Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgical debridement refers to the use of sharp instruments to remove devitalized tissue from wounds. Skin grafting is an adjunctive therapy that uses human (autograft or allograft), nonhuman (xenograft), or artificial (synthetic graft) skin to cover nonhealing ulcers. Bilayer artificial skin plus compression is more effective for venous leg ulcers (VLUs) than standard dressings plus compression. Reconstructive surgery provides options for coverage of deep, refractory pressure ulcers; however, no randomized trials have compared these techniques with standard care. For patients with VLUs with superficial venous reflux, early endovenous ablation plus compression heals VLUs more quickly than compression with deferred ablation. Revascularization restores in-line arterial flow to ischemic extremities, facilitating wound healing and pain resolution. Bypass surgery has been shown to result in better luminal patency at 1 year than percutaneous transluminal angioplasty (PTA), but PTA is associated with fewer perioperative complications and shorter hospitalizations. PTA with and without stenting are comparable in terms of rates of perioperative complications and major amputation and mortality in patients with infrapopliteal arterio-occlusive disease. Amputation is the last option for patients with critical limb ischemia who are not candidates for or have not benefited from revascularization attempts.
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PMID:Skin Ulcers: Surgical Management. 3326 75

Sickle Cell Disease (SCD) is an intractable hematologic condition most commonly affecting patients of African ancestry. It is a serious global public health concern as over 300,000 babies are born annually with SCD, with up to 75% residing in Sub-Saharan Africa.[1] Chronic leg ulcers occur in 20-70% of SCD patients, although 75% of Jamaican patients that are homozygous for hemoglobin S are affected.[2] Systemic therapies such as Hydroxyurea and red blood cell transfusions have dramatically increased the life span of SCD patients and as a result more patients are reaching adulthood, where they are at greatest risk of developing leg ulcerations.[1,2] SCD leg ulcers are very resistant to heal and are associated with significant pain, disability, and negative psychosocial and economic impacts.[1,2] Although the mechanism of ulcer development has yet to be fully elucidated, the pathogenesis is believed to be a result of vaso-occlusion following intracellular precipitation of the sickle hemoglobin. This promotes endothelial dysfunction, a hypercoagulable state, inflammation, ischemia reperfusion injury, and associated tissue necrosis. [1,2].
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PMID:A New Treatment Paradigm for Sickle Cell Disease Leg Ulcers: Topical Cannabis-Based Medicines. 3329 32


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