1/52. A human bite.We report the transmission of group A streptococci by a human bite leading to severe necrotising fasciitis. Rapid surgical and antibiotic treatment led to healing without fractional loss of the patient's infected leg.- - - - - - - - - - ranking = 1keywords = leg (Clic here for more details about this article) |
2/52. Fascial feeder and perforator-based V-Y advancement flaps in the reconstruction of lower limb defects.The principle of the V-Y advancement flap has been used since its first description by Blasius (1848) for reconstruction of smaller defects. We wish to describe V-Y advancement flaps, the design of which includes distinct perforator or fascial feeder vessels, which may originate from periosteum, muscle, cutaneous nerve or from large tendon sheaths. These flaps are planned in an oblique manner when there is a defect over the anterior, antero-lateral or antero-medial aspect, and in a vertical manner when there is a defect over the posterior aspect of the leg. The main advantage of this design is the ability to close the secondary defect primarily, allowing adequate cover of the defect, particularly in the pre-tibial region, without the unsightly divot left by a split skin graft in this area. When the flap includes branches of the long saphenous nerve on the medial aspect, superficial peroneal nerve laterally or sural nerve posteriorly it results in a sensate flap, giving protection in this vulnerable area, which has previously not been possible. We describe 40 cases where perforator-based V-Y advancement flaps have been used to cover large defects of the lower leg following excision of malignant skin lesions and in selected trauma cases that do not involve degloving injuries. This technique allows adequate soft tissue cover in the pre-tibial area and around the ankle with excellent aesthetic results. The planning, operative technique and the results with case presentations have been described.- - - - - - - - - - ranking = 2keywords = leg (Clic here for more details about this article) |
3/52. A case of moraxella canis-associated wound infection.moraxella canis was isolated from an infected foot ulcer in a patient suffering from diabetes mellitus with neuropathy. Bacteriological findings and 16S rDNA data are presented.- - - - - - - - - - ranking = 3.6349107944337keywords = ulcer (Clic here for more details about this article) |
4/52. Sensory radicular neuropathy.A patient had sensory radicular neuropathy. The patient demonstrated features characteristic of this entity: (1) recurrent trophic ulcerations of the hands and feet, (2) onset in early adulthood, (3) distal, dissociated loss of pain and temperature sensation far out of proportion to the loss of other sensory perceptions, and (4) complete sparing of motor function.- - - - - - - - - - ranking = 3.6349107944337keywords = ulcer (Clic here for more details about this article) |
5/52. Cost effectiveness in leg ulcer management in the community.Wound care and leg ulcer management account for the largest part of district nurses' workload. This has major implications on prescribing budgets of primary care groups (PCGs). Ineffective care results in an expensive waste of financial resources and poor quality care for the patients involved. Two case studies of patients with venous leg ulcers are used as an example of how practice can vary within one PCG. Continuing support and training is needed for all community nurses to enable them to meet national and local standards and guidelines.- - - - - - - - - - ranking = 1033.5873939848keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
6/52. Use of sugar in the treatment of infected leg ulcers.Mrs R is an 84-year-old retired shop-keeper with a 17-year history of recurrent leg ulceration. She has received treatment in both primary and secondary care settings, including specialist dermatology and vascular clinics. Mrs R has a long history of non-compliance to treatment regime, removing bandages and rucking them down causing compression injuries that almost resulted in amputation of her right leg. On assessment by the author, she had two partial thickness ulcers to each leg, signs of venous insufficiency and malnutrition, and swabs cultured positive for a range of bacteria. Resistance to topical antimicrobials and allergy to systemic antibiotics meant that another solution had to be tried to relieve the bacterial load on Mrs R's wounds.- - - - - - - - - - ranking = 866.95773911508keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
7/52. Treatment of an infected venous leg ulcer with honey dressings.An infectious diseases unit is potentially an ideal environment in which to carry out research into honey-based dressings. This article looks at the barriers to carrying out case study-based research, and describes the treatment of an elderly gentleman with venous leg ulcers. The patient's wounds improved with the honey-based dressing, but it failed to free the wound of microbes. One possible explanation is that the honey, instead of killing the microbes, actually provided them with a food source.- - - - - - - - - - ranking = 861.32282832064keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
8/52. wound infection due to vibrio vulnificus in spain.vibrio vulnificus is a gram-negative rod that can cause septicaemia and skin lesions, usually in patients with underlying illnesses such as chronic liver disease or diabetes mellitus. Infections caused by this bacterium are unusual in spain. A case of skin infection due to vibrio vulnificus is reported in a patient whose abraded skin on his left leg came into contact with seawater. The patient died suddenly, probably due to septicaemia or bacteraemia caused by this organism. vibrio vulnificus infection must be considered in the differential diagnosis of septicaemia, skin lesions and wound infections, particularly when a patient reports a history of contact with seawater.- - - - - - - - - - ranking = 1keywords = leg (Clic here for more details about this article) |
9/52. Systemic Apophysomyces elegans after trauma: case report and literature review.We present a case of systemic fungal infection caused by Apophysomyces elegans in a 50-year-old patient who developed a progressive skin lesion after a motor vehicle crash. Histopathological and mycological examination of the surgical sample showed non-septated hyphae characteristic of mucoraceous fungi. Despite extensive surgical debridement, and parenteral administration of amphotericin b, the patient died of multi-organ failure. autopsy findings suggested systemic involvement. The fungi recovered from culture had non-apophyseal and globose sporangi, and branched sporaniophores and was identified as Apophysomyces elegans.- - - - - - - - - - ranking = 6keywords = leg (Clic here for more details about this article) |
10/52. Identifying the causes of increased wound pain: the role of the tissue viability nurse.A leg ulcer that had stopped healing was causing a patient increased pain. Heavy infection was identified as the cause, and found to be exacerbated by a range of factors. An assessment resulted in treatment changes, leading to complete healing.- - - - - - - - - - ranking = 172.26456566413keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
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