scholarly journals Treatment of Diabetic Wounds With Photodynamic Therapy - Preliminary Results

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A422-A422
Author(s):  
Mariana Berbert ◽  
Sicilia Arruda ◽  
Camila Bichuetti ◽  
Alice Campos ◽  
Patricia Ceron ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Healing Process ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Promising Alternative ◽  
Significance Level ◽  
Injury Reduction ◽  
End Of Treatment ◽  
Peripheral Arterial ◽  
Diabetic Wounds

Abstract Diabetic patients have greater susceptibility to developing diabetic foot ulcers (DFU), which associated with peripheral arterial disease and/or infection, causes greater difficulty in the healing process. Photodynamic therapy (PDT) presents itself as a promising alternative for ulcer healing. This study aims to analyze the effectiveness and benefits of PDT in the treatment of diabetic wounds, associating the presence of arteriopathy, the size of the lesion, the presence and type of infection and the need for amputation. After the approval of the ethics committee in research and signing of the TCLE, six patients with eight diabetic wounds were evaluated. The study was carried out in an outpatient clinic of a medium complexity hospital in the interior of Minas Gerais, Brazil, with frequency of two weekly meetings, for a period of 5 months. Cultures were collected at the beginning and end of treatment, arterial doppler of the affected lower limb was performed. The photosensitizer used was methylene blue, with subsequent emission of LED light at a power of 100 mW/cm2, for 10 minutes. The data were analyzed by the Qui2 test, using the Software SPSS 25.0, with a significance level of 5% and are described with mean ± EPM. Age was 65.50 ± 7.58 years, 50% male. All had type 2 diabetes mellitus and the disease time was 9.50 ± 8.22 years. Five reported the presence of comorbidities such as SAH and dyslipidemia, and two presented concomitantly nephropathy and retinopathy. One patient was a smoker and two reported previous smoking. All lesions presented grade I classification by Texas classification (superficial cleft not involving tendon, capsule or bone). Five stage B ulcers (infection only), two stage C ulcers (ischemia only) and A stage D ulcer (infection and ischemia). At US arterial doppler, three patients had total viability of the affected limb and three presented arteriopathy, but only two with collateral. There was no association between arteriopathy and injury reduction (p=0.109). The mean area of injury was 11.15 ± 14.93 cm2. There was a reduction of 46.51 ± 31.10%. There was no association between injury area and percentage of reduction (p = 0.213), but there is a tendency for greater reductions in smaller lesions. Infection was present in 75% of the lesions. There was no association between the presence of infection and reduction of lesions (p=0.446). So far, we can conclude that the presence of arteriopathy without collateral, makes the procedure impossible. There was no association with the presence of infection and reduction of the lesion, and can also be used as a stimulator of the healing process. There was no association with wound size and percentage of reduction. It’s a promising therapy that should be better analyzed.

Pro- and Anti-Angiogenic Factors: Their Relevance in Diabetic Foot Syndrome—A Review

Angiology ◽  
2021 ◽  
pp. 000331972110426
Author(s):  
Martyna Schönborn ◽  
Patrycja Łączak ◽  
Paweł Pasieka ◽  
Sebastian Borys ◽  
Anna Płotek ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Arterial Disease ◽  
Angiogenic Factors ◽  
Diabetic Foot Syndrome ◽  
Tissue Loss ◽  
Comprehensive Treatment ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Peripheral Arterial

Peripheral arterial disease can involve tissue loss in up to 50% of patients with diabetic foot syndrome (DFS). Consequently, revascularization of narrowed or occluded arteries is one of the most common forms of comprehensive treatment. However, technically successful angioplasty does not always result in the healing of ulcers. The pathomechanism of this phenomenon is still not fully understood, but inadequate angiogenesis in tissue repair may play an essential role. Changes in pro- and anti-angiogenic factors among patients with DFS are not always clear and conclusive. In particular, some studies underline the role of decreased concentration of pro-angiogenic factors and higher levels of anti-angiogenic mediators. Nevertheless, there are still controversial issues, including the paradox of impaired wound healing despite high concentrations of some pro-angiogenic factors, dynamics of their expression during the healing process, and their mutual relationships. Exploring this process among diabetic patients may provide new insight into well-known methods of treatment and show their real benefits and chances for improving outcomes.

Peripheral Arterial Disease in Non-Diabetic Patients is Associated with Worse Outcomes after LVAD Implantation

2021 ◽  
Vol 40 (4) ◽  
pp. S171-S172
Author(s):  
V.T. Truong ◽  
S. Shreenivas ◽  
I. Rajapreyar ◽  
M. Shah ◽  
R.J. Alvarez ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Peripheral Arterial

scholarly journals Perbandingan efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Angelica M. J. Wagiu ◽  
Richard M. Sumangkut ◽  
Heber B. Sapan ◽  
Louise A. J. Waworuntu
Keyword(s):  
Peripheral Arterial Disease ◽  
Proteus Mirabilis ◽  
Peracetic Acid ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers ◽  
Citrobacter Diversus ◽  
Peripheral Arterial ◽  
Topical Antimicrobial

Abstract: Diabetic ulcer is a condition of infection, ulceration, and or destruction of inner skin tissue related to neurological disorders and degrees of peripheral arterial disease (PAD) in diabetic patients. Diabetic ulcer is prone to infection due to decreased immune response, therefore, opportunistic microbes can become pathogens. Infection is sttill a serious problem in diabetic ulcer since the high cost and long duration of treatment lead to complicated neclected ulcer. This study aimed to obtain the present profile of microbes in diabetic ulcers and the effectivitveness of peracetic acid dan feracrylum in the treatment of diabetic ulcers. This was a descriptive analytical study. The ulcer degree was determined by using PEDIS criteria. Pus specimen was taken with a sterile technique using a transport media, cultured in the Baxtec machine, and the microbes were identified and further tested for sensitivity to peracetic acid dan feracrylum 1%. The results showed that of the 57 patients there were 36 females with a mean age of 58.77+ 9.077 years. Most of the patients (30 patients) had diabetic ulcers of 4th degree. The result of pus culture showed Gram negative Proteus mirabilis as the most frequent microbe (17.5%). The sensitivity test showed that 100% of 12 types of microbes, 83.3% of Citrobacter diversus, and 60% of Proteus mirabilis samples were sensitive to peracetic acid, meanwhile, all microbes were resistant to feracrylum 1% dan NaCl as controls,. Conclusion: Peracetic acid was more effective than feracrylum 1% as topical antimicrobial for diabetic ulcer.Keywords: diabetic ulcer, microbe, topical antimicrobial agentAbstrak: Ulkus diabetik adalah suatu kondisi adanya infeksi, ulserasi dan atau kerusakan jaringan kulit yang lebih dalam yang berhubungan dengan kelainan neurologik serta berbagai tingkatan peripheral arterial disease (PAD) pada penderita diabetes melitus (DM). Ulkus diabetik lebih mudah terinfeksi karena respons kekebalan tubuh penderita DM biasanya menurun, bahkan kuman oportunistik juga dapat menjadi patogen. Infeksi masih menjadi masalah yang paling serius dialami penderita ulkus diabetik oleh karena biaya pengobatan yang besar dan waktu perawatan yang lama sehingga ulkus sering dibiarkan terinfeksi dengan komplikasi tanpa perawatan adekuat. Penelitian ini bertujuan untuk memperoleh data terkini pola kuman penderita ulkus diabetik dan untuk mengetahui efektivitas asam perasetik dan feracrylum pada pola kuman ulkus diabetik. Jenis penelitian ini ialah deskriptif analitik. Derajat ulkus dinilai dengan kriteria PEDIS. Spesimen pus diambil secara steril dengan media transpor, ditanam dalam mesin Baxtec, kemudian dilakukan identifikasi kuman dan uji sensitivitas terhadap asam perasetik dan feracrylum 1%. Hasil penelitian memperlihatkan dari 57 penderita ulkus diabetik terbanyak ialah perempuan (36 penderita) dengan rerata usia 58,77+9,077 tahun. Sebagian besar ulkus diabetik (30 penderita) termasuk derajat 4. Hasil kultur memperlihatkan Proteus mirabilis (Gram negatif) yang tersering (17,5%). Hasil uji sensitivitas pola kuman memperlihatkan 100% sampel dari 12 jenis kuman, 83,3% dari Citrobacter diversus, dan 60% dari Proteus mirabilis sensitif terhadap asam perasetik, sedangkan terhadap feracrylum 1% dan NaCl sebagai kontrol, seluruh kuman telah resisten. Simpulan: Asam perasetik lebih efektif dibandingkan feracrylum 1% sebagai antimikroba topikal pada ulkus diabetik.Kata kunci: ulkus diabetik, mikroba, antimikroba topikal

Prevalence, incidence and progression of peripheral arterial disease in Asian Indian type 2 diabetic patients

2014 ◽  
Vol 28 (5) ◽  
pp. 627-631 ◽  
Author(s):  
Jayasheel Eshcol ◽  
Saravanan Jebarani ◽  
Ranjit Mohan Anjana ◽  
Viswanathan Mohan ◽  
Rajendra Pradeepa
Keyword(s):  
Peripheral Arterial Disease ◽  
Asian Indian ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Peripheral Arterial ◽  
Type 2 Diabetic

scholarly journals Regenerative Therapies for Diabetic Microangiopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Roberto Bassi ◽  
Alessio Trevisani ◽  
Sara Tezza ◽  
Moufida Ben Nasr ◽  
Francesca Gatti ◽  
...  
Keyword(s):  
Arterial Disease ◽  
Matrix Proteins ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Microcirculatory System ◽  
Vessel Injury ◽  
Glycation End Products ◽  
Extracellular Level ◽  
Peripheral Arterial ◽  
Regenerative Therapies

Hyperglycaemia occurring in diabetes is responsible for accelerated arterial remodeling and atherosclerosis, affecting the macro- and the microcirculatory system. Vessel injury is mainly related to deregulation of glucose homeostasis and insulin/insulin-precursors production, generation of advanced glycation end-products, reduction in nitric oxide synthesis, and oxidative and reductive stress. It occurs both at extracellular level with increased calcium and matrix proteins deposition and at intracellular level, with abnormalities of intracellular pathways and increased cell death. Peripheral arterial disease, coronary heart disease, and ischemic stroke are the main causes of morbidity/mortality in diabetic patients representing a major clinical and economic issue. Pharmacological therapies, administration of growth factors, and stem cellular strategies are the most effective approaches and will be discussed in depth in this comprehensive review covering the regenerative therapies of diabetic microangiopathy.

Diabetic Foot and Footwear

2015 ◽  
Vol 19 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Luximon Ameersing ◽  
Ganesan Balasankar ◽  
Younus Abida
Keyword(s):  
Diabetic Foot ◽  
Plantar Pressure ◽  
Arterial Disease ◽  
Sensory Loss ◽  
Foot Deformities ◽  
Diabetic Patients ◽  
Body Parts ◽  
Foot Ulceration ◽  
Materials Used ◽  
Peripheral Arterial

Diabetes mellitus is one of the most common diseases around the world, and mainly affects the foot among the human body parts. The main causes of the diabetic foot are neuropathy, peripheral arterial disease and foot deformities; it leads to foot ulceration. Generally, sensory loss, high plantar pressure, foot deformities, inappropriate footwear, blindness, and age are the causing risk factors for developing foot ulceration in diabetic patients. Foot ulceration will result in prolonged hospitalization, high medical expenses, and serious complications with lower extremity amputation. For a long time, appropriate footwear has been recommended by physicians for reducing plantar pressure to prevent foot ulceration, the risk of amputation, and re-ulceration. A review is provided in this article towards the existing literature on the causes and prevalence of the diabetic foot, foot ulceration, off-loading pressure, footwear modification for different types of diabetic foot deformities, and types of footwear and textile materials used in footwear insoles for healing purposes.

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