scholarly journals Long-term efficient management of diabetic foot ulcer using simultaneous foot ulcer closure and surgical off-loading

JPRAS Open ◽  
2021 ◽  
Author(s):  
Yuta Terabe ◽  
Nobuhito Kaneko ◽  
Keisuke Nakabayashi ◽  
Akihiro Matsui ◽  
Hiroshi Ando
Author(s):  
Bayram Colak ◽  
Serdar Yormaz ◽  
Ilhan Ece ◽  
Akin Çalişir ◽  
Kazım Körez ◽  
...  

Background. Diabetic foot ulcer (DFU) is a difficult, chronic wound with a significant long-term influence on the morbidity, mortality, and quality of life of patients. There is much information about the biochemical features of collagen and its function in wound healing. The aim of this study was to compare the results of DFU patients treated with and without collagen. Methods. A retrospective evaluation was made of the data of patients with DFU who underwent collagen treatment and physiological serum (PS) treatment. The patients were followed-up for a minimum of 12 weeks, and all complications, healing process, and wound characteristics were recorded. Results. Of the total 64 DFU patients included in the study, 30 were treated with PS and 34 with collagen. Complete closure was achieved in 17 (56.6%) of the PS group patients after 12 weeks of treatment. The rate was 25 (73.5%) in the collagen group. The mean duration of treatment was 9.2 weeks (range = 6-12 weeks) in the PS group and 8.08 weeks (range = 5-12 weeks) in the collagen group. The recovery time and recovery rates were determined to be better in the collagen group than in the PS group. Conclusion. A significant reduction in wound size was seen in the collagen group compared with the PS group. The results of this study demonstrated that collagen dressings are better than conventional dressings with regard to early granulation tissue and shorter hospital stay.


2019 ◽  
Vol 28 (9) ◽  
pp. 601-607 ◽  
Author(s):  
Fatma Aybala Altay ◽  
Semanur Kuzi ◽  
Mustafa Altay ◽  
İhsan Ateş ◽  
Yunus Gürbüz ◽  
...  

Objective: To investigate whether the neutrophil-to-lymphocyte ratio (NLR) may be used in the early stage risk assessment and follow-up in diabetic foot infection Methods: Over a five-year study, NLR values on admission and day 14 of treatment were matched with their laboratory and clinical data in a cohort study. Patients were followed-up or consulted in several clinics or polyclinics (infectious diseases). Results: Admission time NLR was higher, in severe cases as indicated by both Wagner and PEDIS infection scores (severe versus mild Wagner score NLR 6.7 versus 4.2; p=0.04; for PEDIS score NLR 6.3 versus 3.6; p=0.03, respectively). In patients who underwent vascular intervention (12.6 versus 4.6; p=0.02); amputation indicated (9.2 versus 4.1; p=0.005) and healed afterwards (6.9 versus 4.3; p<0,001), when matched with others. NLR was also found to be correlated with duration of both IV antibiotic treatment (r=0.374; p=0.005) and hospitalisation (r=0.337; p=0.02). Day 14 NLR was higher in patients who underwent vascular intervention (5.1 versus 2.9; p=0.007) when matched to others. Conclusion: Patients with higher NLR values at admission had more severe diabetic foot infection, higher risk for amputation, need for long-term hospitalisation and aggressive treatment. However, they also have more chance of benefit from treatment.


2021 ◽  
Vol 21 (2) ◽  
pp. 1220-1229
Author(s):  
Lumeng Yang ◽  
Fang Liu ◽  
Yijun Chen ◽  
Zhangyi Liu ◽  
Guowu Zhang

The incidence of diabetes has been increasing year by year. Long-term growth in blood sugar causes complications such as diabetic foot ulcer and infections, which will increase the difficulty of ulcer treatment. The diabetes brings great pain and heavy economic burden to patients and their families. In view of the above problems, a nano-silver antibacterial dressing is synthesized in this paper to control bacterial infection on the ulcer surface and promote wound healing. This paper describes the preparation process and morphological characterization of nano-silver antibacterial dressings. 100 patients were selected, which divided into two groups for comparative experiments. The conventional group used conventional vaseline dressing, and the control group was nano-silver antibacterial dressing. The ulcer surface healing time, the number of dressing changes, and the control of infection were analyzed separately, and statistical analysis was performed with SPSS19.0. The experimental results are as follows. The use of nano-silver antibacterial dressing can significantly reduce the incidence of infection in diabetic foot patients, which is helpful to reduce the number of dressing changes, shorten the healing time of ulcer, and accelerate the turnover rate. It helps to shorten the course of diabetic foot, and it is recommended to promote its clinical application.


Author(s):  
Vasanthi B. ◽  
Ainsy Goldlin T. J.

Background: Diabetes mellitus is a major cause of increased morbidity and mortality in developing countries. Foot ulcer is one of the long term complications of diabetes. Oxidative stress plays a major role in pathogenesis of diabetes mellitus and its long term complications. Impaired wound healing in diabetic individuals is due to ischemia and hypoxia occurring as a consequence of oxidative stress. Vitamin C and E have antioxidant property. This study aims to assess their efficacy in healing of diabetic ulcer. Objective of the study was to evaluate the efficacy of Vitamin C and E in healing diabetic foot ulcer.Methods: 60 adult patients with diabetic foot ulcer were randomized to test and control groups (30 in each). Treatment period was 12 weeks + 4 weeks follow up per patient. After obtaining written informed consent, patients in test group received Vitamin C (500mg BD) and Vitamin E (400mg BD) for 12 weeks along with standard treatment for diabetes and antibiotics for foot ulcer.Results: At the end of 12 weeks, increase in healing of foot ulcer assessed by percent reduction of ulcer area in study group 72.50% than control group 39.67% (p<0.001) was observed. There was a significant reduction of fasting blood glucose, Oxidative stress induced damage to RBCs and BP in the study group compared to control group. No serious adverse effects occurred.Conclusions: Vitamin C and E reverse oxidative stress induced morphological changes in RBCs, improve anemia and increase blood flow to ulcer area. Hence they are highly effective in healing diabetic foot ulcer along with standard therapy. 


Author(s):  
Dr. Devi Das Verma ◽  
Dr. Anil Kumar Saxena

Introduction:  Diabetes is one of the most prevalent metabolic chronic diseases due to the imbalance production of insulin. One of the studies reported that in 2010 worldwide 285 million adults had diabetes and this figure may be increase to 439 million by the year 2030. Globally Diabetic foot ulcers (DFUs) constitute major health problem in people that significantly contribute to morbidity and mortality in diabetes patients. Approximate 1.0% to 4.1% of the annual population-based incidences of a diabetic foot ulcer (DFU) were reported. Due to this the lifetime may be as high as 25%. In Asian countries diabetic foot ulcer are major problems which are different from European countries or developing countries.  From many studies reported diabetic foot problems in India are infectious and neuropathic in nature as compared to developed countries. According to World Health Organization (WHO) diabetic foot is defined as lower limb of a diabetic patient characterized by infection, potential risk of pathologic consequences ulceration or destruction of deep tissues associated with neurological abnormalities, various changes in peripheral neuropathy vasculopathy and superimposed infection that are mainly responsible foot ulceration. Ulcers are one kind of abscess which is difficult to treat because of poor wound healing that result from a combination of neuropathy, ischemia and hyperglycemia.  Aim: The main objective was to study the outcome of treatment modalities and it’s relating factors to complication in diabetic foot ulcer.  Material and method:  Total 60 diabetic foot ulcer patients with the age range from 20 to 70 years were included.  From all the patients’ detailed past and present history were recorded.  For all the patients, general, physical and local and systemic examinations were also done. Detail   laboratory examination like Fasting and Post Prandial Blood sugar levels, blood count, ECG, ESR, complete urine examination for the presence of ketone bodies and sugar, x-ray as well as culture and sensitivity of the discharge from ulcer were also done. Patients were treated with various treatment methods like conservative treatment, split skin grafting and amputation. Result: In this study male patients were more in proportion as compared to female. This study showed that maximum with the age group 14 -50 (43.3%) years old followed by 18.3% in 31-40 years old, 16.7% in 61-70 years old.  6.7% showed the least age group as 20 -30 years old.  Out of total 60 patients, 38.3% of the patients showed diabetic ulcer foot which was more whereas 15% showed diabetic gangrene foot which was least. 25% showed diabetic cellulites foot and 21.7% showed as diabetic abscess foot.  Conclusion: Globally as diabetes mellitus cases are increasing and it became rapidly the public health problem. This may be due to burden on economy, health system and on society to manage the diabetic foot problems. Diabetic foot management guidelines must be made into our practice protocols which may preventing limb loss, and decrease mortality and increase the quality of life of the patient. Hence for this it is only possible with the help of foot care education and health care workers.  Hence, foot infection is to put first and care for it like hands. Keywords: Diabetes, foot ulcers, infections, amputations.


2015 ◽  
Author(s):  
Fakhraddeen Muhammad ◽  
Lateefah Pedro ◽  
Hassan Suleiman ◽  
Enikuomehin Adenike ◽  
Rahila Mukhtar ◽  
...  

2019 ◽  
Author(s):  
Maksym Prystupiuk ◽  
Iuliia Onofriichuk ◽  
Lev Prystupiuk ◽  
Ludmila Naumova ◽  
Marianna Naumova

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