Cultura

Medical Trauma and Spatial Isolation in Alan Brennert’s Moloka’i

VOLUME 23, 2026

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Jetto. R, Dr. J. Chitta

Abstract

American Literature is a unique literature, predominantly written or produced in the United States of America and its preceding colonies. Alan Brennert an American author exhaustively screens out the nineteenth-century untold Hawaiian leper colony. Brennert’s powerful and scrupulous fiction Moloka’i encapsulates the horrors of the disease in order to build up the enticing story in the Hawaiian Island. Nature is beautiful not only because it meets one’s several needs and paves way to render the feeling of bliss but it also helps people to connect with their true ‘selves’. Through different dimensions, it focuses on how nature stands as a healer in a Pacific paradise. The people of Hawaii spin with an exile, widowed, orphaned, legally dead, and physically dying with Hansen’s disease and struck root in a new community, Kalaupapa. In the novel Brennert conveys the effects of Hansen disease, instead of living in a co-dwelling family that men and women live in separate colonies, whose children are removed soon after birth to prevent diseases. The present paper explores the touching account of a seven-year-old Rachel who undergoes sterlization when she rises above the limitations of a devastating illness and isolation within Kalaupapa community.

Keywords : Hansen disease; Healer; Illness; Segregation..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty