Evaluation of three different techniques for measuring wound area in diabetic foot ulcers: a reproducibility study

2020 ◽  
Vol 29 (9) ◽  
pp. 518-524
Author(s):  
Ismail Toygar ◽  
Ilgin Yildirim Simsir ◽  
Sevki Cetinkalp
Keyword(s):  
Diabetic Foot ◽  
Three Dimensional ◽  
Measurement Methods ◽  
Assessment Tools ◽  
Area Measurement ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Area ◽  
Reproducibility Study ◽  
Significant Difference

Objective: Wound surface area can be measured with several assessment tools, including a manual planimetric method, ImageJ software and three-dimensional wound measurement (3DWM) methods. This study aimed to determine the advantages of each method as well as the concordance between them. Method: This reproducibility study included adult patient volunteers with diabetic foot ulcers (DFUs). Wounds with ambiguous borders were excluded. All included wounds were sequentially assessed with each of the three measurement methods, and the time for each measurement was recorded with a chronometer. SPSS and MedCalc package software were used for all statistical analyses. Results: A total of 20 patients with 20 DFUs took part in the study. According to the measurement method, the average wound area was 6.41cm2 by the manual planimetric method, 6.53cm2 by ImageJ and 6.32cm2 by 3DWM. Correlation analyses revealed correlation coefficients of 0.997 between the manual planimetric method and ImageJ, 0.929 between the manual planimetric method and 3DWM, and 0.929 between ImageJ and 3DWM. Bland–Altman analysis was used to determine whether these three measurement methods could be used interchangeably. There was no significant difference between the three measurement methods and, therefore, it was concluded that they could be used interchangeably. Wound area measurement times were 173.35±19.38 seconds by the manual planimetric method, 61.60±9.21 seconds by ImageJ and 36.90±6.91 seconds by the 3DWM method. Conclusion: The three measurement methods studied can be used interchangeably, as each method is highly concordant with the other two. The fastest method was 3DWM and the manual planimetric method was the slowest.

scholarly journals A Comparative Study of Topical Sucralfate and Povidone Iodine Dressing in Diabetic Foot Ulcers in a Tertiary Care Hospital in Tirupati

2021 ◽  
Vol 8 (34) ◽  
pp. 3200-3204
Author(s):  
Bathena Sobha Rani ◽  
Gandikota Venkata Prakash ◽  
Budamala Sarada ◽  
Bharath Kumar Desu ◽  
Yadhuf Krishnan
Keyword(s):  
Comparative Study ◽  
Diabetic Foot ◽  
Povidone Iodine ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Diabetic Foot Ulcers ◽  
Wound Area ◽  
Significant Difference ◽  
The Mean

BACKGROUND Diabetic patients have reduced ability to metabolize glucose resulting in elevated blood sugar levels which further burdens the wound healing process. This leads to non-healing chronic ulcers. The sufferers of chronic diabetic foot ulcers are increasing globally due to lack of preventive and control measures. Sucralfate has been demonstrated in molecular studies to enhance the granulation tissue proliferation and thus promoting ulcer healing in the skin. Various clinical studies have also showed the efficacy of sucralfate in complete healing of the wound and in reducing the size of the wound. The purpose of this study was to compare the efficacy of topical sucralfate with that of povidone iodine dressing, in the healing of diabetic ulcers. METHODS This is a randomized comparative study. Among 100 patients, 50 patients received treatment in the form of povidone iodine dressings and 50 took treatment with sucralfate dressing. The patient underwent a detailed clinical examination. Relevant investigations were also done. The initial wound area was recorded after thorough debridement by measuring length x width. Both the groups underwent dressings once daily. The patients were followed up daily for a period of 3 weeks in both the groups. RESULTS In this study, the mean ± SD area of reduction of the ulcer was observed to be higher in sucralfate group 54.17 ± 10.08 than the povidone iodine group 16.07 ± 4.19. There was a statistically significant difference between the groups for the mean of area reduction (P < 0.0001, significant). CONCLUSIONS The ulcers in subjects treated with sucralfate dressing (S group) contracted more than the ulcers in the patients treated with povidone iodine (P group) (54.17 % Vs 16.07 %; P = < 0.0001, significant) which points out that sucralfate dressing is an effective modality in helping the reduction of wound area in patients with diabetic foot ulcers. KEYWORDS Diabetic, Sucralfate, Area of Reduction

scholarly journals Topical Insulin and Normal Saline in Chronic Diabetic Foot Ulcers- A Prospective Analytical Study

2020 ◽  
Author(s):  
Dayanand Biradar ◽  
Mallikarjun B Patil ◽  
Ramakanth Baloorkar ◽  
Vikram Sindagikar ◽  
K Manoop
Keyword(s):  
Surface Area ◽  
Normal Saline ◽  
Diabetic Foot ◽  
Analytical Study ◽  
Foot Ulcers ◽  
Minor Trauma ◽  
Diabetic Foot Ulcers ◽  
Wound Area ◽  
Significant Difference ◽  
Group A

Introduction: Diabetic foot ulcers are important diabetes-related microvascular complications aggravated due to multiple pre-existing factors such as peripheral arterial disease, immune system factors, bone abnormalities, diabetic neuropathy, infections and repetitive external or minor trauma. Diabetic foot ulcers could lead to lower limb amputation if not managed appropriately. Aim: To evaluate the use of topical insulin in chronic diabetic foot ulcers at a tertiary care centre. Materials and Methods: This prospective analytical study of 12 months duration was conducted in Department of Surgery, in diabetic patients between the age group of 25 to 70 years, presenting for the first time with diabetic foot ulcer. A total of 60 patients were divided into two groups alternately as group A patients underwent dressing with topical insulin and group B patients underwent dressing with regular normal saline. Sterile transparent gauze was placed on the wound to mark the wound borders and the wound area measured. With the help of ruler the two largest perpendicular diameters were measured and these were multiplied to obtain the wound area in cm2. Ulcers were cleaned with normal saline and a sterile gauze soaked with Human mixtard insulin and normal saline. Four units of 0.1 mL-Human mixtard insulin with 1 mL normal saline used for each 10 cm2 of wound in group A. Data was analysed by using SPSS software. Chi-square test was used and p-value of <0.05 was considered as significant. Results: Mean age distribution was 51.2±9.6 years and 50.6±10.9 years in group A and B, respectively. Mean HbA1c at admission was 6.3±0.9 and 6.1±0.8 in group A and B, respectively. On day 0,7,15 wound measurements were done. A statistically significant difference was noted in reduction of average surface area of wound at day 7, 15 between group A and B. Insulin dressing group showed better changes than saline dressing group. Percentage reduction of surface area of wound at day 15 was 67.8±11.45 in insulin dressing group and 49.51±18.21 in saline dressing group, statistically significant difference was noted. Average time required for granulation tissue to appear was 6.08±2.15 days and 9.48±4.21 days in group A and B, respectively, statistically significant difference was noted (p<0.001). Conclusion: The application of topical insulin is secure and successful in patients with diabetic foot ulcers. Topically applied insulin can increase speed of wound healing and there are no chances of systemic side effects.

Three-Dimensional Fibroblast Culture Implant for the Treatment of Diabetic Foot Ulcers: Metabolic Activity and Therapeutic Range

1998 ◽  
Vol 4 (4) ◽  
pp. 403-414 ◽  
Author(s):  
Jonathan Mansbridge ◽  
Kang Liu ◽  
Ruth Patch ◽  
Kent Symons ◽  
Emmett Pinney
Keyword(s):  
Metabolic Activity ◽  
Therapeutic Range ◽  
Diabetic Foot ◽  
Three Dimensional ◽  
Fibroblast Culture ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Association of traditional complementary and alternate medicine usage with quality of life of diabetic patients in a Malaysian tertiary hospital

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chinedum Ogbonnaya Eleazu ◽  
Aniza Abd Aziz ◽  
Tay Chuu Suen ◽  
Lam Chun-Hau ◽  
Chin Elynn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetic Foot ◽  
Heart Diseases ◽  
Tertiary Hospital ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Content Type ◽  
Significant Difference

Purpose This study aims to design to assess the traditional, complementary and alternate medicine (TCAM) usage and its association with the quality of life (QOL) of Type 2 diabetic patients in a tertiary hospital (Hospital Universiti Sains Malaysia) in Malaysia. Design/methodology/approach A total of 300 respondents included in this study were divided into the following two major categories: TCAM (34.33% of respondents) and non-TCAM users (65.67% of the respondents), respectively. The mean ages of the respondents were 59.3 ± 10.2 for the TCAM users and 57.7 ± 12.0 for the non-TCAM users. Findings A greater percentage of non-TCAM users reported poor control of diabetes (14.7%) and blood glucose (55.8%) compared with the TCAM users (9.7% and 48.5%, respectively). Further, the diabetic patients on TCAM reported lower rates of coma, stroke and kidney problems but higher rates of diabetic foot ulcers, heart diseases and retinopathy than the non-TCAM users. Additionally, the diabetic patients with TCAM usage had a significantly better physical (p = 0.02) and overall (p = 0.03) qualities of life compared to the non-TCAM users. However, psychological, social and environmental health did not show any significant difference. Originality/value The prevalence of TCAM usage among diabetic patients was lower than in other comparable studies. Diabetic patients on TCAM reported lower rates of coma, stroke and kidney problems but higher rates of diabetic foot ulcers, heart diseases and retinopathy than the non-TCAM users. Further, diabetes patients on TCAM reported better QOL compared to non-TCAM users especially in terms of physical health.

Comparative study between Negative Pressure Wound Therapy (NPWT) and Standard Moist Wound Dressing (SMWD) in management of diabetic non ischemic foot ulcers

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Kamal ◽  
A N Kamel ◽  
S M Elsayed
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background and Aims Diabetes is rapidly increasing in prevalence worldwide and surgery in patients with diabetic foot is becoming more common. Foot complications are a major cause of admissions in diabetic patients, and comprise a disproportionately high number of hospital days because of multiple surgical procedures and prolonged length of stay in hospital. Diabetic foot is an umbrella term for foot problems in patients with diabetes mellitus. Foot disorders such as ulceration, infection and gangrene are the most common, complex and costly sequelae of diabetes mellitus. The optimal therapy for diabetic foot ulcers remains ill-defined. Saline-moistened gauze has been the standard method; however, it has been difficult to continuously maintain a moist wound environment with these dressings. This has led to the development of various hydrocolloid wound gels, which provided more consistent moisture retention. Refinements in topical ointments have resulted in the addition of various pharmacological agents including growth factors and enzymatic debridement compounds. Hyperbaric oxygen therapy and culture skin substitutes are other wound therapies that have been advocated. All these therapies are associated with significant expense and are being utilized in some situations without sufficient scientific evidence demonstrating their efficacy. Therefore, the search for an efficacious, convenient and cost-effective therapy continues. Negative Pressure Wound Therapy (NPWT) is a newer noninvasive adjunctive therapy system that uses controlled negative pressure using Vacuum-Assisted Closure device (VAC) to help promote wound healing by removing fluid from open wounds through a sealed dressing and tubing which is connected to a collection container. The use of sub-atmospheric pressure dressings, available commercially as a VAC device, has been shown to be an effective way to accelerate healing of various wounds. This was aimed to compare wound outcome, limb salvage, and cost effectiveness between Negative pressure wound therapy (NPWT) and Standard moist wound therapy (SMWT) in management of diabetic non ischemic foot ulcers. Methods we performed a cohort study involving 30 patients with active diabetic foot ulcers, in a high volume tertiary referral vascular center. They were divided into 2 groups: 15 patients (group A) were prescribed NPWT and the other 15 patients (group B) received SMWD. During follow up visits, progress of healing was evaluated and documented in the form of change in wound diameter, depth, up or down scaling along UTWC, wound status at 2, 4, 8, and 12 weeks and 4 weekly thereafter till complete epithelialization. Results As regard to ulcer depth there were statistically significant difference between the 2 groups during follow up duration of the study after 4 weeks with group A showing faster decrease in ulcer depth than group B denoting faster formation of granulation tissue. As regard to complete granulation of ulcer there were statistically significant difference between the 2 groups during follow up duration of the study markedly shown after 6 weeks with group A showing complete ulcer granulation faster than group B, with statistically significant difference as regard to number of days on dressing and follow up duration in weeks between the 2 groups with group A showing lesser number of days on dressing and shorter follow up duration in weeks than group B. Conclusion NPWT has a definitive role in promotion of proliferation of granulation tissue, reduction in the wound size, by and rapid clearing of bacterial load. Our data demonstrates that negative pressure wound dressings decrease the wound size more effectively than saline gauze dressings over the first 4 weeks of therapy. It is suggested that NPWT is a cost-effective, easy to use and patient-friendly method of treating diabetic foot ulcers which helps in early closure of wounds, preventing complications and hence promising a better outcome.

scholarly journals Evaluating the Effects of Spraying Oxytetracycline on Diabetic Foot Ulcers: A Randomized Clinical Trial

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Gholam Hosein Kazemzadeh ◽  
Hasan Ravari ◽  
Masomeh Nabavizadeh ◽  
Saeid Pasban Noghabi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Diabetic Foot ◽  
Intervention Group ◽  
Purulent Discharge ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Significant Difference ◽  
And Control

Background: Diabetic foot ulcers (DFUs) can be created due to neuropathy and peripheral vascular disease in the lower limbs. Objectives: This study aimed to evaluate the effects of spraying oxytetracycline on DFU. Methods: This randomized clinical trial was conducted on 60 diabetic patients suffering from DFU. The patients were randomly assigned into two equal groups of intervention and control (n = 30 each). While all subjects received antibiotic therapy, blood sugar control, and, if necessary debridement, the intervention group received oxytetracycline spraying on the DFUs twice a day. After the intervention, the patients were visited every week (for three weeks), photos were taken of the DFUs by special software, and the size of the DFUs was checked. The DFUs were also studied in terms of purulent discharge, the smell, and erythema, and edema around the ulcer. After three weeks, the healing of ulcers were compared in the two groups. Data were gathered and analyzed using the SPSS software version 11.5, descriptive statistical test, chi-square, and t-test. Results: Before the study, the size of the DFUs in the intervention and control groups was 110.87 ± 38.3 and 127.12 ± 40 mm2, respectively. After the treatment, the alterations in the intervention group in the first, second, and third weeks were 14.90 ± 14.41, 26.93 ± 18.86, and 41.25 ± 19.51, respectively. Also, in the control group, the alterations were 19.45 ± 1.35, 23.78 ± 5.31, and 13.29 ± 8.75, respectively. There was a statistically significant difference in the size of DFUs between the two groups (P < 0.05). Conclusions: According to the results, spraying oxytetracycline on DFUs facilitated the process of healing. Thus, it can be used as an affordable, available, and effective method.

scholarly journals A Factor Increasing Venous Contamination on Bolus Chase Three-dimensional Magnetic Resonance Imaging: Charcot Neuroarthropathy

2018 ◽  
Vol 8 ◽  
pp. 13 ◽  
Author(s):  
Mehmet B. Çildağ ◽  
Mustafa B. Ertuğrul ◽  
Ömer FK. Köseoğlu ◽  
David G. Armstrong
Keyword(s):  
Magnetic Resonance ◽  
Diabetic Foot ◽  
Three Dimensional ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Charcot Neuroarthropathy ◽  
Venous Contamination ◽  
Group A ◽  
Group B

Background: The study aimed to evaluate the ratio of venous contamination in diabetic cases without foot lesion, with foot lesion and with Charcot neuroarthropathy (CN). Materials and Methods: Bolus-chase three-dimensional magnetic resonance (MR) of 396 extremities of patients with diabetes mellitus was analyzed, retrospectively. Extremities were divided into three groups as follows: diabetic patients without foot ulcer or Charcot arthropathy (Group A), patients with diabetic foot ulcers (Group B) and patients with CN accompanying diabetic foot ulcers (Group C). Furthermore, amount of venous contamination classified as no venous contamination, mild venous contamination, and severe venous contamination. The relationship between venous contamination and extremity groups was investigated. Results: Severe venous contamination was seen in Group A, Group B, and Group C, 5.6%, 15.2%, and 34.1%, respectively. Statistically significant difference was seen between groups with regard to venous contamination. Conclusion: Venous contamination following bolus chase MR was higher in patients with CN.

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