Retrospective Matched Case-Control Study on the Use of CO2 Laser for the Treatment of Nonhealing Diabetic Foot Ulcers: The DULCIS-2 (Diabetic ULcer, CO2 Laser, and Infections) Study

2020 ◽  
pp. 153473462096029
Author(s):  
Matteo Monami ◽  
Benedetta Ragghianti ◽  
Antonio Silverii ◽  
Alessia Scatena ◽  
Letizia Landi ◽  
...  
Keyword(s):  
Co2 Laser ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Negative Impact ◽  
Bacterial Load ◽  
Case Control ◽  
Foot Ulcers ◽  
Surgical Approaches ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Purpose Infection, which is one of the possible complications of diabetic foot ulcers (DFUs), makes the treatment of ulcers challenging because of its negative impact on healing processes and the high prevalence of multiresistant germs. This study is aimed at verifying the effect of a surgical CO2 laser (which reduces the bacterial load and allows a more accurate debridement), as compared with the traditional lancets, on the healing rate of DFU. Methods The present case-control retrospective analysis was performed on patients with chronic (>6 months) DFU with Texas grade >1, treated with 80 W surgical CO2 laser (DEKA SmartXide2 C80, El.En. Group) and compared with a matched sample of patients with similar characteristics, who were treated with a traditional surgical approach. The debridement was performed trying to achieve the complete removal of nonviable tissues. The principal endpoint was the proportion of patients healed at 6 months. All analyses were carried out with SPSS 25.0. The study protocol was approved by the local ethical committee. Results This study included 118 patients (59 cases and 59 controls). At 6 months, the proportion of healing patients was 35% and 18% in cases and controls, respectively ( P = .034). The corresponding figure at 1 year was 62% and 38% ( P = .009), whereas no difference was observed at 1, 2, and 3 months. No serious adverse event was observed. Conclusions In this article, we show for the first time that CO2 laser treatment, in comparison with traditional surgical approaches, can be associated with an increased healing rate in patients with DFU.

scholarly journals Bacterial Load Predicts Healing Rate in Neuropathic Diabetic Foot Ulcers

Diabetes Care ◽  
2007 ◽  
Vol 30 (2) ◽  
pp. 378-380 ◽  
Author(s):  
L. Xu ◽  
S. V. McLennan ◽  
L. Lo ◽  
A. Natfaji ◽  
T. Bolton ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Healing Rate ◽  
Bacterial Load ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

scholarly journals Nurse Approach in the Treatment of Piabetic Foot Ulcers with the Management of Negative Pressure Therapy

2021 ◽  
pp. 1-4
Author(s):  
Astasio Picado Álvaro ◽  
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Bacterial Load ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Negative Pressure Therapy ◽  
Novel Therapy ◽  
Pressure Therapy ◽  
Advanced Therapy ◽  
Global Increase

The global increase of Diabetes Mellitus represents serious complications for those who suffer from it, the most frequent complications are diabetic foot ulcers and amputations derived from them. Currently, negative pressure therapy (NPT) is used as an advanced therapy for the treatment of this type of ulcers. This novel therapy promises numerous advantages for the nursing approach to patients with diabetic foot ulcers. Therefore, the objective of this narrative review is to prove the effectiveness of the negative pressure therapy as a treatment for diabetic foot ulcers. The search of the articles was carried out in several scientific databases with the help of a searching chain, which combined the keywords and boolean operators. 16 studies were selected, which indicated that NPT as a treatment for diabetic foot ulcers provides benefits such as promoting the formation of granulation tissue, healing and closing of the ulcer in a shorter time, as well as reducing ulcer depth and area and even decreases the bacterial load, the rate of amputations and reulcerations. Hence, NPT is an effective therapy that should be applied to clinical practice

scholarly journals Vacuum-assisted closure versus conventional dressings in the management of diabetic foot ulcers: a prospective case–control study

2014 ◽  
Vol 5 (1) ◽  
pp. 23345 ◽  
Author(s):  
Ali M. Lone ◽  
Mohd I. Zaroo ◽  
Bashir A. Laway ◽  
Nazir A. Pala ◽  
Sheikh A. Bashir ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Case Control Study ◽  
Case Control ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vacuum Assisted Closure ◽  
Control Study ◽  
Prospective Case Control Study

scholarly journals Home based negative pressure wound therapy and moist dressing in the treatment of diabetic foot ulcers

2019 ◽  
Vol 6 (12) ◽  
pp. 4303
Author(s):  
Shiraz Basheer ◽  
Naseef Kannanavil ◽  
Sunil Rajendran
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafting ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Therapy ◽  
Diabetic Ulcer ◽  
Home Based ◽  
Split Skin Grafting

Background: Negative pressure wound therapy (NPWT) is a non-invasive wound closure system that uses controlled, localized negative pressure to help heal chronic and acute wounds. The objective of the present study was to compare home based NPWT and moist wound dressing in home care setting with respect to wound healing and time taken for healing among diabetic ulcer patients and the comparison of cost involved for the treatment.Methods: A hospital based prospective observational study where all patients were presented to the Department of Surgery at MES Medical College with diabetic ulcer between 1st January 2016 and 30th March 2017 were included in the study; ulcer size and surface area were measured using vernier calipers and Wagner’s grade between the two groups were evaluated at the time of enrollment.Results: Complete ulcer healing by primary intention was achieved in 86.8% in home based NPWT group vs. 44.3% in conventional moist dressing group. Average duration taken for healing in home based NPWT patient was 3.03 months and in moist dressing group was 4.58 months. Split skin grafting was needed in 2 patients in HB-NPWT group vs. 7 in moist dressing group. 9.3 hospital visits in HB-NPWT group vs 136.8 sessions in moist dressing group.Conclusions: The present study states that NPWT is superior to conventional moist dressing for the management of chronic diabetic foot ulcers. Cost is approximately 1/10th of standard NPWT.

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 HEALING RATE IN DIABETIC FOOT ULCERS TREATED WITH BIOMEMBRANE AND HYDROCOLLOID POWDER: RANDOMIZED CLINICAL TRIAL

2021 ◽  
Author(s):  
Manuela de Mendonça Figueirêdo Coelho ◽  
Luciana Catunda Gomes de Menezes ◽  
Shérida Karanini Paz de Oliveira ◽  
Ana Débora Alcantara Coêlho Bonfim ◽  
Viviane Mamede Vasconcelos Cavalcante ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Foot Ulcers ◽  
Calotropis Procera ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Diabetic Foot Ulcers ◽  
Clinical Trial Registry ◽  
Experimental Group

Objective: to evaluate the rate of healing in diabetic foot ulcers treated with a biomembrane of latex proteins from Calotropis procera (BioMem CpLP) when compared to powdered hydrocolloid. Method: randomized controlled clinical trial, registered by the Brazilian Clinical Trial Registry (REBEC), according to protocol RBR-98f3j9, carried out with eight people with diabetic foot, in a diabetic foot clinic, from March to July 2019. In the experimental group (n = 04), biomembrane was applied; in the control group (n = 04), hydrocolloid powder was used. The healing rate was assessed at 30 and 60 days after starting treatment. Results: no statistical differences were found between the healing rates of the control group and the experimental group in the temporal analysis of the initial 30 days (p = 0.726) and in the 60 days following the start of treatment (p = 0.562). Conclusion: BioMem CpLP presented healing rates similar to the conventional product, being an effective and low cost alternative for the treatment of diabetic feet.

scholarly journals “ ASSESSMENT OF SEVERITY OF DIABETIC FOOT ULCERS USING DIABETIC ULCER SEVERITY SCORE.”

2020 ◽  
pp. 19-21
Author(s):  
Aarushi Mishra ◽  
Anilkumar P. Bellad ◽  
M.I. Uppin
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Severity Score ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
The Past

INTRODUCTION : Diabetes mellitus is a common metabolic disorder, prevalence steadily increasing over the past few decades. The complications associated with it , hence , has also increased. Diabetic foot ulcer is one of the most serious complications , utilizing resources, significantly contributing to the morbidity of the patient. There is hence, a need to correctly identify the severity of the diabetic foot ulcer so as to plan the appropriate management and to help in counselling of such patients. AIM : To assess severity in diabetic foot ulcer using diabetic ulcer severity score. MATERIAL AND METHODOLOGY : This is a hospital based longitudinal study , conducted on 93 study subjects admitted with diabetic foot ulcers. Diabetic ulcer severity score was calculated for each patient . The score was calculated by adding scores of the respective parameters constituting site of ulcer, number of ulcers, presence/absence of pedal pulsations, presence/ absence of bone involvement. Each patient was followed up for a period of 6 months , or earlier in case of patient undergoing minor/major amputation. After the study was conducted , analysis was done by calculating various percentages of healing /amputation with respect to the score. RESULTS : Out of the total 93 study subjects , 74.2% were males. The mean age was calculated to be 59.6 years with maximum number of subjects being in 55-60 years of age group range. Majority of them had diabetic ulcer severity score of 2 (42%). Out of the total study subjects , 58% had a complete healing , 28% underwent minor amputation whereas 14% underwent major amputation. 100% of the study participants with score 0 had healing of ulcer which decreased to 85% for score 1 , 53.8% for score 2 , 6.25% for score 3 and 0% for score 4. This was suggestive of poorer chances of healing as the diabetic ulcer severity score increases. CONCLUSION : With the increasing incidence of patients diagnosed with diabetes mellitus , the rate of complications of diabetes has also increased over the past few decades including the risk and occurence of diabetic foot ulcers There is an increasing need for diabetic foot ulcer prognostication systems and universal use of the same. Thus ,we recommend the use of diabetic ulcer severity score as a prognostic tool to assess the severity of the diabetic foot which will further enhance communication and counselling of the patient and will help in providing the appropriate treatment to such patients.

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