International wound journal
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Comparative Study
Insensate foot of diabetic foot ulcer can have underlying silent neuropathic pain.
Subjects with diabetic foot ulcer (DFU) are believed to be less likely to complain of symptoms of painful diabetic peripheral neuropathy (PDPN). When we assessed this using Leeds Assessment of Neuropathic Symptoms and Signs questionnaire (s-LANSS) we found that out of total 44 subjects with DFU, 19 (43·2%) had possible neuropathic discomfort. s-LANSS score was significantly higher in DFU group (8·1 ± 7·7 versus 4·7 ± 4·6; P = 0·04). ⋯ This study suggests that subjects with DFU may suffer from PDPN, but do not perceive it. Further studies are needed to assess if treatment of PDPN in these subjects is beneficial.
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As deep soft tissue defects with exposed bone, cartilage or tendons are not suitable for wound closure with skin mesh grafts, other techniques are needed. We report on six patients, one female and five males, aged between 32 and 89 years, and deep soft tissue defects with exposed tendons, cartilage or bone. The aetiology of these defects was vascular (n = 3), tumour surgery (2), and post-traumatic (1). ⋯ There was no skin contracture of the skin grafts. Collagen-elastin matrix with split-thickness skin grafts is a useful tool in deep soft tissue. The time to heal can be reduced.