scholarly journals Current concepts for the evaluation and management of diabetic foot ulcers

2018 ◽  
Vol 3 (9) ◽  
pp. 513-525 ◽  
Author(s):  
Andreas F. Mavrogenis ◽  
Panayiotis D. Megaloikonomos ◽  
Thekla Antoniadou ◽  
Vasilios G. Igoumenou ◽  
Georgios N. Panagopoulos ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Diabetic Foot ◽  
Wound Care ◽  
Blood Glucose Control ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Therapeutic Footwear ◽  
Patients With Diabetes ◽  
Clinical Awareness

The lifetime risk for diabetic patients to develop a diabetic foot ulcer (DFU) is 25%. In these patients, the risk of amputation is increased and the outcome deteriorates. More than 50% of non-traumatic lower-extremity amputations are related to DFU infections and 85% of all lower-extremity amputations in patients with diabetes are preceded by an ulcer; up to 70% of diabetic patients with a DFU-related amputation die within five years of their amputation. Optimal management of patients with DFUs must include clinical awareness, adequate blood glucose control, periodic foot inspection, custom therapeutic footwear, off-loading in high-risk patients, local wound care, diagnosis and control of osteomyelitis and ischaemia. Cite this article: EFORT Open Rev 2018;3:513-525. DOI: 10.1302/2058-5241.3.180010

scholarly journals Factors associated with wound healing outcome among Diabetic Foot patients- A cross sectional Study

2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Wound Management ◽  
Diabetic Patients ◽  
Foot Care ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
One Year

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.

scholarly journals A randomized controlled trial of the safety and efficacy of a topical gentamicin–collagen sponge in diabetic patients with a mild foot ulcer infection

2018 ◽  
Vol 6 ◽  
pp. 205031211877395 ◽  
Author(s):  
Ilker Uçkay ◽  
Benjamin Kressmann ◽  
Sébastien Di Tommaso ◽  
Marina Portela ◽  
Heba Alwan ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Diabetic Foot ◽  
Wound Care ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Collagen Sponge ◽  
Diabetic Patients ◽  
Topical Antibiotic

Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin–collagen sponge with local care versus local care alone. Systemic antibiotic agents were prohibited. Results: We enrolled a total of 22 patients, 11 in the gentamicin–collagen sponge arm and 11 in the control arm. Overall, at end of therapy, 20 (91%) patients were categorized as achieving clinical cure of infection, and 2 (9%) as significant improvement. At the final study visit, only 12 (56%) of all patients achieved microbiological eradication of all pathogens. There was no difference in either clinical or microbiological outcomes in those who did or did not receive the gentamicin–collagen sponge, which was very well tolerated. Conclusion: The results of this pilot trial suggest that topical antibiotic therapy with gentamicin–collagen sponge, although very well tolerated, does not appear to improve outcomes in mild diabetic foot ulcer infection.

Reducing Lower Extremity Amputations Due to Diabetes: The Application of Diabetic-Foot Protocol in Chiang Mai University Hospital

2008 ◽  
Vol 7 (2) ◽  
pp. 88-92 ◽  
Author(s):  
Kittipan Rerkasem ◽  
Natapong Kosachunhanun ◽  
Siam Tongprasert ◽  
Krit Khwanngern ◽  
Anuchart Matanasarawoot ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Standard Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
University Hospital ◽  
Diabetic Patients ◽  
Foot Care ◽  
Care Groups ◽  
Patients With Diabetes ◽  
Foot Disease

The aim of this study was to determine whether intensive treatment and education strategies for diabetic patients with ulcers help in preventing leg amputation. From August 2005 to March 2007, a diabetic-foot protocol using a multidisciplinary approach was applied at our hospital. All the subjects were educated regarding diabetic-foot disease and its complications and prevention. This report compares the amputation rate in patients receiving the protocol care from August 2005 to March 2007 with those who had standard care from August 2003 to July 2005. Seventy-three and 110 diabetic-foot ulcer patients received protocol and standard foot care, respectively. The incidence of major amputations in the protocol and standard care groups was 4.1% and 13.6%, respectively ( P = .03). Our protocol was associated with improved diabetic-foot care outcomes. It can be used by any hospital to improve outcomes for patients with diabetes.

scholarly journals The risk factors of developing diabetic foot ulcers incidence with diabetic patients in Mukalla/Yemen

2020 ◽  
Author(s):  
مريم باراس ◽  
Eidha A. Bin Hameed
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Glucose ◽  
Bacterial Infection ◽  
Diabetic Foot ◽  
Age Groups ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Patients With Diabetes

Background: Diabetes is on the rise worldwide and is already considered as an epidemic by some experts. So, there is a need to raise awareness on the important factors that can help prevent bacterial infection in wounds of patients with diabetes. Objective: To study the risk factors of developing diabetic foot ulcer (DFU) in patients with diabetes. The study is the first in Yemen to investigate the prevalence of bacterial infection in wounds of diabetic patients. Materials and Methods: This is a case-control study carried out from November 2018 to May 2019. Twenty diabetic patients with foot ulcer and twenty without foot ulcer were examined. Risk factors and clinical profile of patients were studied by using a standardized questionnaire that included gender, age groups, past history of diabetes, duration of the disease, type of diabetes, DFU, type of ulcer, smoking, glucose level, and control of blood glucose level. Results: The risk factors that affected significantly the occurrence of DFU were gender (0.038), age groups (0.010), and duration of diabetes mellitus (DM) while hyperglycemic control, smoking, and family history were not. There was no significant difference (0.977) in mean fasting blood glucose (MBG) between the DM and DFU patients. Conclusions: Male diabetic patients aged more than 55 years and suffering from DM for more than 10 years were most likely to have DFU. Key words: diabetic foot ulcer, diabetes mellitus, risk factors, Yemen 

scholarly journals KEJADIAN DERAJAT LUKA DIABETES TIDAK BERHUBUNGAN DENGAN NILAI RISIKO DIABETIC FOOT ULCER

2017 ◽  
Vol 4 (2) ◽  
pp. 215-227
Author(s):  
Risma Anggraeni Yuliastuti ◽  
Megah Andriany ◽  
Eka Putri Y.
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Risk Level ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Diabetic Ulcer ◽  
Significance Level ◽  
Risk Levels

The highest diabetic complication percentage is neuropathy (54%) causing diabetic foot ulcer (DFU). The study aimed to know the relationship between diabetic foot ulcer risk levels with diabetic ulcer severity levels. Scope of the study was diabetic wound care, particularly on legs mostly experienced by diabetic patients. The method used was descriptive correlation with cross sectional design. Sampling method was non probability with purposive sampling. Respondent number was 16 persons with inclusion criteria was diabetic patients with ulcer in one leg and no ulcer on another side in the second visitation to a diabetic clinic in Bekasi,Indonesia and agreed to be involved in the study. DFU risk level instrument modified from Diabetes Foot Screening and Risk Stratification Form of New Zealand Society for Study of Diabetes (NZSSD) to measure the DFU degree on legs with no ulcer. Another tool was to measure severity level of legs with ulcer according to Wagner. Data analysis used Kendall’s tau with 0.05 of significance level. The result shows there is no relationship between DFU risk levels with severity degree of diabetic ulcers. From the study, we can conclude that nurses do not need provide specific DFU prevention based on diabetic ulcer severity grade. 

Treatment of Diabetic Foot Infections

2020 ◽  
Author(s):  
Shimpo Aoki ◽  
Lauren R Bayer ◽  
Dennis P Orgill
Keyword(s):  
Diabetic Foot ◽  
Multidisciplinary Approach ◽  
New Technologies ◽  
Wound Care ◽  
Full Range ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Diabetic Foot Infections ◽  
Biomechanical Changes

Thirteen percent of diabetic patients will develop a foot ulcer, often associated with infection, vascular disease and biomechanical changes. Limb salvage offers the potential to restore function but does not correct the underlying metabolic disturbance. We review the surgical approach to diabetic foot infections including debridement, skin grafts, local flaps and a variety of new technologies. A comprehensive multidisciplinary approach is beneficial to optimize outcomes. The full range of reconstructive options available to plastic surgeons may be used in the treatment of diabetic foot ulcers. This review has 5 figures, 2 tables, and 20 references. Key words: Diabetic Foot Infection (DFI), Diabetic Foot Ulcer (DFU), Diabetes Mellitus (DM), wound care, foot infection, bacterial infection, surgical management, neuropathy, surgery of the lower extremity, deformities

scholarly journals Karakteristik Diabetic Foot Ulcer (DFU) pada Individu dengan Diabetes Mellitus (DM): Studi Deskripsi – Cross Sectional

2020 ◽  
Vol 7 (2) ◽  
pp. 88-98
Author(s):  
Niken Safitri Dyan Kusumaningrum ◽  
Afriana Dwi Saputri ◽  
Henni Kusuma ◽  
Meira Erawati
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Diabetic Patients ◽  
Fatty Tissue ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Patients With Diabetes

Diabetic Foot Ulcer (DFU) is one of the complications often experienced by patients with diabetes mellitus (DM). This is a serious problem that leads to disability, morbidity, and mortality among diabetic patients. However, in Indonesia, studies about DFU characteristics are very limited. This study aimed to describe DFU characteristics among patients with DM. A consecutive sampling involved patients who met inclusion criteria was performed in Tugurejo Hospital; Islamic Sultan Agung Hospital, and Dr. Moewardi Hospital. Their demographic characteristics, clinical condition, and wound appearances were noted and documented. Diabetic Foot Ulcer Assessment Scale (DFUAS) that consists of 11 characteristics was used to observe the wound features. The data were quantitatively analyzed to elucidate the result. A total of 73 patients participated in this study. It was revealed that 50.7% were females and 75.3% have been diagnosed with hyperglycemia. The average age of the respondents was 53.26 years. Observation of DFU characteristics showed that depth of wound was identified more in subcutaneous/ dermis to fatty tissue (40 patients; 54.8%) than in other layers. Moreover, our findings indicated that most of the respondents were identified at a severe level of the wound (55; 75.3%). It is concluded that DFU characteristics vary among patients with DM. Early identification and intensive surveillance are important to improve the management of DFU and to avoid lower limb amputation.

scholarly journals Different Pain Level Of Diabetes Mellitus Patients With Peripheral Neuropathy Who Have Been Given Tens And Deep Breathing Interventions In Diabetic Foot Ulcer Treatment In Yogyakarta General Hospital

2017 ◽  
Vol 3 (2) ◽  
pp. 11
Author(s):  
SATRIYA PRANATA
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Wound Care ◽  
Intervention Group ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
The Body ◽  
Control Group ◽  
Diabetic Patients ◽  
Ulcer Treatment

Introduction : Regular intervention of diabetic� foot ulcers is wound care. Patients often complain of pain when nurse performs wound care. If the pain is not resolved it will result in anxiety feeling. A routine intervention conducted so far is intra-breath in intervention to reduce pain, as it is expected by reducing the pain it will be followed by a decrease of patients� anxiety. Intra-breath intervention has not been able to reduce pain quickly on a moderate scale, especially high-scale so it is necessary to find out other alternative interventions. The available comparative intervention is TENS. The purpose of this study is to know the difference between intra-breath and TENS intervention in the level of anxiety in diabetic patients with peripheral neuropathy in diabetic foot ulcer treatment. Method : This study used RCT method on 28 respondents divided into 14 intervention groups and 14 control groups. The anxiety of respondents was assessed using Hamilton Scale of Anxiety tools before and after conductin TENS intervention and intra-breath. TENS intervention was given for 15 minutes at a frequency of 100 Hz and intra-breath was given until the wound care intervention was completed. Result : The results showed that there was significant average difference of anxiety level between the use of TENS intervention and the use of intra-breath intervention in intervention group and the control group with value of P <0.05. TENS can reduce the level of anxiety with the value of P 0.000, while intra -breath is able to lower the level of anxiety with the value of P 0.006. Discussion : The respondents admitted the difficulty of experience maximum relaxation when wound care is done, this condition is related to the comfortable position of respondents. When wound care is done, the respondents can not relax maximaly because many of the foot that has ulcers should be padded with a pillow to maximize the treatment. Provision of TENS with a frecuency of 100 Hz is corresponding to the body�s bioelectricity, the patients that receive TENS intervention may become more rrelaxed with endorphine hormone release and decreasing of pain because the electricity blocks pain implans in the neural tube.

scholarly journals Knowledge of Risk Factors for Foot Ulceration among Patients with Diabetes Mellitus Attending a Tertiary Health Facility in Nigeria

2021 ◽  
Author(s):  
Martins Ehizode Emuze ◽  
Taoreed Adegoke Azeez ◽  
Arinola Esan ◽  
Jokotade Adeleye ◽  
William Balogun ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Health Facility ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Foot Ulceration ◽  
Validated Questionnaire ◽  
Patients With Diabetes

Objective: Diabetic foot ulcer (DFU) is a relatively common complication of diabetes mellitus and constitutes a major cause of mortality. This study aimed to assess the knowledge of risk factors for foot ulceration among patients with diabetes in a tertiary health facility in South Western Nigeria. Materials and Methods: This cross-sectional study was initiated with participation of 100 diabetic patients. Diabetic patients were attending the medical outpatient clinic of the University College Hospital, Ibadan. A structured and validated questionnaire was administered and data was analyzed using SPSS 22. Association between sociodemographic characteristics and knowledge of risk factors for foot ulceration was evaluated by chi-square test. Results: Most of respondents were female (66%). The mean age of the patients was 58.77 (±11.8) years and 51% of patients did not know that it is possible to develop foot ulcer without feeling pain and 30% did not know that features suggestive of neuropathy could be associated with development of foot ulcer. 75% did not know that surgical vascular repair could play any role in the healing of a diabetic foot ulcer. 11% of patients were walking barefooted at home and as much as 63% of respondents did not know that poor longterm glycemic control could be a risk factor for the development of diabetic foot ulcers. Conclusion: The knowledge of the patients attending the diabetes clinic of a tertiary hospital in south-western Nigeria on foot care is generally poor. Education in this direction is very paramount to correct this defect.

scholarly journals An approach to diagnosis and management of diabetic foot in rural medical college

2018 ◽  
Vol 5 (12) ◽  
pp. 4031
Author(s):  
Hanumanthaiah C. S. ◽  
V. Sharath Kumar ◽  
Suhas N. Gowda
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Limbs ◽  
Hospital Treatment ◽  
Diabetic Patients ◽  
Predisposing Factor ◽  
Diabetic Ulcer ◽  
Medical College ◽  
Patients With Diabetes

Background: India has the dubious distinction of becoming the diabetic capital of the world within the next few years; with its attendant complications it is going to burden the resources of the country. A majority of diabetic patients develop foot ulcers in one point of time or other during the course of their illness. A significant number of such patients will require long-term hospital treatment and amputations. Objective is to assess the predisposing factor and various modes of clinical presentation and management of Diabetic foot ulcer.Methods: An observational and prospective Hospital based Study was conducted at AIMS, B G Nagara, Bellur Cross from January 2018 to June 2018. A total of 40 patients with Diabetes Mellitus and suffering from diabetic foot ulcer admitted in the department of surgery were included in the study.Results: The mean age was 61+ 13.9 years. The male constituted nearly 26 (65%) and 14 (35%) females. Nearly 31(78%) of the cases had some of the predisposing factors for the diabetic ulcer of the foot The involvement of peripheral Vascular Disease was seen in 6 (16%) of the cases and 9(22%) had. The levels of HbA1C more than 7 mg % was seen in nearly 82 % of the case showing poor glycaemic control.Conclusions: Diabetic patients have always suffered from complications affecting the lower limbs. Foot infection and the subsequent amputation of a lower extremity are the most common cause of hospitalization among diabetic patients.

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