Hyperbaric Oxygen Therapy: Difference between Efficacy and Effectiveness

Hyperbaric oxygen therapy for diabetic wounds.

 Liu showed meta-analysis of 13 trials including 7 prospective randomized trials of 624 patients showing effectiveness.

 Liu R, Li L, Yang M, Boden, Yang G. Systematic review of the effectiveness of hyperbaric

oxygen in the management of chronic diabetic foot ulcers. Mayo Clin Proc.2013;88(2):167-175.

The UHMS Quality, Utilization, Authorization and Reimbursement Committee response trying to explain the difference in “efficacy” and “effectiveness” is at https://www.uhms.org/images/Latest-News/margolisleinterpret.pdf.Phi-Nga Jeannie Le M.D. Interpretation of the study “Lack of effectiveness of hyperbaric oxygen therapy for the treatment of diabetic foot ulcer and the prevention of amputation”

Can we use commercially available less expensive infrared thermometers to measure skin surface temperature associated with deep and surrounding wound infection?.

Validation of Commercially Available Infrared Thermometers for Measuring Skin Surface Temperature Associated with Deep and Surrounding Wound Infection

Mufti, Asfandyar BMSc; Coutts, Patricia RN; Sibbald, R. Gary BSc, MD, MEd, FRCPC(Med)(Derm), MACP, FAAD, MAPWCA, DSc(Hons)Advances in Skin & Wound Care:January 2015 - Volume 28 - Issue 1 - p 11-16

doi: 10.1097/01.ASW.0000459039.81701.b2

Features: Original Investigation

At present time there are several shuttle signs which help us identify wound infection( i,e friable spongy granulation tissue, delayed wound healing, Persistent drainage and evidence of wound pain.) Authors of this article suggest that using less expensive industrial grade non contact infrared thermometers might be useful along with other signs may be associated with deep and surrounding wound infections. This could be very helpful clinically in wound care practice if validated further by more evidence based data. 

Detect hypoxia in wounds by putting "smart" bandage on the wound

see-through, 'smart' bandage that glows to indicate a wound's tissue oxygenation concentration; Awesome discovery
http://www.sciencedaily.com/releases/2014/10/141001102642.htm

AAPI Global Healthcare Summit 2014

Almost half of all patients with PAD dying within year of Major LE amputation

High mortality risks after major lower extremity amputation in Medicare patients with peripheral artery disease.

Jones WS, Patel MR, Dai D, Vemulapalli S, Subherwal S, Stafford J, Peterson ED.

Source

Duke Clinical Research Institute, Duke University Medical Center, Durham, NC; Division of Cardiology, Duke University Medical Center, Durham, NC. Electronic address: schuyler.jones@dm.duke.edu.

Abstract

BACKGROUND:

Little is known regarding the contemporary outcomes of older patients with peripheral artery disease (PAD) undergoing major lower extremity (LE) amputation in the United States. We sought to characterize clinical outcomes and factors associated with outcomes after LE amputation in patients with PAD.

METHODS:

Using data from the Centers for Medicare and Medicaid Services from January 1, 2000, to December 31, 2008, we examined the national patterns of mortality after major LE amputation among patients 65 years or older with PAD. Cox proportional hazards models were used to investigate the association between clinical variables, comorbid conditions, year of index amputation, geographic variation, and major LE amputation.

RESULTS:

Among 186,338 older patients with identified PAD who underwent major LE amputation, the mortality rate was 13.5% at 30 days, 48.3% at 1 year, and 70.9% at 3 years. Age per 5-year increase (hazard ratio [HR] 1.29, 95% CI 1.29-1.29), history of heart failure (HR 1.71, 95% CI 1.71-1.72), renal disease (HR 1.84. 95% CI 1.83-1.85), cancer (HR 1.71, 95% CI 1.70-1.72), and chronic obstructive pulmonary disease (HR 1.33, 95% CI, 1.32-1.33) were all independently associated with death after major LE amputation. Subjects who underwent above knee amputation had a statistically higher hazard of death when compared with subjects who underwent LE amputation at more distal locations (HR with above the knee amputation 1.31, 95% CI 1.25-1.36).

CONCLUSIONS:

Older patients with PAD undergoing major LE amputation still face a slightly high mortality risk, with almost half of all patients with PAD dying within a year of major LE amputation.

Copyright © 2013 Mosby, Inc. All rights reserved.

"#Diabetes kills more people annually than breast cancer and HIV/AIDS combined." #DFCon13 http://buff.ly/13ckkm0

New app Wounddoctor released on I phone and I pad

• What’s New
• What is iTunes
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WoundDoctor

By TimeO2 Healing Concepts, LLC

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Open iTunes to buy and download apps.

Description

WoundDoctor is the perfect tool for nurses, physical therapists and doctors providing wound care.

This comprehensive, all-inclusive Wound Care resource app includes an Algorithm for Wound Management Clinical Guidelines in a drill-down table format, Search interface to find Diagnosis, Glossary, movie on Normal Skin Histology, Hyperbaric Oxygen Therapy, Wound Dressings, Braden Scale scoring, Advance Wound Technology, Physical Therapy Modality and Pop up Quiz.

WoundDoctor Quiz will allow you to test your knowledge in wound care before taking wound care certification exam (answers included). WoundDoctor also has an extensive assortment of photos, tables, diagrams, etc. for aiding with learning.

Please provide your valuable feedback at www.WoundDoctors.com

Copyright © 2013 with:
Dr. Jayesh B. Shah, MD.
Medical Director,
South Texas Wound Associates, PA,
San Antonio, TX, US
www.WoundDoctors.com

Development Partner: Minding Your Enterprise, LLC.

...More

TimeO2 Healing Concepts, LLC Web SiteWoundDoctor Support

What's New in Version 2.0

Data correction on Braden Scale and Algorithm. Bug correction on Back button and clicking Next Steps link on the prior page.

Screenshots

iPhone iPad

View In iTunes

This app is designed for both iPhone and iPad

• $14.99
• Category: Medical
• Updated: Apr 03, 2013
• Version: 2.0
• Size: 28.4 MB
• Language: English
• Seller: TIMEO2 HEALING CONCEPTS, LLC
• © TimeO2 Healing Concepts, LLC 2013

Rated 12+ for the following:

• Infrequent/Mild Horror/Fear Themes
• Infrequent/Mild Sexual Content or Nudity
• Infrequent/Mild Simulated Gambling

Requirements: Compatible with iPhone 3GS, iPhone 4, iPhone 4S, iPhone 5, iPod touch (3rd generation), iPod touch (4th generation), iPod touch (5th generation) and iPad. Requires iOS 5.0 or later. This app is optimized for iPhone 5.