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Biomedical subjects

G Pullium

Publications and source records attributed to G Pullium.

5 recordsLinked to original sources

Total contact casting and chronic diabetic neuropathic foot ulcerations: healing rates by wound location.

This study investigated healing rates of chronic diabetic neuropathic foot ulcerations located on the plantar surface of the forefoot (n = 30) versus those located on other parts of the foot (n = 25). Each type of ulceration was treated with total contact casting. Ulcerations in the first group were located on the metatarsal heads and toes, while ulcerations in the second group were located on the dorsum of the foot, heel, plantar arch, ankle, medial aspect of foot, and toe or transmetatarsal amputation sites. Successfully healed diabetic neuropathic foot ulcerations treated with total contact casting were rated according to patient age, ethnic origin, sex, patient weight, ulcer size, ulcer location, duration of ulcer prior to casting, and ulcer grade. Analysis of variance and posthoc analyses demonstrated that (1) total contact casting was a highly effective method of treatment regardless of ulcer location (forefoot ulcer healing time mean = 30.6 days; nonforefoot ulcer healing time mean = 42.1 days) and (2) forefoot ulcerations healed significantly faster than ulcerations located on other parts of the foot. Complex correlational relationships were explored in this study, and multiple regression equations were developed for each location grouping.

Casts, Surgical

Total contact casting in diabetic patients with neuropathic foot ulcerations.

This study investigated total contact casting in the treatment of diabetic foot ulcerations and factors affecting the rate of ulcer healing. Twenty-two diabetic patients with foot ulcerations were rated on the basis of age, weight, ulcer size, and ulcer grade. After treatment with total contact casting, 16 patients (72.7%) healed in an average of 38.3 days, 3 refused treatment, 1 developed a small tibial ulceration, and the remainder were discontinued due to excessive edema. A significant (p less than 0.01) t test for differences between means was calculated comparing ulcer duration prior to casting to healing rate during casting. All patient variables were intercorrelated, and significant (p less than 0.01) intercorrelations among patient variables were as follows: age with grade, 0.58; grade with healing time, 0.49; size with healing time, 0.50; age with ulcer size, 0.36; weight with ulcer size, 0.37; age with healing time, 0.32. A multiple correlation of 0.69 (p less than 0.01) was found for age, grade, size, and weight with healing time. Ulcer grade and size contributed most directly to the total multiple correlation; age contributed equally to size, grade, and healing time; and weight contributed primarily to ulcer size. These results suggest the following: 1) total contact casting is an extremely valuable method of treatment for diabetic foot ulcerations, and 2) when using this treatment technique associated factors (ulcer size, ulcer grade, patient age, patient weight) may be utilized to help predict patient healing.

Adult

Gradient pressure.

Using a properly timed sequence of early gradient pressure greatly facilitates the burn patient's rehabilitation in our program. Hypersensitivity is avoided or alleviated, skin breakdown is minimized, and early hypertrophic scar development and contracture is controlled. This allows commercial garments to be fitted at an early stage with the assurance that the skin is ready to accept the increased shear force and pressure of the garment. Early use of pressure can give the patient a head start in the rehabilitation process.

Bandages

Burn injury: rehabilitation management in 1982.

Coincident with the recent development of more effective acute care of burn injured patients, has been the growth of dynamic, integrated rehabilitative efforts. The physical, emotional, and social problems that face the thermally injured patient must be solved in a constructive, coordinated manner within the matrix of total patient care. Most burns are minor burns, which may be optimally treated on an outpatient basis in a physical medicine department. Hospitalized patients, with more extensive and severe burns, should have the benefit of rehabilitative team efforts immediately after injury. We describe a comprehensive approach to the rehabilitative care of the thermally injured, including the techniques of wound management, positioning, splinting, and exercise at all chronologic phases of care. The psychosocial component of patient care is also discussed and the importance of counseling and relaxation methods addressed. Specialized problems and therapeutic techniques associated with hand burns are explained and appropriate splinting methods are illustrated.

Adult

Burn rehabilitation-a team approach.

The team concept in the treatment of burned patients is an effective approach in caring for the physical, psychological, and social needs of the patient. Through the initiation of early rehabilitation services, long-term problems can be prevented and a quicker return to a meaningful life style is possible.

Acute Disease