scholarly journals Remaining Question: Does Exercise Improve Healing of Diabetic Foot Ulcers?

2021 ◽  
pp. 153473462110637
Author(s):  
Magali Brousseau-Foley ◽  
Virginie Blanchette
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Direct Evidence ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Foot Ulcers ◽  
Quality Appraisal ◽  
The Subject ◽  
The Impact ◽  
Appraisal Tool

Even though it is reasonable to think that exercise is beneficial to diabetic foot ulcer healing, there are currently no exercise recommendations for this population. A systematic review published recently attempted to answer this question. However, because of both the scarce and heterogenous literature on the subject identified by the selected study design and the chosen quality appraisal tool that is too permissive and overestimates the treatment effects, no clinical recommendations can be drawn from this review. We advocate for research on this topic in order to obtain more direct evidence that exercise benefits wound healing, and to close the persistent gap of knowledge regarding the impact of exercise on diabetic foot ulcer wound healing.

scholarly journals Integrative Analysis of miRNA Expression Profiling of Diabetic Foot Ulcers Wound Treated With Zizhu Ointment

2021 ◽  
Author(s):  
Xiaoming Hu ◽  
Renyan Huang ◽  
Wenhui Li ◽  
Xiao Yang ◽  
Weijing Fan ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chinese Medicine ◽  
Diabetic Foot ◽  
Expression Profiling ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Differentially Expressed Mirnas ◽  
Mirna Expression Profiling

Abstract Background: A major complication of diabetes is diabetic foot ulcers. Millions of patients suffer from the physiological and psychosocial effects of diabetic foot ulcers. However, the current treatment is not effective, and the patients’ prognosis has not been significantly improved.Results: Traditional Chinese medicine-Zizhu ointment exhibited its own characteristics and advantages in treating diabetic foot ulcer by promoting wound healing. The mechanism of Zizhu ointment promoting diabetic foot ulcer wound healing was explored by detecting its miRNA expression profiling. Eighty-three differentially expressed miRNAs were identified, 30 of which were upregulated and 53 were downregulated in diabetic cutaneous wounds treated with Zizhu ointment. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the differentially expressed miRNAs showed that they were involved in several pathways that could regulate the proliferation, differentiation, apoptosis, migration, and secretion of tissue repair cells, and were linked to inflammatory cells, the extracellular matrix, growth factors, and other relevant factors related to wound healing. Furthermore, miRNA-Target regulatory network and protein-protein interaction network were constructed. Twenty hub genes of networks were obtained.Conclusions: Our preliminary study provides a new alternative drug treatment for diabetic foot ulcers by traditional Chinese medicine, and will assist in better understanding its therapeutic targets.

scholarly journals PENATALAKSANAAN ULKUS KAKI DIABETES SECARA TERPADU

2013 ◽  
Vol 3 (2) ◽  
Author(s):  
Yuanita A. Langi
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Peripheral Arterial

Abstract: A diabetic foot ulcer is a common and fearful chronic complication of diabetes mellitus often resulting in amputation, and even death. A diabetic foot ulcer can be prevented by early screening and education in high risk individuals, and the management of underlying conditions such as neuropathy, peripheral arterial disease, and deformity. The prevalence of diabetic foot ulcer patients is 4-10% of the general population, with a higher prevalence in elderly people. Around 14-24 % of diabetic foot ulcer patients need amputations with a recurrence rate of 50% after three years. The main pathogenesis of diabetic foot ulcer is neuropathy and peripheral arterial disease (PAD). PAD contributes to diabetic foot ulcers in 50% of cases; however, it rarely stands alone. Other factors such as smoking, hypertension, and hyperlipidemia may contribute, too. In addition, PAD reduces the access of oxygen and antibiotics to the ulcers. Management of diabetic foot ulcers includes treatment of ischemia by promoting tissue perfusion, debridement for removing necrotic tissues, wound treatment for creating moist wound healing, off-loading the affected foot, surgery intervention, management of the co-morbidities and infections, and prevention of wound recurrences. Other adjuvant modalities include hyperbaric oxygen treatment, GCSF, growth factors, and bioengineered tissues. Key words: diabetic ulcer, debridement, off loading.   Abstrak: Ulkus kaki diabetes (UKD) merupakan salah satu komplikasi kronik diabetes melitus yang sering dijumpai dan ditakuti oleh karena pengelolaannya sering mengecewakan dan berakhir dengan amputasi, bahkan kematian. UKD dapat dicegah dengan melakukan skrining dini serta edukasi pada kelompok berisiko tinggi, dan penanganan penyebab dasar seperti neuropati, penyakit artei perifer dan deformitas. Prevalensi pasien UKD berkisar 4-10% dari populasi umumnya, dengan prevalensi yang lebih tinggi pada manula. Sekitar 14-24% pasien UKD memerlukan amputasi dengan rekurensi 50 % setelah tiga tahun. Patogenesis utama UKD yaitu neuropati dan penyakit arteri perifer (PAP). PAP berkontribusi 50% pada pasien UKD, tetapi hal ini jarang dijumpai tunggal. Terdapat faktor-faktor lain yang turut berperan seperti merokok, hipertensi dan hiperlipidemia. Selain itu PAP menurunkan akses oksigen dan antibiotik ke dalam ulkus. Penatalaksanaan UKD meliputi penanganan iskemia dengan meningkatkan perfusi jaringan, debridemen untuk mengeluarkan jaringan nekrotik, perawatan luka untuk menghasilkan moist wound healing, off-loading kaki yang terkena, intervensi bedah, pananganan komorbiditas dan infeksi, serta pencegahan rekurensi luka. Terapi ajuvan meliputi terapi oksigen hiperbarik, pemberian granulocyte colony stimulating factors (GCSF), growth factors dan bioengineerd tissues. Kata kunci: ulkus diabetes, debridemen, off loading.

scholarly journals Healing of Diabetic Foot Ulcers in Patients Treated at the Copenhagen Wound Healing Center in 1999/2000 and in 2011/2012

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Marie Louise Buhl Sørensen ◽  
Rasmus Bo Jansen ◽  
Therese Wilbek Fabricius ◽  
Bo Jørgensen ◽  
Ole Lander Svendsen
Keyword(s):  
Wound Healing ◽  
Median Time ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Healing Time ◽  
Foot Ulcers ◽  
Time Range ◽  
Diabetic Foot Ulcers ◽  
One Year

Aim. To describe differences in healing time of diabetic foot ulcers for patients treated at the Copenhagen Wound Healing Center, Bispebjerg Hospital, between the years 1999/2000 and 2011/2012. The Center is highly specialized and receives diabetes patients with hard-to-heal foot ulcers. A further aim is to attempt to find predictors of healing time of diabetic foot ulcers. Methods. A retrospective descriptive study of records from patients with diabetic foot ulcer treated at the Copenhagen Wound Healing Center in 1999, 2000, 2011, or 2012. Follow-up data was collected until the 3rd of August 2018. Results. Median time (range) to healing was 6 (61.3) months in 1999/2000 and 6.6 (67.8) in 2011/2012 (p=0.2). About 33% of ulcers were healed, 17% were minor or major amputated, and 1.5% were dead within one year in 1999/2000, whereas 30% of ulcers were healed (p=0.6), 14% were amputated (p=0.2), and 12.8% were dead within one year in 2011/2012 (p<0.001). The single factor found significantly associated with longer ulcer duration was infection. Related to shorter ulcer duration were toe localization of the ulcer and good glycemic control. Conclusion. The median time to healing of a diabetic foot ulcer was long, around 6 months and with a high recurrence rate in 1999/2000 as well as in 2011/2012. Some factors were found to be significantly related to healing time, and intervention addressing these may improve the time to heal, although such interpretations must be taken with precaution from the present study and should be proven in randomized prospective intervention trials.

scholarly journals Study to Determine the Complications and Treatment of Diabetic Foot Ulcer

2021 ◽  
pp. 85-90
Author(s):  
Ghazanfar Ali Shah ◽  
Niaz Hussain Keerio ◽  
Aftab Alam Khanzada ◽  
Muhammad Rafique Joyo ◽  
Nizam Ahmed ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Multivariate Logistic Regression Analysis ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetes Duration ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
The Impact

Background: Diabetic foot ulcer is a solitary most costly and severe complication of diabetes mellitus. Foot ulcers are the after-effect of a combination of various causes, counting peripheral arterial disease and peripheral neuropathy. Patients with diabetic foot ulcers for the most part require lower limb amputation. Objective: The purpose of this examination is to survey the outcomes and complications of diabetic foot ulcers in diabetic patients and to explore the impacts of certain hazard factors on ulcer healing. Place and Duration: In the Orthopedic unit, Dow University Of Medical and Health Sciences, SMBBIT Karachi, for nearly a two-year duration from March 2018 to April 2020. Methods: This study was conducted on 120 patients. All patients with diabetes and DFU 18 to 90 of age were selected. 120 grown-up patients with DFUs were selected for the analysis. The diabetes duration and demographic data were recorded. Clinical proof of infection has been accounted for, as indicated by the American Association for Infectious Diseases. At that point debridement and careful treatment were begun to evacuate all the dead tissue. Follow-up was done week by week for two-year. SPSS 22 was utilized for data collection and statistical analysis. Data are introduced as a percentage and p < 0.05 was considered as the significance level. The Fisher’s test and χ2 test were utilized to test the variables relationship. Multivariate logistic regression analysis was utilized to change different variables when testing the impact of each risk factor on the outcome of DFU. Results: A sum of 120 patients with diabetic foot ulcers were selected. 60% of patients had relieved ulcers, 8% still not resolved; In 27% of patients, minimum amputation, 7% more protuberant amputation, 2% repetitive ulcer and mortality rate was 1%. The investigation indicated that there is a measurably noteworthy connection between the foot ulcers healing with diabetes and the accompanying factors: HbA1c level, patients’ age, diabetes duration, diabetes complications (ulcer size and peripheral neuropathy). Conclusion: The outcomes and complications of diabetic foot ulceration can be anticipated by a few factors, some of which can be changed. Changing compatible factors, for example, better diabetes control, peripheral neuropathy treatment and early treatment of ulcers can reduce complications and encourage healing of ulcers.

scholarly journals Relationship Between Leukocyte, ESR, and CRP Infection Markers with Changes in Wound Wagner 2 and 3 Diabetic Foot Ulcers

2020 ◽  
Vol 1 (2) ◽  
pp. 26-29
Author(s):  
Patrianef Darwis ◽  
Jimmy Candra Putra ◽  
Dedy Pratama ◽  
Aria Kekalih
Keyword(s):  
Wound Healing ◽  
Significant Relationship ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Research Subjects ◽  
Cross Sectional ◽  
Wound Area

Introduction: In 2012, the annual incidence rate of diabetic foot ulcers and gangrene are estimated to be around 2-5% of the general population. About 15% of patients with diabetic foot can have an amputation in the lower limb. Diabetic foot is a health problem that is very difficult to cure. This is further exacerbated by severe conditions of infection and disrupt the process of tissue regeneration, so amputation must be done to prevent the spread of infection. Infection that is not well controlled can inhibit all phases of wound healing. This study aimed to know the relationship between laboratory profile and wound healing in diabetic foot ulcer patients. Method: This was a cross-sectional study with research subjects who were diabetic foot ulcer patients who went to the emergency room and the Cipto Mangunkusumo National Hospital polyclinic during August-December 2019. Statistical analysis was performed to see the correlation between changes in infection marker values and changes in the wound area. Results: During the period August 2019 to December 2019, 30 subjects met the inclusion and exclusion criteria. There were 14 subjects (46.77%) male and 16 subjects (53.3%) female. From the diagnosis, there were 20 subjects (66.3%) with ulcer pedis and ten subjects (33.3%) gangrene pedis. From this study, the average and standard deviation of changes in ABI values were 0.9080 ± 0.100, changes in the number of leukocytes amounted to 4899.87 ± 4512.048, changes in ESR values was 1.8333 ± 1.147, changes in CRP values was 2.6500 ± 1.702, changes in wound area was 10.2727 ± 6.512, and albumin was 2.9487 ± 0.392. From the correlative analysis, it was found between changes in the number of leukocytes with changes in wound area (p=0.058, r=0.350), changes in ESR values with changes in wound area (p=0.034, r=0.388), and changes in CRP values with changes in wound area (p=0.008, r=0.477). Conclusion: There was a significant relationship between changes in ESR values and CRP values with moderate correlation strength changes in the wound area. There was no significant relationship between changes in the number of leukocytes with changes in the wound area. Keywords: wound area, leukocytes, CRP, ESR, diabetic foot ulcer, leukocytes.

scholarly journals The Effects of Silver-Releasing Foam Dressings on Diabetic Foot Ulcer Healing

2021 ◽  
Vol 10 (7) ◽  
pp. 1495
Author(s):  
Yu-Chi Wang ◽  
Hsiao-Chen Lee ◽  
Chien-Lin Chen ◽  
Ming-Chun Kuo ◽  
Savitha Ramachandran ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Early Period ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Control Group ◽  
Diabetic Patients ◽  
High Morbidity

Diabetic foot ulcers (DFUs) are a serious complication in diabetic patients and lead to high morbidity and mortality. Numerous dressings have been developed to facilitate wound healing of DFUs. This study investigated the wound healing efficacy of silver-releasing foam dressings versus silver-containing cream in managing outpatients with DFUs. Sixty patients with Wagner Grade 1 to 2 DFUs were recruited. The treatment group received silver-releasing foam dressing (Biatain® Ag Non-Adhesive Foam dressing; Coloplast, Humlebaek, Denmark). The control group received 1% silver sulfadiazine (SSD) cream. The ulcer area in the silver foam group was significantly reduced compared with that in the SSD group after four weeks of treatment (silver foam group: 76.43 ± 7.41%, SSD group: 27.00 ± 4.95%, p < 0.001). The weekly wound healing rate in the silver foam group was superior to the SSD group during the first three weeks of treatment (p < 0.05). The silver-releasing foam dressing is more effective than SSD in promoting wound healing of DFUs. The effect is more pronounced in the initial three weeks of the treatment. Thus, silver-releasing foam could be an effective wound dressing for DFUs, mainly in the early period of wound management.

scholarly journals Emerging Diabetic Foot Ulcer Microbiome Analysis using Cutting Edge Technologies

2021 ◽  
pp. 193229682199009
Author(s):  
Brian M. Schmidt
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Standard Of Care ◽  
Molecular Techniques ◽  
Foot Ulcers ◽  
Care Practice ◽  
Antibiotic Administration ◽  
Diabetic Foot Ulcers ◽  
Conventional Culture

One of the most prevalent complications of diabetes mellitus are diabetic foot ulcers (DFU). Diabetic foot ulcers represent a complex condition placing individuals at-risk for major lower extremity amputations and are an independent predictor of patient mortality. DFU heal poorly when standard of care therapy is applied. In fact, wound healing occurs only approximately 30% within 12 weeks and only 45% regardless of time when standard of care is utilized. Similarly, diabetic foot infections occur in half of all DFU and conventional microbiologic cultures can take several days to process before a result is known. DFU represent a significant challenge in this regard because DFU often demonstrate polymicrobial growth, become resistant to preferred antibiotic therapy, and do not inform providers about long-term prognosis. In addition, conventional culture yields may be affected by the timing of antibiotic administration and collection of tissue for analysis. This may lead to suboptimal antibiotic administration or debilitating amputations. The microbiome of DFU is a new frontier to better understand the interactions between host organisms and pathogenic ones. Newer molecular techniques are readily available to assist in analyzing the constituency of the microbiome of DFU. These emerging techniques have already been used to study the microbiome of DFU and have clinical implications that may alter standard of care practice in the near future. Here emerging molecular techniques that can provide clinicians with rapid DFU-related-information and help prognosticate outcomes in this vulnerable patient population are presented.

The Influence of Arterial Calcification on Clinical Outcomes in Patients with Diabetic Foot Ulcer Complicated by Osteomyelitis Treated by Surgery

2021 ◽  
pp. 153473462110225
Author(s):  
Marta Carmena-Pantoja ◽  
Francisco Javier Álvaro-Afonso ◽  
Esther García-Morales ◽  
Yolanda García-Álvarez ◽  
Aroa Tardáguila-García ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Calcification ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Time To Recurrence ◽  
Artery Disease ◽  
Clinical Records

The aim of our study was to analyze the influence of radiographic arterial calcification (RAC) on clinical outcomes and wound healing in patients with diabetic foot ulcers complicated by osteomyelitis treated by surgery. We analyzed retrospectively the clinical records of 102 patients with diabetic foot osteomyelitis who underwent surgery at a specialized diabetic foot unit between January 2014 and December 2016. The clinical data of evolution until its complete epithelialization and a follow-up 1 year were reviewed, and after reviewing the radiological images, patients were classified into 2 groups: those with RAC and those without RAC. We analyzed several clinical features in both groups. The presence of RAC was associated with a greater time of healing (10.68 ± 7.24 vs 8.11 ± 4.50 weeks; P = .029) and shorter time to recurrence and reulceration (13.30 ± 9.25 vs 18.81 ± 11.63 weeks; P = .036). However, this association was not found for patients with mild and moderate peripheral artery disease (PAD), whose time of healing was 8.97 ± 4.51 weeks compared to 9.16 ± 6.39 weeks for patients without PAD; P = .864. The time of healing of diabetic foot ulcers complicated by osteomyelitis treated by surgery can be negatively affected by the presence of RAC even more than by the presence of mild and moderate ischemia. The presence of RAC may offer clinical guidance at the level of primary care though this would need thorough validation in future studies.

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