scholarly journals Treatment of diabetic neuropathy induced non healing foot ulcer using merisistm supercellplatelet rich fibrin matrix: a clinical study

2021 ◽  
Vol 6 (10) ◽  
Keyword(s):  
Point Of Care ◽  
Foot Ulcer ◽  
Complete Healing ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Mellitus ◽  
Platelet Rich Fibrin ◽  
Quick Recovery ◽  
Fibrin Matrix ◽  
Effective Treatment Modality

Objective: Non healing foot ulcers are a major debilitating condition in diabetic patients which leads to limb amputation.In this study we discuss the use ofMERISISTM Supercell plus Platelet Rich Fibrin Matrix (PRFM) kitfor point of care treatments towards limb salvation. Method: We selected diabetic mellitus patients havingDiabetic foot ulcer (DFU) grade 1 or higher. Use of MERISISTM Supercell plus PRFM is a biological matrix of extracellular matrix (ECM) protein plus growth factors derived from peripheral blood to treat the DFU 45 days over. Result: Following treatment the patients showed quick recovery and complete healing of the ulcers. Conclusion: Supercellplus PRFM therapy promotes wound healing in patients suffering from chronic non-healing diabetes foot ulcers. Supercells plus PRFM dressing is a safe and effective treatment modality to promote wound contraction in patients suffering from non-healing diabetic foot ulcers.

Use of GBT013, a Collagen-Based Dressing, for the Healing of Diabetic Foot Ulcers

2018 ◽  
Vol 108 (5) ◽  
pp. 419-429
Author(s):  
Isabelle J. Dumont ◽  
Marc Lepeut ◽  
Coralie Segalen ◽  
Yannis Guillemin ◽  
Jean Noel Gouze
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Complete Healing ◽  
Ease Of Use ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Foot Care ◽  
University Of Texas

The number of people with diabetes is expected to reach 592 million in the year 2035. Diabetic foot lesions are responsible for more hospitalizations than any other complication of diabetes. The aims of this study were to examine for the first time a new biocompatible and biodegradable tridimensional collagen-based matrix, GBT013, in humans for diabetic foot ulcer wound healing and to evaluate its ease of use to better define a protocol for a future clinical trial. Seven adult patients with a diabetic foot ulcer of grade 1A to 3D (University of Texas Diabetic Wound Classification) were treated using GBT013, a new collagen-based advance dressing and were monitored in two specialized foot care units for a maximum of 9 weeks. Five of seven wounds achieved complete healing in 4 to 7 weeks. Nonhealed ulcers showed a significant reduction of the wound surface (>44%). GBT013 was well tolerated and displayed positive wound healing outcomes as a new treatment strategy of chronic foot ulcers in diabetic patients.

The Feasibility and Effectiveness of Wearable Sensor Technology in the Management of Elderly Diabetics with Foot Ulcer Remission: A Proof-Of-Concept Pilot Study with Six Cases

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Chenzhen Du ◽  
Hongyan Wang ◽  
Heming Chen ◽  
Xiaoyun Fan ◽  
Dongliang Liu ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Stride Length ◽  
Wearable Sensors ◽  
Foot Ulcer ◽  
Wearable Devices ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Wearable Sensor ◽  
Double Support ◽  
Gait Parameters

Aims: Using specials wearable sensors, we explored changes in gait and balance parameters, over time, in elderly patients at high risk of diabetic foot, wearing different types of footwear. This assessed the relationship between gait and balance changes in elderly diabetic patients and the development of foot ulcers, in a bid to uncover potential benefits of wearable devices in the prognosis and management of the aforementioned complication. Methods: A wearable sensor-based monitoring system was used in middle-elderly patients with diabetes who recently recovered from neuropathic plantar foot ulcers. A total of 6 patients (age range: 55–80 years) were divided into 2 groups: the therapeutic footwear group (n = 3) and the regular footwear (n = 3) group. All subjects were assessed for gait and balance throughout the study period. Walking ability and gait pattern were assessed by allowing participants to walk normally for 1 min at habitual speed. The balance assessment program incorporated the “feet together” standing test and the instrumented modified Clinical Test of Sensory Integration and Balance. Biomechanical information was monitored at least 3 times. Results: We found significant differences in stride length (p < 0.0001), stride velocity (p < 0.0001), and double support (p < 0.0001) between the offloading footwear group (OG) and the regular footwear group on a group × time interaction. The balance test embracing eyes-open condition revealed a significant difference in Hip Sway (p = 0.004), COM Range ML (p = 0.008), and COM Position (p = 0.004) between the 2 groups. Longitudinally, the offloading group exhibited slight improvement in the performance of gait parameters over time. The stride length (odds ratio 3.54, 95% CI 1.34–9.34, p = 0.018) and velocity (odds ratio 3.13, 95% CI 1.19–8.19, p = 0.033) of OG patients increased, converse to the double-support period (odds ratio 6.20, 95% CI 1.97–19.55, p = 0.002), which decreased. Conclusions: Special wearable devices can accurately monitor gait and balance parameters in patients in real time. The finding reveals the feasibility and effectiveness of advanced wearable sensors in the prevention and management of diabetic foot ulcer and provides a solid background for future research. In addition, the development of foot ulcers in elderly diabetic patients may be associated with changes in gait parameters and the nature of footwear. Even so, larger follow-up studies are needed to validate our findings.

scholarly journals Staphylococcus aureus strains isolated from diabetic foot ulcers. Identification of the antibiotic resistant phenotypes

2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Resistance Pattern ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Bacterial Strains ◽  
Diabetes Clinic

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.

scholarly journals Efficacy of autologous platelet rich fibrin matrix in the management of non-healing ulcers

2019 ◽  
Vol 5 (4) ◽  
pp. 686
Author(s):  
Prachi V. Gole ◽  
Naziya Muhammed ◽  
Siddhi R. Patadia
Keyword(s):  
Therapeutic Option ◽  
Venous Blood ◽  
Middle Layer ◽  
Complete Healing ◽  
Duration Of Treatment ◽  
Platelet Rich Fibrin ◽  
Average Percentage ◽  
Fibrin Matrix ◽  
Plain Tube ◽  
Healing Wounds

<p class="abstract"><strong>Background:</strong> Non healing ulcers have a worldwide prevalence of 1.9%-13.1% with lower extremity being the commonest site. They are difficult to manage for the physician and frustrating for the patient due longer duration of treatment, cost, unsatisfactory outcomes and impairment caused due to them. Standard conventional management may fail at times and hence growth factors derived from platelets have been tried in the management of these ulcers. The purpose of our study was to evaluate the efficacy of platelet rich fibrin matrix (PRFM) in treatment of these ulcers.</p><p class="abstract"><strong>Methods:</strong> Twelve patients with fifteen non-healing ulcers more than 3 months duration were included in the study. 10cc of venous blood was withdrawn in plain tube without anti-coagulants and centrifuged at 1500 rpm for 14 minutes as early as possible as per advanced PRF protocol. Middle layer of PRFM was applied to the clean ulcer followed by a secondary dressing. All patients received PRFM sittings every 7-10 days or till ulcer healed. Baseline photographs and measurements of length, breadth and depth were taken to calculate the area of ulcer at every sitting.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average percentage reduction in area and volume of the ulcer was 95.84% and 98.18% respectively at the end of six sittings. Twelve out of fifteen ulcers showed complete healing by 6 weeks, while three ulcers showed significant improvement but did not heal completely. The procedure was safe, well tolerated without any side effects.</p><p class="abstract"><strong>Conclusions:</strong> Platelet rich fibrin matrix is a novel modality and an ideal, safe, affordable therapeutic option for non-healing wounds of varied causes.</p>

scholarly journals Prevention and treatment of diabetic foot ulcers

2017 ◽  
Vol 110 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Jonathan Zhang Ming Lim ◽  
Natasha Su Lynn Ng ◽  
Cecil Thomas
Keyword(s):  
Diabetic Foot ◽  
Healthcare Access ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Healthcare Provision ◽  
Foot Complications

The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

scholarly journals The Effectiveness of the 15 Psi Irrigation Technique in Wound Cleansing to Reduce the Number of Bacteria on Patients with Diabetic Foot Ulcers

2018 ◽  
Vol 1 (1) ◽  
pp. 88-97
Author(s):  
Lestari Makmuriana (Corresponding author) ◽  
Suriadi ◽  
Yani Sofiani ◽  
Fitrian Rayasari
Keyword(s):  
Normal Saline ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Clinical Test ◽  
Diabetic Foot Ulcers ◽  
Double Blind ◽  
Saline Irrigation ◽  
Number Of Bacteria

The increasing population of diabetic patients leads to the increasing number of diabetic foot ulcer (DFU) cases. To avoid the expansion of the infection, the wound cleansing is conducted through the irrigation and pressure methods. The aim of this research was to identify the effectiveness of wound cleansing using 0.9% normal saline technique with the pressure of 15 Psi in reducing the number of bacteria. This research used the randomized control trial method with a double blind design which had been approved by the ethnical committee of Muhammadiyah University of akarta with the ethnical committee number 261/PMK-UMJ/IV/2017. There were as many as 31 samples in each group collected through consecutive sampling technique with randomization. It had been found that there was a signi fi cant difference in the number of bacteria before and after wound cleansing. Thus, it could be concluded that from the statistical test and clinical test, wound cleansing with normal 0.9% saline technique with the pressure of 15 Psi could decrease the number of bacteria in diabetic foot ulcers. Wound cleansing with 0.9% normal saline irrigation technique pressurized at 15 Psi was recommended as a safe wound cleansing method for diabetic foot ulcers.

scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

Study the susceptibility pattern of bacteria isolated from infected wounds and determine various risk factors associated with foot ulcer

2020 ◽  
Vol 10 (3) ◽  
pp. 52-58
Author(s):  
Divya C Reddy ◽  
Ashin Vareeth ◽  
Bonnie Ascah Joseph ◽  
Anu Thomas ◽  
Sheba Baby John ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antimicrobial Susceptibility ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Previous History ◽  
Foot Ulcer ◽  
College Teaching ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Factors Associated

Studying of bacteria prevalence and antimicrobial susceptibility in samples from foot ulcer patients with chronic wounds will provide the epidemiological information on chronic wound infections, representing support for diagnosis, treatment and management of this pathology, thus preventing further complications of foot infection. There are many risk factors associated with a foot ulcer, so identifying those risk factors and preventing them will help in reducing the incidence of the disease to a certain extend.  Identifying the type of organisms causing the chronic wound infection, antibiotic sensitivity and resistance representing support for diagnosis, treatment and management thus preventing further complications of foot infection, and to understand the significant risk factors associated with the development of foot ulcers. An interventional study was conducted among the 80 patients with foot ulcers admitted in General surgery ward of a medical college teaching hospital from Dec 2018 to May 2019. Antimicrobial susceptibility results showed that gram-negative organism was more prevalent and among the species, the isolated majority was found to be Staphylococcus aureus 28 (0.35%) followed by Klebsiella 16(20%) and E.coli15(18.75%). The most sensitive antibiotic found was Meropenam70 (87.5%) followed by Imipenam 67(83.75%) and Linezolid 65(81.25%) The most resistant antibiotic was Cotrimoxazole 66(82.5%). This study concludes that high proportion of foot ulcers were found amongst diabetic patients than non-diabetic patients, and were often associated with trauma, cellulitis, gangrene. Some of the critical risk factors for foot ulcers included low educational status, previous history of foot ulcer, previous amputation was done, duration of ulcers, smoking, peripheral neuropathy, infection and HbA1c levels of patients.

P1506IMPROVEMENTS IN MICROVASCULAR AND MACROVASCULAR DIABETES-RELATED COMPLICATIONS IN DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Kofod Dea ◽  
Thomas Peter Almdal ◽  
Vibeke Rømming Sørensen ◽  
Bo Feldt-Rasmussen ◽  
Mads Hornum
Keyword(s):  
Visual Acuity ◽  
Substantial Reduction ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
The Past ◽  
History Of

Abstract Background and Aims Newer data suggests that there has been a substantial reduction in the incidence of diabetic complications over the past 30 years. However, little is known about whether this reduction also applies to patients with diabetes and end stage renal disease. The present study examined the current prevalence and the changes in microvascular and macrovascular diabetes-related complications in dialysis patients. Method The study was carried out as a cross-sectional study of all 119 diabetic patients in chronic dialysis at our department during June 2019. Data on diabetes-related complications was obtained from the patients’ electronic medical records and compared with a historic control group of all 38 diabetic dialysis patients examined in 2004. Results Currently, 12.3% had foot ulcer, while 40.3% had a history of foot ulcer. Lower extremity amputations were seen in 19.3%, with 7.6 % being amputated above-knee level. Development of Charcot foot was seen in 3.4%, and 64.1% had diabetic retinopathy (27.2% with proliferations), 27.2% had maculopathy, and 18.4% had a visual acuity lower than 0.3. A total of 31.1% had atrial fibrillation or flutter, 14.3% had angina pectoris and 20.2% had a history of myocardial infarction. A history of stroke or transient ischemic attack was observed in 21.8% and 6.7%, respectively. Compared with data from the 2004 cohort, we found a significant reduction in the prevalence of current foot ulcers (p=0.013), proliferative retinopathy (p=0.007) and visual acuity lower than 0.3 (p=0.028). Conclusion The findings of this study indicate that there has been a reduction in current foot ulcers and eye complications over the past 15 years among diabetic dialysis patients, whereas the prevalence of amputations, cardiovascular and cerebrovascular complications remains high.

Reducing the burden of chronic wounds: Prevention and management of the diabetic foot in the context of clinical guidelines

2008 ◽  
Vol 13 (3_suppl) ◽  
pp. 82-91 ◽  
Author(s):  
Aidan Searle ◽  
Lone Gale ◽  
Rona Campbell ◽  
Mark Wetherell ◽  
Karen Dawe ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Diabetic Foot ◽  
Clinical Guidelines ◽  
Chronic Wounds ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Shared Decision ◽  
Behavioural Factors

Objectives: Chronic wounds such as diabetic foot and venous leg ulcers are a major burden for health services. Our programme was developed to explore the psychological and behavioural factors that may influence both the incidence of chronic wounds and their progression. The present article focuses on two particular aspects of the programme: patient knowledge of diabetic foot ulceration and factors influencing foot-related behaviour in patients with and without foot ulcers; and patient and podiatrist perspectives of consultations for diabetic foot ulcers. Methods: Two independent qualitative studies were undertaken: one with diabetic patients without a history of ulceration; and the other with diabetic patients with active ulceration and podiatrists treating these patients. Results: We found that patients may find it difficult understanding the rationale underlying prevention and treatment of foot ulcers; ulcerated patients may find it difficult to engage in the management of their foot ulcer outside consultations; and some podiatrists feel frustrated and unsupported in their attempts at empowering and building partnerships with patients. Conclusion: Patient and practitioner factors may contribute to the effective implementation of clinical guidelines regarding education, partnership building and shared decision-making. These findings are discussed in relation to patient education, partnership building and shared decision-making as recommended in NICE guidelines.

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