scholarly journals Comparative investigation of the Diabetic foot ulcer microbiome

2021 ◽  
Author(s):  
Amr T. M. Saeb ◽  
Hamsa T. Tayeb ◽  
Samir Ouizi ◽  
Majed S. Nassar ◽  
Assim Alfadda ◽  
...  

AbstractBackgroundMany factors may affect wound healing in Diabetic foot ulcer, namely, microbial density, microorganisms, microbial synergy, the host immune response, and infected tissue quality.MethodologyThis study used a cross-sectional design. We assessed 38 Subjects with DFUs, 23 neuroischaimic, and 15 neuropathic, for microbiota colonizing the DFU utilizing traditional cultures and 16S gene sequencing methods. All the relevant clinical factors were collected. Wound swabs were collected for both traditional microbiological analysis, direct swab (DSM), and cultured (CM) microbiome analysis. DNA isolation, and 16SrRNA hypervariable regions were amplified. Bioinformatics analysis was performed using IonReporter Software, statistical analysis, and diversity indices were computed with vegan R-package.ResultsThe traditional microbiological method was able to detect a maximum of one or two pathogens, and, in some cases, no pathogen was detected. The total number of the observed species was 176. The number of identified species was higher in the cultured microbiome (155) than the direct swab microbiome (136). Diversity analysis indicated that biological diversity is higher in the cultured microbiome compared with the DSM. The Shannon H index was 2.75 for the cultured microbiome and 2.63 for DSM. We observed some differences in the major bacterial taxa amongst neuroischaimic and neuropathic DFU microbiomes.ConclusionsCultured microbiome is superior to both the traditional method and direct swab microbiome. The Neuroischaimic group showed higher values for the tested diversity indices than the Neuroischaimic group. Neither Cluster Analysis nor Principal Component Analysis showed apparent clustering amongst the two types of ulcers.

2020 ◽  
Vol 16 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Mutasem Ababneh ◽  
Mousab Y. Al Ayed ◽  
Asirvatham A. Robert ◽  
Mohamed A. Al Dawish

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018. Materials and Methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients’ medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the “χ2” test. Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI. Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.


2020 ◽  
Vol 15 ◽  
pp. 117727192095482
Author(s):  
Ignacio I Álvarez-Rodríguez ◽  
Eduardo Castaño-Tostado ◽  
David G García-Gutiérrez ◽  
Rosalía Reynoso-Camacho ◽  
Juana E Elton-Puente ◽  
...  

Diabetic foot ulcer (DFU) is a common complication of type 2 diabetes mellitus (T2DM) characterized by ulcer formation, which can lead to the amputation of lower extremities. However, the metabolic alterations related to this complication are not completely elucidated. Therefore, we carried out a metabolomic analysis of serum samples obtained from T2DM adult patients diagnosed with diabetic foot ulcer in a cross-sectional, observational, and comparative study. Eighty-four volunteers were classified into the following groups: without T2DM (control group, n = 30) and with T2DM and different stages of diabetic foot ulcer according to Wagner-Meggitt classification system: DFU G0 (n = 11), DFU G1 (n = 14), DFU G2 (n = 16), and DFU G3 (n = 13). The non-target metabolomic profile followed by chemometric analysis revealed that lysophosphatidylethanolamine (16:1) could be proposed as key metabolite related to the onset of diabetic foot ulcer; however, this phospholipid was not affected by diabetic foot ulcer progression. Therefore, further studies are necessary to validate these phospholipids as biomarker candidates for the early diagnosis of diabetic foot ulcer in T2DM patients.


2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.


Author(s):  
Uiara Aline de Oliveira Kaizer ◽  
Neusa Maria Costa Alexandre ◽  
Maria Helena de Melo Lima ◽  
Roberta Cunha Matheus Rodrigues ◽  
Marilia Estêvam Cornélio ◽  
...  

Objective: to presenting the linguistic validation of the Diabetic Foot Ulcer Scale Short-Form (DFS-SF) among patients with ulcer diabetic foot (DFU) to Brazilian Portuguese and evaluate its content, practicability and acceptability.Methods and casuistry: a cross-sectional, methodological research, was conducted among 30 outpatients in follow-up for DF, assessed regarding QoL, sociodemographic and clinical data. International recommendations provided bythe Mapi Research Trust on adaptation procedures were followed: the stages of Forward translation, Backward translation and the Cognitive interview were carried out. The Content Validity Index was calculated and a pre-test were gathered to produce a pre-final version. Practicability and acceptability were also assessed. Results: the semantic, idiomatic, cultural and conceptual equivalences between the linguistic validated and the original version were obtained.The DFS-SF was practical, well accepted and easy to understand. Conclusion: the linguistic validation process of the Brazilian version of the DFS-SF has been completed in accordance with internationally recommended standards.The instrument was easy to apply, to understand and presented short time for administration.


2020 ◽  
Vol 14 (2) ◽  
pp. 197-205
Author(s):  
Putri Puspitasari

Pendahuluan : Diabetic Foot Ulcer (DFU) merupakan komplikasi jangka panjang yang umum ditemukan pada pasien Diabetes Mellitus (DM). Penurunan kualitas kesehatan, proses penyembuhan yang lambat, ancaman amputasi, serta ancaman kematian berdampak terhadap keadaan psikologis yang buruk bagi penderita DFU. Keadaan emosi yang mungkin timbul pada pasien dengan penyakit kronis seperti DFU adalah perasaan chronic sorrow dan Quality Of Life yang kurang baik. Tujuan dari penelitian ini adalah melihat keadaan chronic sorrow dan quality of life pada pasien dengan DFU serta secara spesifik melihat hubungan antara chronic sorrow dengan quality of life pasien dengan DFU Metode Penelitian: Penelitian ini merupakan jenis penelitian kuantitatif dengan desain analytic correlative dan rancangan penelitian menggunakan pendekatan cross sectional study. Tujuan penelitian ialah untuk menganalisis hubungan antara chronic sorrow dan kualitas hidup pada pasien dengan DFU. Sampel penelitian adalag 46 Responden. Hasil dan kesimpulan: hasil penelitian menunjukan dari 46 responden 29 (63,04 %) mengalami keadaan chronic sorrow dan diantara 46 responden 27 (58,7 %) mengalami keadaan kualitas hidup yang kurang baik. Responden yang mengalami chronic sorrow memiliki kualitas hidup yang kurang baik sebesar 78,13 % dan kualitas hidup yang baik sebesar 21,87 % dengan p= 0,000 lebih kecil dari α= 0,05, yang dapat diartikan bahwa terdapat hubungan bermakna antara keadaan chronic sorrow dan quality of life.


Author(s):  
Sari Hari Yani .

Latar Belakang : Beberapa faktor yang berhubungan dengan terjadinyakecemasan pada pasien diabetic foot ulcer yaitu usia, jenis kelamin, dukungankeluarga, status ekonomi dan kondisi lingkungan. Hal ini sesuai dengan data padapasien Klinik Kitamura Pontianak bahwa setiap bulannya jumlah pasien diabeticfoot ulcer mengalami peningkatan, terdapat 12 orang pasien (60%) dari 20 pasienyang diobservasi. Ini bertujuan untuk mengidentifikasi faktor mana yang lebihdominan yang menyebabkan terjadinya kecemasan pada pasien dengan diabeticcfoot ulcer.Tujuan : Untuk mengetahui faktor yang mempengaruhi tingkat kecemasan padapasien diabetic foot ulcer di Klinik Kitamura Pontianak.Metode : Penelitian kuantitatif secara observasional dengan bersifat deskriptifanalitik dengan pendekatan cross sectional jumlah sampel 52 dengan uji statistikchi-square.Hasil : Setelah menganalisa faktor-faktor tingkat kecemasan pada pasien diabeticfood ulcer tidak ada hubungan Usia dengan nilai p= 0,262 Jenis kelamin dengannilai p=0,054 status ekonomi dengan nilai p= 0,812 dukungan keluarga dengan nilai p= 0,262 kondisi lingkungan dengan nilai p=0,335.Kesimpulan : Tidak ada hubungan usia, jenis kelamin, dukungan keluarga, statusekonomi, dan kondisi lingkungan pada pasien diabetic foot ulcer di KlinikKitamura Pontianak. Kata Kunci : Faktor-Faktor Kecemaan, Diabetic Foot UlcerReferensi : 2007-2017


2020 ◽  
Vol 4 (1) ◽  
pp. 8
Author(s):  
Manik Elisa Putri

ABSTRAKLatar Belakang : Quality of Life (QoL) atau Kualitas hidup pasien dengan ulkus kakik diabetes melitus lebih buruk, daripada pasien dengan Diabetes Melitus (DM) tanpa ulkus kaki dalam populasi umum. Tujuan dari penelitian ini adalah untuk mengetahui gambaran Quality of Life (Kualitas hidup) pada pasien dengan ulkus kaki diabetes melitus (Diabetic Foot Ulcer / DFU) di Bali.Metode : Desain deskriptif dengan pendekatan cross sectional. Teknik sampel direkrut menggunakan convenience sampling yang melibatkan pasien dengan ulkus kaki diabetes melitus (Diabetic Foot Ulcer / DFU) dengan total sampel yang melibatkan 201 orang responden. yang dilakukan di ruangan department rawat jalan bedah Rumah Sakit Wangaya serta klinik perawatan luka di Bali Indonesia. Data dikumpulkan menggunakan kuesioner Diabetic Foot Ulcer Scale-Short Form (DFS-SF) dan Independent t-test digunakan untuk memahami gambaran kualitas hidup antara perempuan dan laki-laki dengan DFU. Penelitian ini sudah mendapatkan ijin etik oleh komite etik Universitas Udayana.Hasil : Karakteristik responden perempuan (n= 103; 51.2%), dan laki-laki (n= 98; 48.8%). Kualitas hidup sebagian besar memiliki kualitas hidup rendah yang buruk yaitu (<50)(n=133; 66.2%), dan kualitas hidup yang lebih baik yaitu (> 50)[n=68; 33.8%]. Skor rata-rata kualitas hidup pada pasien dengan DFU 42.4±15.5.Kesimpulan: Laki-laki dan perempuan pada pasien dengan ulkus kaki diabetes melitus menunjukkan kualitas hidup perempuan lebih rendah daripada laki-laki dengan diabetes melitus (DFU). Keluarga diharapkan tetap memotivasi dan mendukung pasien agar dapat berpartisipasi dalam aktivitas keagamaan atau kegiatan positif lainnya. Berdasarkan hasil penelitian yang telah didapat, Pasien dengan ulkus kaki diabetes melitus, baik laki-laki maupun perempuan merupakan suatu hal yang perlu kita perhatikan.  Kata Kunci : Ulkus Kakik Diabetes Mellitus, Jenis kelamin, dan Kualitas Hidup  ABSTRACTBackground: Quality of Life (QoL) or Quality of Life of patients with diabetic ulcer diabetes is worse, than patients with Diabetes Mellitus (DM) without foot ulcers in the general population. The purpose of this study was to study the description of Quality of Life (quality of life) in patients with Diabetic Foot Ulcer (DFU) in Bali. Methods: Descriptive design by discussing cross sectional. Sampling techniques were recruited using convenience sampling involving diabetic foot ulcer patients with diabetes mellitus (DFU) with a total sample involving 201 respondents. Performed in the Wangaya Hospital surgical outpatient room and wound care in Bali Indonesia. Data were collected using a Diabetic Foot Ulcer Scale-Short Form (DFS-SF) questionnaire and Independent t-test was used to collect assessments of quality of life between women and men with DFU. Udayana University Ethics Committee.Results: Characteristics of female respondents (n = 103; 51.2%), and male (n = 98; 48.8%). Quality of life mostly has a low quality of life that is poor (<50) [n = 133; 66.2%], and a better quality of life (> 50) [n = 68; 33.8%]. The mean score of quality of life was 42.4±15.5. Conclusion: Male and female patients with diabetes mellitus foot ulcers show a lower quality of life for women than men with diabetes mellitus (DFU). Families are expected to continue to motivate and support patients to participate in religious activities or other positive activities.Keywords: diabetic foot ulcer, gender, and quality of life


2019 ◽  
Vol 34 (1) ◽  
pp. 52-57
Author(s):  
AL Gaddafi ◽  
DK Das ◽  
G Faruque ◽  
Z Islam ◽  
MA Rahman ◽  
...  

A descriptive type of cross sectional study among 210 diabetic patients with foot ulcer was carried out in Diabetic Association Medical College during the period of May 2016 to April 2017 and were categorized based on Meggitt-Wagner system to find out the complications, management, below knee amputation rate and mortality rate. The aim of this study was to practise a profile of diabetic foot ulcer (DFU), complications and its management to assess the outcome of the surgical interventions. Majority of the patients were male 112(53%), and most of them 116 patients (55.23%) presented within Wegner grade - 2 and grade-3 diabetic foot ulcers. The duration of diabetes more than 10 years was 116 (55%). 99 (47%) patients out of 210 patients developed diabetic neuropathy. 76 (36%) patients presented with CKD. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center, associated habit of smoking are all factors which lead to incidence of DFU at an earlier age than that seen in other studies. After admission of diabetic foot ulcer patients, diabetic foot ulcer is classified according to Wagner grading and treated the diabetic foot ulcer patients as the using protocol ’!1.Assesment whether it was conservative or surgical. 2. Optimal blood sugar control. 3. Systemic antibiotic. 4. Moist wound environment. 5. Offloading such as total contact casting. 6. Improves peripheral arterial circulation due to lack of vascularity. 7. Surgical debridement or minor amputation or major amputation. In case of G-4 or G-5 patients, ischemia was treated before debridement or amputation so that vascular circulation improved in the ulcer area and then healing potential was fastened. Bangladesh Heart Journal 2019; 34(1) : 52-57


2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Daba Abdissa ◽  
Tesfaye Adugna ◽  
Urge Gerema ◽  
Diriba Dereje

Background. Diabetic foot ulceration is a devastating complication of diabetes mellitus and is a major source of morbidity and mortality. So far, there are few published data on diabetic foot ulcers and its determinants among diabetic patients on follow-up at Jimma Medical Center. Hence, the aim of this study was to assess the prevalence of diabetic foot ulcer and its determinants among patients with diabetes mellitus at Jimma Medical Center. Methods. A hospital-based cross-sectional study was conducted from June 1 to August 30, 2019, and systematic random sampling technique was applied. The total number of study subjects who participated in the study was 277. Data were collected using an interview-administered structured questionnaire. Data were entered into EpiData version 3.1 and exported to SPSS version 20 software for analysis. Analysis was done using descriptive statistics and logistic regression. A variable having a p value of <0.25 in the bivariate model was subjected to multivariate analysis to avoid confounding the variable’s effect. Adjusted odds ratios (AOR) were calculated at 95% confidence interval and considered significant with a p value of ≤0.05. Result. The mean of age of participants was 50.1±14.19 years. More than three-fourths of participants (82.7%) were type 2 DM. The mean duration of diabetic patients was 6.00±5.07 years. The prevalence of diabetic foot ulcer was 11.6% among study participants. According to multivariate logistic regression analysis, previous history of ulceration (AOR=5.77; 95% CI: 2.37, 14.0) and peripheral neuropathy (AOR=11.2; 95% CI: 2.8, 44.4) were independent predictors of diabetic foot ulcer. Conclusion. The prevalence of diabetic foot ulcer was 11.6%. Previous history of ulceration and peripheral neuropathy were associated with diabetic foot ulcer. The health care providers are recommended to thoroughly give emphasis during follow-up of patients who had previous history of ulceration and peripheral neuropathy in order to decrease the occurrence of diabetic foot ulcer.


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