Micronutrients and Natural Compounds Status and Their Effects on Wound Healing in the Diabetic Foot Ulcer

2017 ◽  
Vol 16 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Kanokwan Kulprachakarn ◽  
Sakaewan Ounjaijean ◽  
Jukkrit Wungrath ◽  
Raj Mani ◽  
Kittipan Rerkasem
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Herbal Remedies ◽  
Current Evidence ◽  
Wound Healing Process ◽  
Impaired Wound Healing ◽  
Wide Range

The diabetic foot ulcer (DFU) is an invariably common complication of diabetes mellitus, it is also a significant cause of amputation as well as extended hospitalization. As most patients with DFU suffer from malnutrition, which has been related to improper metabolic micronutrients status, alterations can affect impaired wound healing process. Micronutrients and herbal remedies applications present a wide range of health advantages to patients with DFU. The purpose of this review is to provide current evidence on the potential effect of dietary supplementations such as vitamins A, C, D, E, magnesium, zinc, copper, iron, boron, and such naturally occurring compounds as Aloe vera, Naringin, and Radix Astragali (RA) and Radix Rehmanniae (RR) in the administration of lower extremity wounds, especially in DFU, and to present some insights for applications in the treatment of DFU patients in the future.

scholarly journals Efek Terapi Oksigen Hiperbarik (TOHB) pada Penyembuhan Ulkus Kaki DM Tipe 2 Berdasarkan Skor PEDIS

2019 ◽  
Vol 11 (2) ◽  
pp. 110
Author(s):  
Ekanova R. N. Sumarauw ◽  
Mendy J. Hatibie ◽  
Djony E. Tjandra ◽  
Fredrik G. Langi
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Controlled Trial ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Wound Healing Process ◽  
Holistic Treatment ◽  
The Third

Abstract: Diabetic foot ulcer (DFU) is still a health problem related to the extent amount of time in wound healing process hence increasing the treatment cost. Given any methods that are not sat-isfying, encourage the search of other methods that would increase the wound healing rate, in which hyperbaric oxygen therapy (HBOT) is amongst them. The DFU patient that receives HBOT shows a significant increase in angiogenesis process markedly by faster epithelialization and granulation process. This study was aimed to prove that HBOT could accelerate the wound healing process among DFU patients measured by wound size and depth of PEDIS score. This was a ran-domized controlled trial study, conducted at Surgery Department of Prof. Dr. R. D. Kandou Gen-eral Hospital from September 2018 to March 2019. There were 20 DFU patients divided into two groups, each of 10 patients. The control group received a holistic treatment, meanwhile the HBOT group received a holistic treatment added with the inclusion of HBOT. PEDIS score assessment of DFU in HBOT group was measured before and after the third HBOT session, meanwhile the con-trol group was measured on the first and the third day. The results showed that the difference in PEDIS score value was markedly found in HBOT group compared to the control group (2 vs. 0, P=0.001). Conclusion: HBOT could enhance the wound healing process in DFU patients based on the declined PEDIS score.Keywords: HBOT, PEDIS score, diabetic foot ulcerAbstrak: Ulkus kaki diabetik (UKD) masih merupakan masalah kesehatan terkait proses penyembuhan lama sehingga biaya pengobatan meningkat. Belum adanya metode penanganan yang memuaskan, mendorong pencarian metode percepatan penyembuhan luka, salah satunya ialah terapi oksigen hiperbarik (TOHB). Penderita UKD yang menjalani tambahan TOHB diketahui mengalami peningkatan proses angiogenesis yang menghasilkan proses epitelialisasi dan granulasi yang lebih cepat. Tujuan penelitian ialah untuk membuktikan bahwa TOHB dapat mempercepat proses penyembuhan UKD, dinilai berdasarkan ukuran dan kedalaman luka melalui skor PEDIS. Penelitian ini menggunakan randomized controlled trial dan dilaksanakan di Bagian Bedah RSUP Prof. Dr. R.D. Kandou Manado sejak September 2018 sampai dengan Maret 2019. Subyek penelitian sebanyak 20 penderita UKD, dibagi dalam dua kelompok, masing-masing 10 penderita. Kelompok kontrol menjalani penanganan holistik UKD, sedangkan kelompok TOHB menjalani penanganan holistik UKD dengan TOHB. Penilaian skor PEDIS terhadap UKD pada kelompok TOHB dilakukan sebelum dan sesudah TOHB sesi ke-3, sedangkan pada kelompok kontrol dilakukan penilaian pada hari ke-1 dan hari ke-3 sesudahnya. Hasil penelitian mendapatkan bahwa perubahan skor PEDIS yang terjadi antara kedua pengukuran terlihat lebih besar pada kelompok TOHB dibandingkan kelompok kontrol (2 vs 0, P=0,001). Simpulan. TOHB mempercepat proses penyembuhan UKD dinilai dari penurunan skor PEDIS.Kata kunci: TOHB, skor PEDIS, ulkus kaki diabetik

Characteristics of microbial drug resistance and its correlates in chronic diabetic foot ulcer infections

2014 ◽  
Vol 63 (10) ◽  
pp. 1377-1385 ◽  
Author(s):  
Thokur S. Murali ◽  
Shettigar Kavitha ◽  
Jain Spoorthi ◽  
Deepika V. Bhat ◽  
Alevoor S. Bharath Prasad ◽  
...  
Keyword(s):  
Immune Response ◽  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Healing Process ◽  
Diabetic Patients ◽  
Bacterial Strains ◽  
Microbial Drug Resistance

While virulence factors and the biofilm-forming capabilities of microbes are the key regulators of the wound healing process, the host immune response may also contribute in the events following wound closure or exacerbation of non-closure. We examined samples from diabetic and non-diabetic foot ulcers/wounds for microbial association and tested the microbes for their antibiotic susceptibility and ability to produce biofilms. A total of 1074 bacterial strains were obtained with staphylococci, Pseudomonas, Citrobacter and enterococci as major colonizers in diabetic samples. Though non-diabetic samples had a similar assemblage, the frequency of occurrence of different groups of bacteria was different. Gram-negative bacteria were found to be more prevalent in the diabetic wound environment while Gram-positive bacteria were predominant in non-diabetic ulcers. A higher frequency of monomicrobial infection was observed in samples from non-diabetic individuals when compared to samples from diabetic patients. The prevalence of different groups of bacteria varied when the samples were stratified according to age and sex of the individuals. Several multidrug-resistant strains were observed among the samples tested and most of these strains produced moderate to high levels of biofilms. The weakened immune response in diabetic individuals and synergism among pathogenic micro-organisms may be the critical factors that determine the delicate balance of the wound healing process.

scholarly journals Atypical Diabetic Foot Ulcer Keratinocyte Protein Signaling Correlates with Impaired Wound Healing

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Glenn D. Hoke ◽  
Corrine Ramos ◽  
Nicholas N. Hoke ◽  
Mary C. Crossland ◽  
Lisa G. Shawler ◽  
...  
Keyword(s):  
Wound Healing ◽  
Signaling Pathways ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Predictive Biomarkers ◽  
Diabetic Foot Ulcer ◽  
Study Data ◽  
Protein Signaling ◽  
Impaired Wound Healing ◽  
Signal Transduction Networks

Diabetes mellitus is associated with chronic diabetic foot ulcers (DFUs) and wound infections often resulting in lower extremity amputations. The protein signaling architecture of the mechanisms responsible for impaired DFU healing has not been characterized. In this preliminary clinical study, the intracellular levels of proteins involved in signal transduction networks relevant to wound healing were non-biasedly measured using reverse-phase protein arrays (RPPA) in keratinocytes isolated from DFU wound biopsies. RPPA allows for the simultaneous documentation and assessment of the signaling pathways active in each DFU. Thus, RPPA provides for the accurate mapping of wound healing pathways associated with apoptosis, proliferation, senescence, survival, and angiogenesis. From the study data, we have identified potential diagnostic, or predictive, biomarkers for DFU wound healing derived from the ratios of quantified signaling protein expressions within interconnected pathways. These biomarkers may allow physicians to personalize therapeutic strategies for DFU management on an individual basis based upon the signaling architecture present in each wound. Additionally, we have identified altered, interconnected signaling pathways within DFU keratinocytes that may help guide the development of therapeutics to modulate these dysregulated pathways, many of which parallel the therapeutic targets which are the hallmarks of molecular therapies for treating cancer.

scholarly journals Rationale of Orthosiphon aristatus for Healing Diabetic Foot Ulcer

2020 ◽  
Vol 15 (9) ◽  
pp. 1934578X2095330
Author(s):  
Farah Izana Abdullah ◽  
Lee Suan Chua ◽  
Siti Pauliena Mohd Bohari ◽  
Eka Sari
Keyword(s):  
Wound Healing ◽  
Plant Extract ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
South East Asia ◽  
Diabetic Wound Healing ◽  
Preclinical And Clinical Studies ◽  
Significant Concentration

Orthosiphon aristatus (Blume) Miq. is traditionally used for wound healing in South East Asia and scientifically proven for its antidiabetic potential. Wounds due to diabetes, especially diabetic foot ulcer (DFU), always involve a complicated healing process. The present work aims to review the information on the rationale of the phytochemicals from O. aristatus in promoting DFU healing. The findings showed that the DFU healing potential of O. aristatus was characterized by a reduction in the blood glucose level, mainly attributed to the significant concentration of constituents such as caffeic acid, rosmarinic acid, and sinensetin in the plant extract. These phytochemicals possibly induce insulin secretion and sensitivity, improve the lipid profile, and stimulate glucose uptake. Furthermore, the healing effect may also be contributed to the antioxidant, anti-inflammatory, and antihyperglycemic properties of the plant. The roles of phytochemicals have been systematically postulated in the 4 phases of the healing process. Moreover, no adverse toxic sign or abnormality has been reported upon oral administration of the plant extract. This suggests that O. aristatus extract could be a potential diabetic wound healing phytomedicine for further preclinical and clinical studies.

scholarly journals Low level red laser therapy using wavelength 635nm for diabetic foot ulcers: a prospective study

2019 ◽  
Vol 6 (2) ◽  
pp. 527
Author(s):  
Madhavakumaran Pakkiriappan ◽  
Manivannan Velayutham ◽  
Santhana Mariappan Karthikeyan ◽  
Madhavakumaran Pakkiriappan
Keyword(s):  
Wound Healing ◽  
Laser Therapy ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Laser Wavelength ◽  
Contact Method ◽  
Initiation Of Therapy ◽  
A Prospective Study

Background: Diabetic foot ulcer is one of the important complications of diabetes. After effective debridement and antibiotic therapy, lasers are used to hasten the healing process. Red laser of wavelength 635nm promotes wound healing. This study will aid us to find out the efficacy of red laser wavelength 635nm in healing of diabetic foot ulcers.Methods: After obtaining informed consent, diabetic foot ulcer patients admitted to Rajiv Gandhi government hospital were selected based on non-probability convenience sampling. Necessary history obtained, clinical examination of the ulcer done, investigations done. Cases are given 30minutes of laser therapy by non-contact method before regular ulcer dressing. Controls are given saline dressing. Ulcer area measured before initiation of therapy and measured at 1st week, 2nd week and 3rd week after initiation of therapy.Results: Wound contraction rate was 39.65% with laser and 11.26% with saline dressing alone (p<0.001). The data were statistically significant; thus, laser have wound healing property.Conclusions: Cases have more mean contraction percentage than controls (37.99% versus 11.68%, p<0.001). So LLLT is an effective therapy to heal diabetic ulcers. Need for additional surgeries can be avoided by using LLLT.

scholarly journals Advance-Platelet Rich Fibrin and Hyaluronic Acid Combination Improves Interleukin-6 and Granulation Index in Diabetic Foot Ulcer Patients

2021 ◽  
Vol 13 (2) ◽  
pp. 170-7
Author(s):  
Ronald Winardi Kartika ◽  
Idrus Alwi ◽  
Franciscus Dhyanagiri Suyatna ◽  
Em Yunir ◽  
Sarwono Waspadji ◽  
...  
Keyword(s):  
Wound Healing ◽  
Hyaluronic Acid ◽  
Interleukin 6 ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Fibrin Gel ◽  
Platelet Rich Fibrin ◽  
Wound Protection

BACKGROUND: Diabetic foot ulcer (DFU) is the most common and threatening complication of Diabetes Mellitus (DM). Ideal wound dressing for DFU management should relieve symptoms, provide wound protection, and encourage healing. Advanced-Platelet Rich Fibrin (A-PRF) and Hyaluronic Acid (HA) have been proven to improve wound healing process. This study was aimed to demonstrate the ability of combination of A-PRF and HA in reducing inflammation and improving DFU tissue healing.METHODS: Twenty DFU subjects were involved in this study, and divided into two groups based on the topical fibrin gel treatment: A-PRF + HA group and A-PRF only group. A-PRF was obtained by peripheral blood centrifugation. A-PRF + HA was prepared by homogening A-PRF and AH with a ratio of 1:0.6. Interleukin-6 (IL-6) level, granulation index (GI), numeric pain score (NPS), and inflammation clinical symptoms (ICS) were assessed on day-0, 3, 7 and 14.RESULTS: Wound swabs’ IL-6 level on day-7 was found to be significantly lower in A-PRF + HA compared to A-PRF alone (p=0.041). The IL-6 level reduction also found to be significant higher either in wound swabs (day 0-7, p=0.015) or fibrin gel (day 0-3, p=0.049; day 0-7, p=0.034). A-PRF + HA treatment significantly increased the GI even since day-3 (p=0.043), with lower NPS (p<0.001), and ICS score.CONCLUSION: The combination of A-PRF and HA increases the GI in DFU healing by reducing the inflammation state which will induce the angiogenesis process, as well as reducing pain in DFU subjects better than A-PRF alone.KEYWORDS: inflammation, interleukin-6, wound healing, angiogenesis, proliferation 

scholarly journals Quantitative Studies of Diabetic Foot Ulcer Evolution Under Treatment by Digital Stereotactic Photography

2019 ◽  
Vol 13 (5) ◽  
pp. 821-826
Author(s):  
Carlos Alberto Cabal Mirabal ◽  
Jorge Berlanga Acosta ◽  
José Fernández Montequín ◽  
Leonardo Oramas Díaz ◽  
Evelio González Dalmau ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Main Idea ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Digital Photography ◽  
Tissue Loss ◽  
Color Changes ◽  
Relative Contribution

Background: Imaging the lower extremity reproducibly and accurately remains an elusive goal. This is particularly true in the high risk diabetic foot, where tissue loss, edema, and color changes are often concomitant. The purpose of this study was to evaluate the reproducibility of a novel and inexpensive stereotaxic frame in assessment of wound healing. Methods: The main idea is to keep constant and reproducible the relative position of extremities related to the sensor used for the examination during a serial studies by stereotaxic digital photographic sequence. Ten healthy volunteers were evaluated at 10 different time moments to estimate the foot position variations in the stereotaxic frame. The evolution of 40 of DFU patients under treatment was evaluated before and during the epidemical grow factor intralesional treatment. Results: The wound closing and granulation speeds, the relative contribution of the contraction and tissue restauration mechanism were evaluated by stereotaxic digital photography. Conclusions: The results of this study suggest that the stereotaxic frame is a robust platform for serial study of the evolution of wound healing which allow to obtain consistent information from a variety of visible and hyperspectral measurement technologies. New stereotaxic digital photography evidences related to the diabetic foot ulcer healing process under treatment has been presented.

A Clinical Study on Vrana Shodhana Action of Gomutra Arka in Dushtavrana w.s.r. to Diabetic Foot Ulcer

2017 ◽  
Vol 2 (06) ◽  
Author(s):  
Mrudul Mohan ◽  
Sanjay Sharma ◽  
Shyam Prasad M. ◽  
Rajneesh V. Giri ◽  
Gururaja D.
Keyword(s):  
Clinical Study ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Healing Process ◽  
Surrounding Area ◽  
Post Test ◽  
Group A ◽  
Group B

Context: The diabetic foot ulcer, being chronic in nature involves various tissues, it can be considered as Dushtavrana in Ayurveda. Proper Care for diabetic foot with medication and procedures that has hastened the healing process with less complication is the need of the hour. Aim: To evaluate the Vrana Shodhana action of Gomutra Arka in Dushtavrana w.s.r. to diabetic foot ulcers. Settings and Design: It is a clinical study with pre-test and post-test design. Total number of patient’s taken for the study was 40 excluding dropouts. The patients selected for the study were divided in to 2 groups, Group-A and Group-B, consisting of 20 patients each. Materials and Methods: The wound is examined, exudates, debris, slough were removed, the surrounding area was cleaned and pad soaked in Gomutra Arka was placed and wound dressing was done once in a day. Duration of study was 45 days or till the formation of granulation tissue whichever is earlier, assessment was done every 7 days. For healing Jatyadi Taila was applied after the Shodhana Kriya with Gomutra Arka. Conclusion: Gomutra Arka was having good results in reducing burning sensation, itching, smell, size, depth, discharge, edge, floor and presence of granulation tissues compared to Betadine. Both drugs have equal effect in reducing pain. Both drugs have Shodhana, Lekhana properties, hastens the wound healing process which helps in reduction of wound size. It can be concluded that Gomutra Arka application is effective in all types of Diabetic foot ulcer by their faster, effective Shodhana, Lekhana, Vedana Shamaka, Kandu Shamaka, Daha Shamaka properties compared to Betadine.

Topical Application of Teucrium polium Can Improve Wound Healing in Diabetic Rats

2019 ◽  
Vol 19 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Hasan Fallah Huseini ◽  
Amir Hossein Abdolghaffari ◽  
Maryam Ahwazi ◽  
Eghbal Jasemi ◽  
Maryam Yaghoobi ◽  
...  
Keyword(s):  
Wound Healing ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Rats ◽  
Control Group ◽  
Wound Healing Process ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Teucrium Polium

Diabetic foot ulcer is one of the major complications among diabetic patients. Several studies have shown that the extract of Teucrium polium (T. polium) is effective in the treatment of diabetic and non-diabetic wounds, as well as burn wounds. The aim of current study was to assess the wound healing activity of T. polium extract ointment in diabetic rats. Sixty-four male Wistar rats were induced diabetes with alloxan injection (125 mg/kg) and surgical wound induced. The rats were divided into 8 groups of eight rats each: control group, eucerin group, phenytoin group, 2%, 3%, 4%, 5% and 10% T. polium groups. The ointment was dressed on the wound twice a day. The process of wound healing was screened by macroscopy and digitalization on days 14 and 21 and until complete wound healing. There was no infection in the wounds of rats in any groups. The process of wounds healing of the 2%, 3%, 4%, 5%, and 10% T. polium ointments, with phenytoin ointment and base ointment (eucerin) on day 14 and 21, showed that the significant difference between the treatment groups with 4% (P = 0.003), 5% (P = 0.001), 10% (P = 0.001) T. polium ointment and phenytoin ointment group (P = 0.001) compared to eucerin group. The results of this study showed that T. polium extract ointment with a 10% ointment accelerates the wound healing process in diabetic rats and is comparable to the phenytoin group.

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