Hospital Laboral Solimat

Background: Diabetic foot syndrome is a common complication of diabetes mellitus, and its incidence is increasing due to increasing rates of overweight and an aging population. Negative pressure wound therapy has been shown to improve wound healing. This study aimed to analyze the efficacy of this therapy compared with conventional treatments in patients with diabetic foot ulcers. Methods: A systematic search was conducted in the following databases: PubMed, SCOPUS, CINAHL, and the Cochrane Library, and the methodological quality was assessed using the Rob2 scale. This meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 11 clinical trials involving 1117 subjects. The primary outcome was efficacy, which was measured by the complete healing rate, wound size, time to granulation tissue formation, adverse effects, amputations, hospital stay, and cost. This study demonstrated that this therapy improves healing (OR= −10.39, 95% CI [−14.22, −6.57]) and reduces wound size (OR = −4.11, 95% CI [−7.83, −0.39]) while potentially lowering overall costs. Conclusions: Limitations include heterogeneity and different variables measured in studies. Additionally, there were differences among the trials due to the lack of blinding. Although no significant differences were found in amputations or infections, this therapy reduces pain and decreases the use of antibiotics and analgesics. Its use requires individual and expert assessment to maximize its benefits.

Aim Distal femoral shaft fractures are characterized by increasing incidence and complexity and are still considered a challenging problem. No consensus on best surgical option has been achieved. The aim of this study is to investigate mineral bone densitometry, radiographic and clinical outcomes of locking retrograde intramedullary nailing (LRN) and non-locking retrograde intramedullary nailing (NLRN) regarding surgical treatment of distal femoral shaft fractures in adults based on the hypothesis that there is no statistical difference among the results of both surgical options. Methods Retrospective study: 30 patients divided into 2 groups (Group 1 LRN, Group 2 NLRN). Average age was 42.67±18.32 for Group 1 and 44.27±15.11 for Group 2 (range of age 18-65 for both groups). Gender ratio (male:female) was 2.75 (11:4) for both groups. AO Classification, Non Union Scoring System (NUSS) and Radiographic Union Score Hip (RUSH), Visual Analogic Score (VAS), Dexa scans, plain radiographs were used. Evaluation endpoint: 12 months after surgery. Results No statistical difference was obtained in terms of surgery time, transfusions or wound healing. There were similar results regarding average time of bone healing, RUSH scores, VAS, regression between RUSH and VAS, average correlation clinical-radiographic results and patients outcomes. Only one patient of LRN group had reduction of mineral bone densitometry values. Conclusion No statistical difference in terms of radiographic, bone densitometry and clinical outcomes among LNR and NLNR for the treatment of distal femur fractures was found. The presence of no statistical difference regarding radiological findings is the main factor supporting our hypothesis given their strong objectivity.