Maarit Venermo

Bio: Maarit Venermo is an academic researcher from University of Helsinki. The author has contributed to research in topics: Revascularization & Abdominal aortic aneurysm. The author has an hindex of 40, co-authored 183 publications receiving 7477 citations. Previous affiliations of Maarit Venermo include Helsinki University Central Hospital.

2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries

Abstract: 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries

A review of indocyanine green fluorescent imaging in surgery

Abstract: The purpose of this paper is to give an overview of the recent surgical intraoperational applications of indocyanine green fluorescence imaging methods, the basics of the technology, and instrumentation used. Well over 200 papers describing this technique in clinical setting are reviewed. In addition to the surgical applications, other recent medical applications of ICG are briefly examined.

Treatment of diabetic foot ulcers.

Abstract: Diabetic foot ulcers are a major health care problem. Complications of foot ulcers are a leading cause of hospitalization and amputation in diabetic patients. Diabetic ulcers result from neuropathy or ischemia. Neuropathy is characterized by loss of protective sensation and biomechanical abnormalities. Lack of protective sensation allows ulceration in areas of high pressure. Autonomic neuropathy causes dryness of the skin by decreased sweating and therefore vulnerability of the skin to break down. Ischemia is caused by peripheral arterial disease, not by microangiopathy. Poor arterial inflow decreases blood supply to ulcer area and is associated with reduced oxygenation, nutrition and ulcer healing. Necrotic tissue is laden with bacteria apt to grow in such an environment, which also impairs general defence mechanisms against infection. Infections often complicate existing ulcers, but are seldom the cause for ulcers. Protective footwear helps to reduce ulceration in diabetic feet at risk. Relieving pressure on the ulcer area is necessary to allow healing. Blood supply needs to be improved by revascularisation whenever compromised. Systemic antibiotics are helpful in treating acute foot infections, but not uninfected ulcers. Osteomyelitis may underlie a diabetic ulcer and is often treated by resection of the infected bone and always by antibiotics, the mode and length of treatment depending on the adequacy of the debridement. The aim of ulcer bed preparation is to convert the molecular and cellular environment of the chronic ulcer to that of an acute healing wound by debridement, irrigating and cleaning. Moist dressings maintain wound environment favorable for healing. All attempts should be done to prevent diabetic foot ulceration and treat existing ulcers by multidisciplinary teams in order to decrease amputations. Indeed, improvement in ulcer healing has been observed with primary healing rates of 65-85% in mixed series. Even when healed, diabetic foot should be regarded as a life-long condition and treated accordingly to prevent recurrence. Long-term efforts have reduced amputation 37-75% in different European countries over 10-15 years.

2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD

Abstract: This is the second iteration of the European Society of Cardiology (ESC) and European Association for the Study of Diabetes (EASD) joining forces to write guidelines on the management of diabetes mellitus (DM), pre-diabetes, and cardiovascular disease (CVD), designed to assist clinicians and other healthcare workers to make evidence-based management decisions. The growing awareness of the strong biological relationship between DM and CVD rightly prompted these two large organizations to collaborate to generate guidelines relevant to their joint interests, the first of which were published in 2007. Some assert that too many guidelines are being produced but, in this burgeoning field, five years in the development of both basic and clinical science is a long time and major trials have reported in this period, making it necessary to update the previous Guidelines.

Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017

Abstract: Importance The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. Objective To provide new and updated evidence-based recommendations for the prevention of SSI. Evidence Review A targeted systematic review of the literature was conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library from 1998 through April 2014. A modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence and the strength of the resulting recommendation and to provide explicit links between them. Of 5759 titles and abstracts screened, 896 underwent full-text review by 2 independent reviewers. After exclusions, 170 studies were extracted into evidence tables, appraised, and synthesized. Findings Before surgery, patients should shower or bathe (full body) with soap (antimicrobial or nonantimicrobial) or an antiseptic agent on at least the night before the operative day. Antimicrobial prophylaxis should be administered only when indicated based on published clinical practice guidelines and timed such that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made. In cesarean section procedures, antimicrobial prophylaxis should be administered before skin incision. Skin preparation in the operating room should be performed using an alcohol-based agent unless contraindicated. For clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses should not be administered after the surgical incision is closed in the operating room, even in the presence of a drain. Topical antimicrobial agents should not be applied to the surgical incision. During surgery, glycemic control should be implemented using blood glucose target levels less than 200 mg/dL, and normothermia should be maintained in all patients. Increased fraction of inspired oxygen should be administered during surgery and after extubation in the immediate postoperative period for patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation. Transfusion of blood products should not be withheld from surgical patients as a means to prevent SSI. Conclusions and Relevance This guideline is intended to provide new and updated evidence-based recommendations for the prevention of SSI and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety.

Diabetic Foot Ulcers and Their Recurrence

Abstract: Foot ulceration is the most common lower-extremity complication in patients with diabetes mellitus. This review considers the pathogenesis, treatment, and management of diabetic foot ulcers, including prevention of recurrence.