scholarly journals CODIFI (Concordance in Diabetic Foot Ulcer Infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019437 ◽  
Author(s):  
Andrea Nelson ◽  
Alexandra Wright-Hughes ◽  
Michael Ross Backhouse ◽  
Benjamin A Lipsky ◽  
Jane Nixon ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tissue Samples ◽  
Additional Information ◽  
Wound Swab

ObjectiveTo determine the extent of agreement and patterns of disagreement between wound swab and tissue samples in patients with an infected diabetic foot ulcer (DFU).DesignMulticentre, prospective, cross-sectional study.SettingPrimary and secondary care foot ulcer/diabetic outpatient clinics and hospital wards across England.ParticipantsInclusion criteria: consenting patients aged ≥18 years; diabetes mellitus; suspected infected DFU. Exclusion criteria: clinically inappropriate to take either sample.InterventionsWound swab obtained using Levine’s technique; tissue samples collected using a sterile dermal curette or scalpel.Outcome measuresCoprimary: reported presence, and number, of pathogens per sample; prevalence of resistance to antimicrobials among likely pathogens. Secondary: recommended change in antibiotic therapy based on blinded clinical review; adverse events; sampling costs.Results400 consenting patients (79% male) from 25 centres.Most prevalent reported pathogens wereStaphylococcus aureus(43.8%),Streptococcus(16.7%) and other aerobic Gram-positive cocci (70.6%). At least one potential pathogen was reported from 70.1% of wound swab and 86.1% of tissue samples. Pathogen results differed between sampling methods in 58% of patients, with more pathogens and fewer contaminants reported from tissue specimens.The majority of pathogens were reported significantly more frequently in tissue than wound swab samples (P<0.01), with equal disagreement forS. aureusandPseudomonas aeruginosa.Blinded clinicians more often recommended a change in antibiotic regimen based on tissue compared with wound swab results (increase of 8.9%, 95% CI 2.65% to 15.3%). Ulcer pain and bleeding occurred more often after tissue collection versus wound swabs (pain: 9.3%, 1.3%; bleeding: 6.8%, 1.5%, respectively).ConclusionReports of tissue samples more frequently identified pathogens, and less frequently identified non-pathogens compared with wound swab samples. Blinded clinicians more often recommended changes in antibiotic therapy based on tissue compared with wound swab specimens. Further research is needed to determine the effect of the additional information provided by tissue samples.Trial registration numberISRCTN52608451.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

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.

scholarly journals Chronic Sorrow Dan Quality Of Life Pada Pasien Dengan Diabetic Foot Ulcer (DFU)

2020 ◽  
Vol 14 (2) ◽  
pp. 197-205
Author(s):  
Putri Puspitasari
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Chronic Sorrow ◽  
Sectional Study ◽  
Cross Sectional

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.

scholarly journals Relationship between Wound Severity, Discomfort, and Psychological Problems in Patients with a Diabetic Foot Ulcer in Indonesia: A Cross-sectional Study

Aquichan ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 1-10
Author(s):  
Dewi Gayatri ◽  
Elly Nurachmah ◽  
Muchtaruddin Mansyur ◽  
Pradana Soewondo ◽  
Suriadi Suriadi
Keyword(s):  
Diabetic Foot ◽  
Assessment Tool ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Psychological Problems ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Burden ◽  
The Relationship

Objectives: The purpose of this study is to identify the relationship between wound severity, discomfort, and psychological problems in patients with a diabetic foot ulcer in Indonesia. Methods: A cross-sectional study is conducted in three general hospitals and one clinic in Indonesia. The Bates-Jensen wound assessment tool (BWAT), the discomfort evaluation of wound instrument (DEWI), and the depression, anxiety, and stress scale (DASS) are used to measure the variables of interest. Path analysis is performed to evaluate the association between wound severity, discomfort, and psychological problems. Results: Of 140 patients with diabetic foot ulcers who joined this study, the majority experienced immobilization (74.3 %), pain (69.3 %), and sleep disturbance (63.6 %). The means were as follows: discomfort (2.35 ± 0.33), depression (1.34 ± 0.41), stress (1.49 ± 0.48), anxiety (1.43 ± 0.40), and wound severity (31.35 ± 9.96). Discomfort partially mediated the relationship between wound severity and psychological problems, which indirect effect was 0.11. Conclusion: High prevalence of discomfort, both physical and psychological, was found in patients with a diabetic foot ulcer. Discomfort mediates the relationship between wound severity and psychological problems. Integrating comfort into wound care management may help to reduce the psychological burden.

scholarly journals Risk of diabetic foot ulcer and its associated factors among Bangladeshi subjects: a multicentric cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034058 ◽  
Author(s):  
Palash Chandra Banik ◽  
Lingkan Barua ◽  
Mohammad Moniruzzaman ◽  
Rajib Mondal ◽  
Farhana Zaman ◽  
...  
Keyword(s):  
At Risk ◽  
Diabetic Foot ◽  
Associated Factors ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group 1

ObjectiveTo assess the risk of diabetic foot ulcer (DFU) and find out its associated factors among subjects with type 2 diabetes (T2D) of Bangladesh.Design, setting and participantsThis cross-sectional study recruited 1200 subjects with T2D who visited 16 centres of Health Care Development Project run by Diabetic Association of Bangladesh.Primary and secondary outcome measuresRisk of DFU was assessed using a modified version of International Working Group on the Diabetic Foot (IWGDF) Risk Classification System. The modified system was based on five parameters, namely peripheral neuropathy (PN), peripheral arterial diseases (PAD), deformity, ulcer history and amputation. The risks were categorised as group 0 (no PN, no PAD), group 1 (PN, no PAD and no deformity), group 2A (PN and deformity, no PAD), group 2B (PAD), group 3A (ulcer history) and group 3B (amputation). The associated factors of DFU risk were determined using multinomial logistic regression for each risk category separately.ResultsOverall, 44.5% of the subjects were found ‘at risk’ of DFU. This risk was higher among men (45.6%) than women and among those who lived in rural areas (45.5%) as compared with the urban population. According to IWGDF categories, the risk was distributed as 55.5%, 4.2%, 11.6%, 0.3%, 20.6% and 7.9% for group 0, group 1, group 2A, group 2B, group 3A and group 3B, respectively. The associated factors of DFU (OR >1) were age ≥50 years, rural area, low economic status, insulin use, history of trauma, diabetic retinopathy and diabetic nephropathy.ConclusionA significant number of the subjects with T2D under study were at risk of DFU, which demands an effective screening programme to reduce DFU-related morbidity and mortality.

Prevalence of Diabetic Foot Ulcer in Lahore, Pakistan: A Cross Sectional Study

2020 ◽  
pp. 34-38
Author(s):  
OJS Admin
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Insulin Action ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inborn Errors ◽  
Cross Sectional ◽  
Prevalence Of Diabetes Mellitus

Diabetes Mellitus is one of the largest universal st health emergencies of the 21 century. Diabetes is a group of inborn errors of metabolism which results from either defect in insulin or insulin action or both. Now a days, prevalence of diabetes mellitus is increasing worldwide, especially young and fat people are affected by this disease. Diabetic Foot Ulcer (DFU) is a longlasting diabetes syndrome and one of the most popular and dreaded issue of DM.

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