fibrin and Gangrene

This study investigated the effect of L-PRF on promoting full-thickness skin grafting for the treatment of diabetic foot ulcer wounds and attempted to characterize the mechanism. In a retrospective study, we centrifugated 10-20 ml of venous blood at 1006.2 g for 20 min. The fibrin clot between the top oligocellular plasma layer and the bottom erythrocyte layer was extracted and directly used, without compression, to cover the wound after debridement. Patients who received L-PRF before skin grafting underwent surgery earlier than patients in the control group. Skin necrosis occurred in 7 patients (28%) in the L-PRF group and 16 (64%) in the control group. The difference was statistically significant, P < .05. The postoperative infection rate in the control group (56%) was significantly higher than that in the L-PRF group (24%), P < .05. During a mean follow-up of 1 year, ulcer recurrence occurred in 9 patients (36%) in the control group compared with 4 patients (16%) in the L-PRF group, P < .05. The final amputation rate was also higher in the control group (48%) than in the L-PRF group (20%). The difference is statistically significant, P < .05. The Maryland scale score and SF-36 score of the two groups of patients after treatment were significantly better than those before treatment, and the difference was statistically significant (P < .05). The L-PRF group (94.80 ± 4.14) had better foot scores at the last follow-up after treatment than the control group (88.84 ± 5.22) (P < .05). The results showed that L-PRF played a positive role in the treatment of Wagner grade 4 ulcer gangrene with free full-thickness skin grafts.. What is the context?● Diabetic foot is a serious complication in the later stage of the disease course of diabetic patients. The incidence rate is increasing year by year. In severe cases, it can lead to amputation or even death.● For diabetic ulcer wounds, dressings such as L-PRF or autologous fat are often used in the initial stage to speed up wound healing. For advanced wounds, especially patients with local tissue gangrene, simple wound dressings cannot meet the needs of wounds. People often use skin flaps or different types of skin grafts to treat advanced wounds.● Flap or skin grafting has been shown to be effective, but because of the patient’s own neurovascular injury and infection, the rate of graft necrosis and ulcer recurrence is extremely high. What is new?● This study discusses the treatment of advanced wounds in diabetes. After thorough debridement and before skin grafting, we first covered the wound with L-PRF and observed the wound condition. Studies have shown that the use of L-PRF can allow the original poor wound to be reconstructed: the content of growth factors and growth-related cells is increased, blood circulation is improved and granulation tissue growth, bone and tendon exposure is improved, and infection is controlled. What is the impact?● This study provides evidence that using L-PRF to reconstruct wounds can greatly shorten the preparation time for elective surgery. Reconstructed wounds can better accept free skin grafts, and the incidence of postoperative complications and amputation (particularly, toe amputation) is also lower.

Topics: Diabetes Mellitus; Diabetic Foot; Fibrin; Gangrene; Humans; Leukocytes; Retrospective Studies; Skin Transplantation; Toes; Wound Healing

We present a case report of a man who experienced vascular thromboses, which subsequently resolved following discontinuation of clopidogrel.

Topics: Aged; Biopsy; Clopidogrel; Fibrin; Fingers; Gangrene; Humans; Male; Platelet Aggregation Inhibitors; Skin; Thrombosis; Ticlopidine

Data from the literature concerning the frequent lack of correlation between the clinical manifestations of diabetic neuropathy on the one hand and the morphofunctional status of the appropriate nerves, disorders in carbohydrate and lipid metabolism, and the influence of antidiabetic therapy on metabolism and the clinical picture of diabetic neuropathy on the other, are presented. In this connection, abundant evidence of frequent affection of various blood vessels, particularly small and smallest, in diabetic neuropathy is considered. But even these data attest to a non-infrequent lack in diabetic neuropathy of the involvement of the appropriate vessels, particularly the lack of basal membrane thickening which is a most common indication to the diabetic involvement of capillaries. Attention is drawn to the possible role of genetic heterogeneity of people with regard to the development of various forms of diabetic neuropathy.

Topics: Adult; Aged; Basement Membrane; Blood Vessels; Chronic Disease; Diabetic Angiopathies; Diabetic Neuropathies; Diabetic Retinopathy; Endothelium; Fibrin; Gangrene; Humans; Microcirculation; Middle Aged; Nerve Fibers; Nervous System

Ninety-three postoperative patients 1 day to 13 years of age had blood cultures, limulus lysate assay, determination of fibrin degradation products, white blood cell and platelet counts. Seven groups were studied. The limulus lysate assay was often positive (64%) in the presence of gram negative septicemia but there were false positives and negatives. The tests for fibrin degradation products were inconsistent. The white blood cell count was low in babies with gram negative septicemia. One hundred per cent of the infants with gram negative septicemia had a platelet count below 150,000; 71% below 100,000 (average 67,000 septic babies, 257,000 non-septic babies). The drop in platelet count with gram negative septicemia was abrupt---as much as 222,000 in 24 hours. Platelets increased when therapy was effective. Two children with gram negative septicemia had platelet counts of 50,000 and 20,000. The platelet count for patients with gram positive septicemia was 299,000, and above 150,000 in all children with ruptured and non-ruptured appendicitis and major surgery without gram negative septicemia. It was concluded that serial measurements of platelet count in the postoperative infant and child was a rapid and reliable method for early detection of gram negative septicemia and changes in platelet count in response to treatment was an indicator of the effectiveness of therapy.

Topics: Abdominal Muscles; Adolescent; Appendicitis; Bacteria; Bacterial Infections; Blood Cell Count; Blood Platelets; Child; Child, Preschool; Enterocolitis, Pseudomembranous; Escherichia coli Infections; Fibrin; Gangrene; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Klebsiella Infections; Leukocyte Count; Liver Neoplasms; Platelet Aggregation; Postoperative Complications; Pseudomonas Infections; Sepsis; Time Factors

Topics: Anemia, Hemolytic; Breast Diseases; Disseminated Intravascular Coagulation; Female; Fibrin; Gangrene; Humans; Middle Aged; Necrosis; Thrombophlebitis; Warfarin

Topics: Arthritis, Rheumatoid; Blood Sedimentation; Exudates and Transudates; Fibrin; Gangrene; Humans; Osteoarthritis; Polyarteritis Nodosa; Synovial Fluid; Vascular Diseases; Wounds and Injuries

Topics: Adult; Aged; Blood Coagulation Tests; Cardiac Output; Disseminated Intravascular Coagulation; Extracorporeal Circulation; Female; Fibrin; Fibrinogen; Gangrene; Heparin; Humans; Male; Middle Aged