Bone and wound healing in the diabetic patient.
Impaired soft tissue regeneration and delayed osseous healing are known complications associated with diabetes mellitus with regard to orthopedic surgery, making the management and treatment of diabetic patients undergoing foot and ankle surgery more complex and difficult. At the moment several options are available to address the known issues that complicate the clinical outcomes in these high-risk patients. Using a multifaceted approach, with close attention to intraoperative and perioperative considerations including modification of surgical technique to supplement fixation, local application of orthobiologics, tight glycemic control, administration of supplementary oxygen, and biophysical stimulation via low-intensity pulsed ultrasound and electrical bone stimulation, the impediments associated with diabetic healing can potentially be overcome, to yield improved clinical results for diabetic patients after acute or elective foot and ankle surgery.
Mehta
Siddhant K
SK
Department of Orthopaedics, University of Medicine and Dentistry of New Jersey, Newark, 07103, USA.
Breitbart
Eric A
EA
Berberian
Wayne S
WS
Liporace
Frank A
FA
Lin
Sheldon S
SS
D019485:Bone Morphogenetic Proteins / Q000502:physiology; D050281:Bones of Lower Extremity / Q000098:blood supply / Q000294:innervation / Q000601:surgery*; D048909:Diabetes Complications / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000379:methods; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D019990:Perioperative Care / Q000009:adverse effects / Q000379:methods*; D053657:Platelet-Rich Plasma / Q000502:physiology; D012189:Retrospective Studies; D014945:Wound Healing / Q000502:physiology*
D019485:Bone Morphogenetic Proteins