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Biomedical subjects

R G Frykberg

Publications and source records attributed to R G Frykberg.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Diabetic foot ulcers: current concepts.

Foot ulcerations and their sequelae remain a major source of morbidity for patients with diabetes mellitus. Often leading to infection, osteomyelitis, or gangrene, these lesions have consistently been ascertained as significant risk factors for subsequent lower extremity amputation. Hence education, appropriate foot care, and early intervention have assumed important roles in programs focused on amputation prevention. Multidisciplinary cooperation has been demonstrated as the most successful approach to the management and prevention of foot lesions in patients with diabetes. This article reviews the epidemiology, current understanding of the underlying pathophysiology, and treatment rationale for diabetic foot ulcerations. Such knowledge is essential in the overall management of these complicated patients and, when incorporated into daily practice, can significantly reduce the incidence and morbidity of foot disease in diabetes.

Diabetic Foot↗
PubMedDate not supplied

Functional outcome in the elderly following lower extremity amputation.

Data regarding functional outcome in the elderly following major lower extremity amputation (LEA) are minimal. In the general diabetic population there is a significant mortality associated with these procedures, with the 5-year survival rates approaching only 40%. Contrasts between this group and the nondiabetic population will help to clarify the morbidity of these procedures and substantiate efforts at limb salvage. The authors review their experience with patients 80 years of age and above undergoing major LEA between 1990 and 1995 with a specific focus on postoperative mortality and functional status. Forty-one patients were studied, 67% of whom had diabetes mellitus. Postoperative functional status remained unchanged in 40% and worsened in 55% of patients, while residential status was unchanged in 68% and worsened in 32%. The median survival for patients with and without diabetes was 19 and 49 months, respectively. The 5-year survival for the entire group was 25% and was not statistically different in the two subgroups. The authors conclude that major LEA in the very elderly is associated with a considerable mortality and deterioration of functional and residential status.

Aged↗
PubMedDate not supplied

Diabetic foot infections: evaluation and management.

Management of diabetic foot infections requires a thorough knowledge of the pathophysiology involved, the associated microbiological characteristics, and current diagnostic and treatment regiments. Management of the infected diabetic foot requires a combination of therapies including antimicrobial agents, surgical drainage, local wound care, and avoidance of weight-bearing. The complexities of this problem often require the input of multiple specialists working cohesively to manage the concurrent complications of the disease in general, as well as the foot lesion in particular.

Anti-Bacterial Agents↗
PubMedDate not supplied

Foreign body reaction in a Dacron-meshed hemi-implant.

With increased experience in the use of silicone elastomer great toe implants, there has been a commensurate increased incidence of foreign body reaction to these prostheses. In the mid- to late 1970s, the use of Dacron-meshed hemi-implants was abandoned due to the high incidence of such reactions. Although previously thought to be due to the Dacron mesh itself, the authors content that it was, rather, due to the inferior grade of silicone elastomer used in these products.

Female↗
PubMedDate not supplied

The team approach in diabetic foot management.

A significant reduction in the incidence of ulceration, infection, and lower extremity amputation can be realized through the institution of an organized foot care service in community and major academic medical centers. A multidisciplinary team approach has proven to be the most effective means of providing treatment and preventing foot lesions in the diabetic patient. Aside from prevention and early intervention, education is an essential component in overall patient management. In the scheme presented in this article, outpatient management is optimized through the services of numerous specialists dedicated to limb preservation. Risk factors must be evaluated, risk status determined, and preventive measures taken to preserve an intact foot. Ulcers must be thoroughly evaluated and appropriately treated through established protocols utilizing all members of the team. When acute problems present, they are more efficiently managed and coordinated by this approach, thereby reducing lengths of hospital stay, morbidity, and loss of limbs.

Diabetic Foot↗