scholarly journals Wound Bed Preparation for Chronic Diabetic Foot Ulcers

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Arman Zaharil Mat Saad ◽  
Teng Lye Khoo ◽  
Ahmad Sukari Halim
Keyword(s):  
Diabetic Foot ◽  
Management Strategies ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcers ◽  
Holistic Approaches ◽  
Practice Of Medicine ◽  
Moisture Balance ◽  
Infection And Inflammation ◽  
Wound Bed Preparation

The escalating incidence of diabetic mellitus has given rise to the increasing problems of chronic diabetic ulcers that confront the practice of medicine. Peripheral vascular disease, neuropathy, and infection contribute to the multifactorial pathogenesis of diabetic ulcers. Approaches to the management of diabetic ulcers should start with an assessment and optimization of the patient’s general conditions, followed by considerations of the local and regional factors. This paper aims to address the management strategies for wound bed preparation in chronic diabetic foot ulcers and also emphasizes the importance of preventive measures and future directions. The “TIME” framework in wound bed preparation encompasses tissue management, inflammation and infection control, moisture balance, and epithelial (edge) advancement. Tissue management aims to remove the necrotic tissue burden via various methods of debridement. Infection and inflammation control restores bacterial balance with the reduction of bacterial biofilms. Achieving a moist wound healing environment without excessive wound moisture or dryness will result in moisture balance. Epithelial advancement is promoted via removing the physical and biochemical barriers for migration of epithelium from wound edges. These systematic and holistic approaches will potentiate the healing abilities of the chronic diabetic ulcers, including those that are recalcitrant.

scholarly journals Wound bed preparation with NPWT in diabetic foot ulcers: case report

2010 ◽  
Vol 10 (S1) ◽  
Author(s):  
V Padovano Sorrentino ◽  
A Della Corte ◽  
F Campitiello ◽  
F Freda ◽  
P Petronella ◽  
...  
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Bed Preparation

scholarly journals Effect of Health Education on Improving the Knowledge among Diabetes Mellitus Patients in the Prevention of Diabetic Ulcer in Regional Hospital of Tidore Island

2021 ◽  
Vol 4 (4) ◽  
pp. 379-384
Author(s):  
Haeril Amir ◽  
Nur Wahyuni Munir
Keyword(s):  
Diabetes Mellitus ◽  
Health Education ◽  
Diabetic Foot ◽  
Regional Hospital ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers

International  Diabetes  Federation  (IDF) reported that the number of diabetes mellitus patients worldwide increases every year. Diabetes mellitus is a chronic disease due to damage to the pancreas in producing enough insulin and characterized by impaired metabolism of fats, increased blood sugar, carbohydrates and protein both absolutely and relatively. Diabetic foot ulcers (DFU) are among the most common complications in diabetic patients and are associated with high mortality, morbidity, and health costs.   This study was to determine the effect of health education on knowledge improvement about diabetic ulcers in the regional hospital of Tidore Islands.  This research is a quasi-experimental type with a pretest-posttest without a control group design. The research sample consisted of 30 respondents who met the inclusion criteria. Data were analyzed using a paired test and processed with statistic version 21. Based on the research results, there was an improved knowledge in pre and post-health education counseling, where the average score before health education counseling was 11.6. After health counseling, the average value was 15.0. The results showed the effect of knowledge in the prevention of diabetic ulcers with a p-value =0,000.  Health education is an effort to improve patient's ability to prevent diabetic foot ulcers that have been proven in several scientific studies. Health education methods provide additional information so that patients who previously wondered about their disease can directly ask health workers. Health education affects the knowledge improvement of Diabetes Mellitus patients in the Regional hospital of Tidore Islands  

scholarly journals A clinicopathogical study on diabetic foot ulcer with special reference to the causative factors and its management

2019 ◽  
Vol 6 (5) ◽  
pp. 1540
Author(s):  
Sailendranath Paul ◽  
Dilip Kumar Das
Keyword(s):  
Diabetic Foot ◽  
Age Of Onset ◽  
Management Strategies ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
E Coli ◽  
Related Risk

Background: Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. The present study was done to identify the incidence and related risk factors of diabetic foot ulcers in study participants.Methods: This was a prospective done on 50 patients with diabetic foot ulcers. All the patients were examined thoroughly and related laboratory investigations were done. Wound culture and sensitivity was done in all cases.Results: Mean age of onset with foot ulcers was 53.5 yrs in male and 55 yrs in females. Nephropathy was present in 12 (24%) patients. Sensorimotor neuropathy was present in 29 (58%) cases and autonomic neuropathy was present in 06 (12%) cases. Most common infection identified in diabetic foot ulcers was due to gram-negative bacteria (E. coli in 45 cases). Major amputation was done in 2 (4%) patients.Conclusions: Implementation of management strategies at early stages prevents the development of complications related to diabetic foot ulcers in patients. 

Preferred Offloading Modalities for Management of Diabetic Foot Ulcers in Private Clinical Settings: A Survey of Australian Podiatrists

2021 ◽  
Author(s):  
Adriaan Erasmus ◽  
Michael Melek ◽  
Malia Ho
Keyword(s):  
Diabetic Foot ◽  
Online Survey ◽  
Management Strategies ◽  
Ease Of Use ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Therapeutic Footwear ◽  
Human Research Ethics ◽  
Protective Sensation ◽  
Loss Of Protective Sensation

Abstract Background Diabetic peripheral neuropathy is a common complication of diabetes mellitus. Neuropathy predisposes patients to diabetic foot ulcers (DFU) due to the loss of protective sensation and associated deformities. Management of foot ulcers are multifactorial, but pressure offloading can be considered as one of the most important aspects of management. According to IWGDF Guidelines, non-removable knee-high offloading devices are recommended as the 1st line of treatment for these ulcers. However, this is a very underutilised treatment modality. This study aimed to evaluate the practitioner preferred offloading modalities and reasons for their preference. Methods This project was approved by the university’s human research ethics committee. An online survey was distributed amongst Australian podiatrist via an industry related social media group. The survey collected simple demographical information, management strategies, preferred offloading modalities for the management of diabetic foot ulcers and reasons for their preferred method. Results Sixty-three podiatrists completed the survey with the majority practicing in private clinics. All practitioners treat diabetic foot ulcers regularly with most participants treating up to ten ulcer cases per week and 14% of participants treating more than 20 ulcers per week. Contrary to the IWGDF guidelines, standard therapeutic footwear was the most preferred method of management for the treatment of diabetic foot ulcers, with ease of use reported as the main reason for practitioners using this modality. Non-compliance to the use of non-removable knee-high offloading devices include perceived patient non-compliance and poor tolerance. Conclusion This study shows that practitioners’ offloading strategies do not adhere to the IWGDF guidelines. The reasons for not adhering to the guidelines seems to be a clinical practicality rather than evidence-based practice. Reasons for choosing a management strategy is multi-factorial (not just reducing plantar pressures). Further studies may be required to evaluate the effectiveness of therapeutic footwear in ulcer healing, taking into consideration other factors such as practitioner and patient preference, clinical practicality, and access to support. Based on the findings, this study provides suggestions on how to overcome the barriers that prevent podiatrist from adhering to the recommendations of the IWGDF when selecting offloading devices in general clinical practice.

scholarly journals A Comparative Study between the Use of Negative Pressure Wound Therapy and Silver-Releasing Foam Dressings in the Management of Diabetic Ulcers

2021 ◽  
Author(s):  
George Taliat ◽  
Clement D’Souza
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Treatment Modalities ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Therapy ◽  
Diabetic Ulcers ◽  
Surgical Department

Abstract Introduction Diabetic foot ulcers are one among the most commonly encountered complication of diabetes mellitus tackled by the surgical department worldwide. Negative pressure wound therapy (NPWT) and silver-releasing foam dressings are effective modalities for the treatment of ulcers. This study compares the two treatment modalities. Methods Sixty adult patients admitted with diabetic foot ulcers undergoing NPWT (vacuum-assisted closure [VAC]) or silver-releasing foam dressing (Biatain Ag) treatment were included in the study. Patients undergoing either of the treatment modalities were observed and followed up on a weekly basis prospectively. Wounds were routinely examined for the size of ulcer in area (cm2) and time taken for wound healing. Patients were also assessed qualitatively by means of a questionnaire to find out patient satisfaction and compliance. Results Time taken for wound healing among Biatain Ag group was found to be 24±9.483 days compared with only 19.73±7.575 days in the VAC group. Decrease in size ulcer measured in area was found to be 38.79% in Biatain Ag group, whereas in the VAC group it was found to be 26.56%. Patients were satisfied with both modalities of treatment; however, patient compliance was better for the Biatain Ag Group due to decrease in restriction of mobility and decrease in cost. Conclusion Overall, both modalities of treatment were found to be comparable and can be used with similar efficacy. It can be concluded that silver-releasing foam dressing can act as a beneficial alternative to NPWT in the treatment of diabetic ulcers.

scholarly journals Fungal Infection: A Hidden Enemy in Diabetic Foot Ulcers

2015 ◽  
Vol 2 (2) ◽  
pp. 74-76
Author(s):  
Saravanan Sanniyasi ◽  
Jagan Balu ◽  
Cunnigaiper Dhanasekharan Narayanan
Keyword(s):  
Antibiotic Therapy ◽  
Fungal Infection ◽  
Antifungal Therapy ◽  
Diabetic Foot ◽  
Fungal Infections ◽  
Asia Pacific ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcers ◽  
Fungal Stain

ABSTRACT Diabetic foot ulcers are on the rise and increasingly associated with amputations. Fungal infections have recently been implicated in the nonhealing nature of these wounds. One hundred five patients treated as in-patients with nonhealing diabetic ulcers in a tertiary care hospital were included in this prospective study. Wound swabs and deep tissue biopsies were taken from these ulcers for fungal stain and culture and bacterial culture. Once the fungal stain or the culture study is positive, oral Fluconazole was started. Nineteen patients grew fungus in the ulcer, commonest species being Candida tropicalis (10.5%). The most common bacterial organism isolated with fungal infection is Pseudomonas followed by Enterococcus. Patients on prolonged antibiotic therapy showed statistically significant increase in fungal infection. Patients who underwent amputation within 15 days of admission were higher in fungal culture positive group, due to progression of ulcer in spite of antibiotic therapy. There is a definite correlation between incidence of amputation and fungal infection in whom antifungal therapy was not started, though not statistically significant. Fourteen patients, who did not undergo amputation, had faster wound healing and lesser progression of disease, with none of them requiring amputation after initiating antifungal therapy. Our study reveals that there is a definite relation between fungal infections and nonhealing nature of diabetic ulcers. Further randomized trials are necessary to substantiate this finding. How to cite this article Sanniyasi S, Balu J, Narayanan CD. Fungal Infection: A Hidden Enemy in Diabetic Foot Ulcers. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):74-76.

scholarly journals A randomized controlled trial comparing low cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers

2017 ◽  
Vol 4 (12) ◽  
pp. 3858
Author(s):  
Caren Dsouza ◽  
. Rouchelle ◽  
. Chirag ◽  
Erel Diaz ◽  
Shubha Rao
Keyword(s):  
Randomized Controlled Trial ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Low Cost ◽  
Controlled Trial ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vac Therapy ◽  
Randomized Controlled ◽  
Wound Bed Preparation

Background: Diabetic foot ulcers are chronic wounds which are difficult to heal, due to ischemia and intrinsic defects in angiogenesis and impaired immunity against infection. VAC therapy influences positive mechanical forces on the growth of tissues, especially in stimulating cell migration and mitosis, optimizes blood flow, decreases local tissue edema from the wound bed and provides an occlusive environment for wound healing under moist, clean and sterile conditions. Aims and objective was to compare the effectiveness of low cost hospital made VAC dressing with conventional dressings in healing of diabetic foot ulcers.Methods: This study was a prospective, randomized controlled trial and included 60 patients with diabetic foot ulcers admitted over 3 months. Patients were randomly allocated to two groups: odd numbered patients to VAC therapy and the even numbered patients to conventional dressings. Wound swab was taken before the start of the study. The data was analyzed and presented in percentages or proportions using Chi-square test and Student-t-test wherever applicable. Results: In this study it was found that in the VAC dressing group 76.7% of the ulcers had red granulation tissue at the end of therapy compared to 46.7% in conventional group. The mean wound bed preparation time was found to be 15.60 days in the conventional dressing group and 8.50 days in the VAC therapy group. In the VAC group 72.73% ulcers had no bacteria at the end of therapy.Conclusion: In this study, it was found that Vacuum Assisted Closure therapy was more effective than conventional dressings in the wound bed preparation of diabetic foot ulcers.

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