[Plausible solution to prevent major amputation in diabetic foot patients]. / Sto nakon amputacije dijabetickog stopala?

Diabetes mellitus is one of the leading public health problems in the world. Complications of diabetes mellitus include cardiovascular diseases, retinopathy, neuropathy and diabetic foot, which can in turn lead to lower extremity amputations. This is the main cause of mortality and the biggest expenditure for health system. Treatment is long and frustrating for the patient and also for medical staff. Amputations are becoming more frequent, while the quality of life after amputation is greatly reduced. Healing of postoperative infection is long lasting and demands a lot of hard work from the surgeon and the rest of medical staff, while causing severe suffering for the patient. Progression of infection increases mortality. Negative pressure therapy after minor foot amputations greatly reduces healing time. Negative Pressure Wound Therapy (NPWT) was applied after surgical treatment. All necrotic tissue and fibrin deposits were removed. Initial therapy was administered continuously with 125 mm Hg of vacuum. The NPWT was continued intermittently. Additionally, all patients underwent additional hyperbaric treatment and local hemoglobin administration. In conclusion, in all cases presented, combined NPWT, hyperbaric and topical hemoglobin therapy proved to be a highly effective therapeutic option in preventing pending major amputation following minor diabetic foot amputation.

Can non-adhesive short stretch bandages change a life?

Venous stasis ulcers are common in patients who have a history of leg swelling, varicose veins, or a history of blood clots in either the superficial or the deep veins of their legs. The treatment is long and hard but the main aim of it is to create such an environment that allows skin to grow over an ulcer. Chronic wounds are a growing social, economical and health issue throughout the world. The purpose of this retrospective study was to establish detailed characterization of how effective a compression is in reducing the time of wound healing. A total of 176 patients with leg ulcers were included in our three years study. The measurements were taken based on the anamnesis, presenting clinical symptoms, digital photography at each dressing foam change, and, finally, wounds. During a 3 years period (2011-2013) a total of 176 patients (61 male and 115 female, 34.66% and 65.34% respectively) with different types of leg ulcers were treated at our Hospital. The average age is 68.94 years (male 68 years, female 70 years). We measured how long the patient had the wound before starting the treatment, and also how long the treatment lasted. This led us to the conclusion that compression therapy shortened the time of treatment by two thirds, compared to the usual therapy. Compression systems improve the healing of venous leg ulcers and should be used routinely regarding venous ulcers.

Impact of adolescents awareness on perception of sexually transmitted infections.

Sexually transmitted infections (STIs) are diseases transmitted by direct contact during sexual intercourse. Because of high incidence and possibility of development severe consequences on general and reproductive health, STIs are a major problem among young people in the world. Lack of information is one of the major risk factors for STI transmission. Most of young people (53.3%) had their first sexual intercourse at the age of 18 years, 67.7% of students have no knowledge about STI, 53.3% of students have already entered into sexual relations and 13% of them with more than 4partners. 31.1% of students who are sexually active was not examined by a gynecologist because of shame and fear. Most sexually active adolescents did not use contraceptives and they are not satisfied with the available information about STI. There is also continuing problem of teen pregnancy. The main goal of this research is to examine whether there is relationship between level of information and awareness of surveyed adolescents and their perception of sexually transmitted diseases.

[A role of negative pressure therapy in the treatment of surgical wound infection after intramedullary osteosynthesis in pertrochanteric femoral fracture]. / Uloga terapije negativnim tlakom u lijecenju infekcije kirurske rane nakon intramedularne osteosinteze pertrohanternog prijeloma bedrene kosti.

Fractures of the proximal femur are specific to older adults. Today, life expectancy for men and women is increasing, so one can expect an increased number of hip fractures. Elderly people suffer from associated diseases that may compromise the biological potential in healing of surgical wounds. On the other hand, there is an increased number of microorganisms resistant to antimicrobial drugs, so an increased number of postoperative infections can be expected. With conventional treatment methods of postoperative infections where the osteo-synthetic material is present in tissue, negative pressure therapy is gradually taking an increasingly important role in the treatment of these conditions. Because of its simple application in hospital or outpatient setting and good comfort with no pain for the patient, negative pressure therapy contributes significantly to healing of the wounds without removing osteosynthetic material from the wound.

[What is behind a wound?- case report]. / Sto se krije iza rane? - prikaz bolesnika.

Chronic wound is a wound that does not heal in four to eight weeks. The most important predisposing factors are tissue ischemia and infection. In approximately 80% of cases, chronic wounds of lower limbs are the final form of chronic venous insufficiency. We report a case of chronic wound of lower limb that was treated as a posttraumatic war wound. After proper treatment of chronic venous wound of lower limb, it healed after almost 20 years. When chronic wound of lower limb is present, all diagnostic criteria should first exclude chronic venous insufficiency, and then proper treatment should be introduced.

[Weight loss and healing of ulcers - case report]. / Mrsavljenjem do cijeljenja ulkusa - prikaz bolesnika.

Diabetes mellitus type 2 is one of the most common diseases with a prevalence increasing with age. If blood sugar is not controlled, complications arise and diabetic foot ulcer occurs. Depending on the blood vessels involved, we distinguish venous and arterial ulcers. Venous ulcers respond very well to modern methods of treatment such as compression therapy and hydrocolloid dressings, but for arterial ulcer prevention is most significant, e.g. weight loss, dietary modification, etc. The aim of this study was to show that despite all the available therapeutic options, we cannot cure ulcers completely because the patient's readiness to change his lifestyle plays a decisive role. Therefore, we present a patient having suffered from venous ulcers for several years and arterial ulcer that healed only after the patient had lost about 20 pounds.