Role of growth factors and cytokines in diabetic foot ulcer healing: A detailed review

Nanocrystalline silver (nAg) and Manuka honey (MH) dressing have increasing popularity for treating diabetic foot ulcer (DFU). This study was an open-label randomized controlled trial with three parallel groups’ design in examining the preliminary effectiveness of nAg against MH and conventional dressing in healing DFU in terms of ulcer healing, ulcer infection, and inflammation. 31 participants (11 in the nAg group, 10 in the MH group, and 10 in the convention group) diagnosed with type 2 diabetes were enrolled. Wound cleaning, debridement, and topical dressing application were performed according to the group allocation in each visit at weeks 1, 2, 3, 4, 6, 8, 10, and 12. The results found that the proportions of complete ulcer healing were 81.8%, 50%, and 40% in the nAg, MH, and conventional groups, respectively. The ulcer size reduction rate was potentially higher in the nAg group (97.45%) than the MH group (86.21%) and the conventional group (75.17%). In bacteriology, nAg showed a greater rate of microorganism reduction although it was not significant. To conclude, nAg alginate was potentially superior to MH and conventional dressing in healing diabetic foot ulcer in terms of ulcer size reduction rate.

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Continuous diffusion of oxygen improves diabetic foot ulcer healing when compared with a placebo control: a randomised, double-blind, multicentre study

Journal of Wound Care ◽

10.12968/jowc.2018.27.sup9.s30 ◽

2018 ◽

Vol 27 (Sup9) ◽

pp. S30-S45 ◽

Cited By ~ 19

Author(s):

Mark Q. Niederauer ◽

Joel E. Michalek ◽

Qianqian Liu ◽

Klearchos K. Papas ◽

Lawrence A. Lavery ◽

...

Keyword(s):

Multicentre Study ◽

Ulcer Healing ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Placebo Control ◽

Double Blind

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Efficacy of Cellular Therapy for Diabetic Foot Ulcer

Cell Transplantation ◽

10.1177/0963689717738013 ◽

2017 ◽

Vol 26 (12) ◽

pp. 1931-1939 ◽

Cited By ~ 8

Author(s):

Ye Zhang ◽

Hong Deng ◽

Zhouping Tang

Keyword(s):

Ulcer Healing ◽

Diabetic Foot ◽

Cellular Therapy ◽

Meta Analysis ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Mean Difference ◽

Cochrane Library ◽

Transcutaneous Oxygen ◽

Randomized Controlled

Diabetes mellitus is a widely spread chronic disease with growing incidence worldwide, and diabetic foot ulcer is one of the most serious complications of diabetes. Cellular therapy has shown promise in the management of diabetic foot ulcer in many preclinical experiments and clinical researches. Here, we performed a meta-analysis to evaluate the efficacy and safety of cellular therapy in the management of diabetic foot ulcer. We systematically searched PubMed, MEDLINE, EMBASE, and Cochrane Library databases from inception to May 2017 for randomized controlled trials assessing the efficacy of cellular therapy in diabetic foot ulcer, and a meta-analysis was conducted. A total of 6 randomized controlled clinical trials involving 241 individuals were included in this meta-analysis. The results suggested that cellular therapy could help accelerating the healing of diabetic foot ulcer, presented as higher ankle-brachial index (mean difference = 0.17, 95% confidence interval [CI] = 0.11 to 0.23), higher transcutaneous oxygen pressure (standardized mean difference [SMD] = 1.43; 95% CI, 1.09– to 1.78), higher ulcer healing rate (relative risk [RR] = 1.78; 95% CI, 1.41 to 2.25), higher amputation-free survival (RR = 1.25; 95% CI, 1.11 to 1.40), and lower scale of pain (SMD = −1.69; 95% CI, −2.05 to −1.33). Furthermore, cellular therapy seemed to be safe, with no serious complications and low risk of short-term slight complications. Cellular therapy could accelerate the rate of diabetic foot ulcer healing and may be more efficient than standard therapy for diabetic foot treatment.

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Osteomyelitis, diabetic foot ulcers and the role of the community nurse

British Journal of Community Nursing ◽

10.12968/bjcn.2021.26.sup6.s6 ◽

2021 ◽

Vol 26 (Sup6) ◽

pp. S6-S9

Author(s):

Melanie Lumbers

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Holistic Approach ◽

Diabetic Patients ◽

Positive Outcomes ◽

Community Nurse ◽

Complex Needs ◽

Health And Wellbeing

Community nurses face numerous challenges in both diagnosing and effectively treating their patients. The diabetic patient has complex needs requiring a holistic approach. With a reported increase in diabetic patients, and a possible decline in some routine screening following Covid-19 pandemic, complications in diabetic patients are likely to rise. It is estimated that 25% of diabetic patients will develop a diabetic foot ulcer (DFU), with a reported 43% of DFU already infected at first presentation to a health professional. NICE categorise the level of infection in DFU based on standardised assessments such as SINBAD. A high categorised DFU has the possibility of osteomyelitis. It is imperative that osteomyelitis is treated immediately to achieve positive outcomes, benefitting the patients' health and wellbeing in addition to reducing the financial implications to the NHS.

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