The Role of Leukocyte-Platelet-Rich Fibrin in Promoting Wound Healing in Diabetic Foot Ulcers

2021 ◽  
pp. 153473462110528
Author(s):  
Yuqi Wang ◽  
Xiaotao Wang ◽  
Rong Chen ◽  
Liuwei Gu ◽  
Desen Liu ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Early Stage ◽  
Treatment Method ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Foot Ulcers ◽  
External Application ◽  
Traditional Treatment ◽  
Platelet Rich Fibrin

To explore the effect of leukocyte-platelet-rich fibrin (L-PRF) on promoting wound healing in diabetic foot ulcers. A total of 42 patients with diabetic foot ulcers at our hospital from January 2017 to July 2020 were retrospectively analyzed. A control group and a PRF group were established. The two groups of patients underwent debridement. In the platelet-rich fibrin (PRF) group, autologous L-PRF was used to cover ulcer wounds. One time each week, Vaseline gauze was used to cover the ulcer wounds. In contrast, the control group was treated with the external application of mupirocin ointment and recombinant human epidermal growth factor gel (yeast). Two times each week, the sterile Vaseline gauze was covered with a bandage. Both groups were treated for 5 weeks. The wound recovery of the two groups was observed. During the early stage of treatment (first and second weeks) for diabetic foot ulcers, the wound healing rate was significantly better with L-PRF treatment than traditional treatment. For later-stage treatment (third to fifth weeks), the overall cure rate was higher with L-PRF than the traditional treatment method. L-PRF can effectively promote wound healing in diabetic foot ulcers.

Effect of Family Empowerment on HbA1c Levels and Healing of Diabetic Foot Ulcers

2020 ◽  
pp. 153473462093012
Author(s):  
Rasnah Appil ◽  
Elly Lilianty Sjattar ◽  
Saldy Yusuf ◽  
Kasmawati Kadir
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Intervention Group ◽  
Foot Ulcers ◽  
Control Group ◽  
Wound Healing Process ◽  
Diabetic Foot Ulcers ◽  
Family Empowerment ◽  
Hba1c Levels

Objective. To evaluate the effectiveness of family empowerment through educational interventions against HbA1c level and healing progress of diabetic foot ulcers. Method. A quasi-experimental design was employed involving 33 participants from 4 wound care clinics in Makassar, eastern Indonesia. The intervention group consisted of 17 participants and their families; the control group was composed of 16 participants who received nonstructural education. Family empowerment was measured by the Indonesian version of the Family Empowerment Scale instrument. Glycemic control was evaluated with HbA1c levels, and the wound healing process was evaluated on the Diabetic Foot Ulcers Assessment Scale. Result. After 3 months, Family Empowerment Scale scores improved, particularly in the subdomain of family knowledge (16.59 ± 3.92 vs 13.38 ± 1.26; P = .005) and attitude (3.65 ± 0.93 vs 2.75 ± 0.45; P = .002). After 3 months of intervention, HbA1c decreased (from 10.47 ± 2.44% to 8.81 ± 1.83%), compared with the control group ( P = .048). Meanwhile, an independent t test further revealed that the wound healing process tended to be better with the intervention group (4.71 ± 7.74) compared with the control group (17.25 ± 17.06), with P = .010 at the third month. Conclusion. Family-based education intervention creates family empowerment to control HbA1c levels and accelerate wound healing of diabetic foot ulcer.

scholarly journals Nutrition Supplementation and Education May Increase the Healing Rate in Diabetic Patients with Foot Ulcers (P19-005-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Raedeh Basiri ◽  
Maria Spicer ◽  
Bahram Arjmandi
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Diabetic Foot ◽  
Healing Rate ◽  
High Protein ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Wound Healing Rate

Abstract Objectives This study examined the effects of high protein dietary supplementation and nutrition education on the healing of diabetic foot ulcers. Methods Twenty-nine adults with diabetic foot ulcers were recruited from the Tallahassee Memorial Hospital Wound Care Clinic. Participants were randomly assigned to treatment (n = 15) or control (n = 14) group. The treatment group received two carbohydrate controlled high protein shakes to consume daily, and was educated regarding adequate intake of low-fat protein sources, fruits, vegetables, complex carbohydrates and minimizing simple carbohydrates. The control group did not receive any intervention. Daily supplementation provided a total of 500 kilocalories, 28 grams of high-quality protein, and approximately 50% of micronutrient requirements. Anthropometric measurements (weight, height, BMI) and wound planimetry were examined at baseline and every four weeks until the wound healed or up to 12 weeks. Results There was no significant difference between the groups at baseline for BMI (mean = 33.8 ± 7 kg/m2), age (mean = 53.34 ± 11.14 years), duration of diabetes (mean = 13 years), duration of wounds (mean 10.8 months) or wound area (mean = 450 mm2). Wound healing rate (decrease in the area of the wound/week) for the treatment group was three times faster than the control group (151.1 mm2/week vs. 45.2 mm2/week respectively). Conclusions Improved nutritional intake using nutritional supplementation and patient education has a strong positive effect on the wound healing rate of diabetic foot ulcers. Faster wound healing improves quality of life and functionality of patients with diabetic foot ulcers. Funding Sources Dissertation award.

Punch Grafting for the Management of Hard-to-Heal Diabetic Foot Ulcers: A Prospective Case Series

2021 ◽  
pp. 153473462110310
Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Donor Site ◽  
Case Series ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Debridement ◽  
Prospective Case Series

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.

Therapeutic Properties of Honey for the Management of Wounds; Is There a Role in the Armamentarium of Diabetic Foot Ulcer Treatment? Results From In vitro and In vivo Studies

2021 ◽  
pp. 153473462110268
Author(s):  
Ioanna A. Anastasiou ◽  
Ioanna Eleftheriadou ◽  
Anastasios Tentolouris ◽  
Georgia Samakidou ◽  
Nikolaos Papanas ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Diabetic Animal ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Wound ◽  
Diabetic Wound Healing ◽  
Therapeutic Properties

Diabetic foot ulcers are one of the most dreadful complications of diabetes mellitus and efforts to accelerate diabetic wound healing are of paramount importance to prevent ulcer infections and subsequent lower-limb amputations. There are several treatment approaches for the management of diabetic foot ulcers and honey seems to be a safe and cost-effective therapeutic approach on top of standard of care. The aim of this review was to summarize the therapeutic properties of honey and the data regarding its possible favorable effects on diabetic wound healing. A literature search of articles from 1986 until April 2021 was performed using MEDLINE, EMBASE, and the Cochrane Library to assess for studies examining the therapeutic wound healing properties of honey, it's in vitro effect, and the efficacy and/or mechanism of action of several types of honey used for the treatment of diabetic animal wounds. Honey has antioxidant, anti-inflammatory, and antibacterial properties and in vitro studies of keratinocytes and fibroblasts, as well as studies in diabetic animal models show that treatment with honey is associated with increased re-epithelialization and collagen production, higher wound contraction, and faster wound healing. The use of honey could be a promising approach for the management of diabetic foot ulcers.

scholarly journals Surgical Treatment of Diabetic Foot Ulcers Complicated by Osteomyelitis with Gentamicin-Loaded Calcium Sulphate-Hydroxyapatite Biocomposite

2021 ◽  
Vol 10 (2) ◽  
pp. 371
Author(s):  
Kor H. Hutting ◽  
Wouter B. aan de Stegge ◽  
Jaap J. van Netten ◽  
Wouter A. ten Cate ◽  
Luuk Smeets ◽  
...  
Keyword(s):  
Wound Healing ◽  
Surgical Treatment ◽  
Treatment Regimen ◽  
Diabetic Foot ◽  
Prospective Trial ◽  
Calcium Sulphate ◽  
Foot Ulcers ◽  
Ulcer Recurrence ◽  
Diabetic Foot Ulcers ◽  
Cox Regression Analysis

Diabetic foot ulcers, complicated by osteomyelitis, can be treated by surgical resection, dead space filling with gentamicin-loaded calcium sulphate-hydroxyapatite (CaS-HA) biocomposite, and closure of soft tissues and skin. To assess the feasibility of this treatment regimen, we conducted a multicenter retrospective cohort study of patients after failed conventional treatments. From 13 hospitals we included 64 patients with forefoot (n = 41 (64%)), midfoot (n = 14 (22%)), or hindfoot (n = 9 (14%)) ulcers complicated by osteomyelitis. Median follow-up was 43 (interquartile range, 20–61) weeks. We observed wound healing in 54 patients (84%) and treatment success (wound healing without ulcer recurrence) in 42 patients (66%). Treatment failures (no wound healing or ulcer recurrence) led to minor amputations in four patients (6%) and major amputations in seven patients (11%). Factors associated with treatment failures in univariable Cox regression analysis were gentamicin-resistant osteomyelitis (hazard ratio (HR), 3.847; 95%-confidence interval (CI), 1.065–13.899), hindfoot ulcers (HR, 3.624; 95%-CI, 1.187–11.060) and surgical procedures with gentamicin-loaded CaS-HA biocomposite that involved minor amputations (HR, 3.965; 95%-CI, 1.608–9.777). In this study of patients with diabetic foot ulcers, complicated by osteomyelitis, surgical treatment with gentamicin-loaded CaS-HA biocomposite was feasible and successful in 66% of patients. A prospective trial of this treatment regimen, based on a uniform treatment protocol, is required.

The efficacy of platelet-derived wound healing formula (PDWHF) in diabetic foot ulcers: Revisited

2010 ◽  
Vol 6 (1) ◽  
pp. 93-103
Author(s):  
Hany M Abdel Aziz ◽  
Basim M Zaki ◽  
Nahed S Boughdadi ◽  
Karim El-Lamie ◽  
Ashraf Maher ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

scholarly journals The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) Classification Independently Predicts Wound Healing in Neuroischemic Diabetic Foot Ulcers

2017 ◽  
Vol 66 (3) ◽  
pp. e61 ◽  
Author(s):  
Caitlin W. Hicks ◽  
Joseph K. Canner ◽  
Nestoras Mathioudakis ◽  
Ronald Sherman ◽  
Kathryn F. Hines ◽  
...  
Keyword(s):  
Wound Healing ◽  
Vascular Surgery ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers
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