen leg. Clinical significance and differential diagnosis. Cardiol Clin. 1991;9:443–56.PubMed
21.
Zurück zum Zitat • Mosti G, Iabichella ML, Partsch H. Compression therapy in mixed ulcers increases venous output and arterial perfusion. J Vasc Surg. 2012;55:122–8. This study determined a safe level of compression in mixed arterial/venous ulcers, while improving venous return, which has not previously been established. PubMedCrossRef • Mosti G, Iabichella ML, Partsch H. Compression therapy in mixed ulcers increases venous output and arterial perfusion. J Vasc Surg. 2012;55:122–8. This study determined a safe level of compression in mixed arterial/venous ulcers, while improving venous return, which has not previously been established. PubMedCrossRef
22.
Zurück zum Zitat Falanga V. The chronic wound: impaired healing and solutions in the context of wound bed preparation. Blood Cells Mol Dis. 2004;32:88–94.PubMedCrossRef Falanga V. The chronic wound: impaired healing and solutions in the context of wound bed preparation. Blood Cells Mol Dis. 2004;32:88–94.PubMedCrossRef
23.
Zurück zum Zitat Ennis WJ, Foremann P, Mozen N, Massey J, Conner-Kerr T, Meneses P. Ultrasound therapy for recalcitrant diabetic foot ulcers: results of a randomized, double-blind, controlled, multicenter study. Ostomy Wound Manag. 2005;51:24–39. Ennis WJ, Foremann P, Mozen N, Massey J, Conner-Kerr T, Meneses P. Ultrasound therapy for recalcitrant diabetic foot ulcers: results of a randomized, double-blind, controlled, multicenter study. Ostomy Wound Manag. 2005;51:24–39.
24.
Zurück zum Zitat Voigt J, Wendelken M, Driver V, Alvarez OM. Low-frequency ultrasound (20–40 kHz) as an adjunctive therapy for chronic wound healing: a systematic review of the literature and meta-analysis of 8 randomized controlled trials. Int J Low Extrem Wounds. 2011;10:190–9.PubMedCrossRef Voigt J, Wendelken M, Driver V, Alvarez OM. Low-frequency ultrasound (20–40 kHz) as an adjunctive therapy for chronic wound healing: a systematic review of the literature and meta-analysis of 8 randomized controlled trials. Int J Low Extrem Wounds. 2011;10:190–9.PubMedCrossRef
25.
Zurück zum Zitat Driver VR, Yao M, Miller CJ. Noncontact low-frequency ultrasound therapy in the treatment of chronic wounds: a meta-analysis. Wound Repair Regen. 2011;19:475–80.PubMedCrossRef Driver VR, Yao M, Miller CJ. Noncontact low-frequency ultrasound therapy in the treatment of chronic wounds: a meta-analysis. Wound Repair Regen. 2011;19:475–80.PubMedCrossRef
26.
Zurück zum Zitat Kavros SJ, Liedl DA, Boon AJ, Miller JL, Hobbs JA, Andrews KL. Expedited wound healing with noncontact, low-frequency ultrasound therapy in chronic wounds: a retrospective analysis. Adv Skin Wound Care. 2008;21:416–23.PubMedCrossRef Kavros SJ, Liedl DA, Boon AJ, Miller JL, Hobbs JA, Andrews KL. Expedited wound healing with noncontact, low-frequency ultrasound therapy in chronic wounds: a retrospective analysis. Adv Skin Wound Care. 2008;21:416–23.PubMedCrossRef
27.
Zurück zum Zitat Medrano S, Beneke MJ. Acoustic pressure wound therapy to debride unstageable pressure ulcers in the acute care setting: a case series. Ostomy Wound Manag. 2008;54:54–8. Medrano S, Beneke MJ. Acoustic pressure wound therapy to debride unstageable pressure ulcers in the acute care setting: a case series. Ostomy Wound Manag. 2008;54:54–8.
28.
Zurück zum Zitat Hopf HW, Ueno C, Aslam R, Burnand K, Fife C, Grant L, et al. Guidelines for the treatment of arterial insufficiency ulcers. Wound Repair Regen. 2006;14:693–710.PubMedCrossRef Hopf HW, Ueno C, Aslam R, Burnand K, Fife C, Grant L, et al. Guidelines for the treatment of arterial insufficiency ulcers. Wound Repair Regen. 2006;14:693–710.PubMedCrossRef
29.
Zurück zum Zitat Mulder GD, Lee DK, Jeppesen NS. Comprehensive review of the clinical application of autologous mesenchymal stem cells in the treatment of chronic wounds and diabetic bone healing. Int Wound J. 2012;9(6)595–600. Mulder GD, Lee DK, Jeppesen NS. Comprehensive review of the clinical application of autologous mesenchymal stem cells in the treatment of chronic wounds and diabetic bone healing. Int Wound J. 2012;9(6)595–600.
30.
Zurück zum Zitat Armstrong DG, Nguyen HC, Lavery LA, van Schie CH, Boulton AJ, Harkless LB. Offloading the diabetic foot wound: a randomized clinical trial. Diabetes Care. 2003;24:1019–22.CrossRef Armstrong DG, Nguyen HC, Lavery LA, van Schie CH, Boulton AJ, Harkless LB. Offloading the diabetic foot wound: a randomized clinical trial. Diabetes Care. 2003;24:1019–22.CrossRef
31.
Zurück zum Zitat Katz IA, Harlan A, Miranda-Palma B, Prieto-Sanchez L, Armstrong DG, Bowker JH, et al. A randomized trial of 2 irremovable off-loading devices in the management of plantar neuropathic diabetic foot ulcers. Diabetes Care. 2005;28:555–9.PubMedCrossRef Katz IA, Harlan A, Miranda-Palma B, Prieto-Sanchez L, Armstrong DG, Bowker JH, et al. A randomized trial of 2 irremovable off-loading devices in the management of plantar neuropathic diabetic foot ulcers. Diabetes Care. 2005;28:555–9.PubMedCrossRef
32.
Zurück zum Zitat • Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Executive summary: heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:188–97. This article provides current statistical data on CVD, obesity, and diabetes, as well as current vascular surgical procedure trends and usage, and quality and cost of cardiovascular associated costs of care. PubMedCrossRef • Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Executive summary: heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:188–97. This article provides current statistical data on CVD, obesity, and diabetes, as well as current vascular surgical procedure trends and usage, and quality and cost of cardiovascular associated costs of care. PubMedCrossRef
33.
Zurück zum Zitat Mitchell ME. Lower extremity major amputations. In: Sidawy AN, editor. Diabetic foot, lower extremity arterial disease and limb salvage. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 341–50. Mitchell ME. Lower extremity major amputations. In: Sidawy AN, editor. Diabetic foot, lower extremity arterial disease and limb salvage. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 341–50.
34.
Zurück zum Zitat Game FL, Hinchliffe RJ, Apelqvist J, Armstrong DG, Bakker K, Hartemann A, et al. A systematic review of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab Res Rev. 2012;28 Suppl 1:119–41.PubMedCrossRef Game FL, Hinchliffe RJ, Apelqvist J, Armstrong DG, Bakker K, Hartemann A, et al. A systematic review of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab Res Rev. 2012;28 Suppl 1:119–41.PubMedCrossRef
35.
Zurück zum Zitat Kavalukas SL, Barbul A. Nutrition and wound healing: an update. Plast Reconstr Surg. 2011;127 Suppl 1:38S–43S.PubMed Kavalukas SL, Barbul A. Nutrition and wound healing: an update. Plast Reconstr Surg. 2011;127 Suppl 1:38S–43S.PubMed
Metadaten
Titel
The ABC’s of Wound Care
verfasst von
Kelly Bumpus
Michael A. Maier
Publikationsdatum
01.04.2013
Verlag
Current Science Inc.
Erschienen in
Current Cardiology Reports / Ausgabe 4/2013
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-013-0346-6

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