scholarly journals Efficacy of Vitamin C and Vitamin E as an add on therapy in diabetic foot ulcer and red blood cell morphology as a biomarker of oxidative stress: a randomized, open label, comparative pilot study

2018 ◽  
Vol 7 (3) ◽  
pp. 548
Author(s):  
Vasanthi B. ◽  
Ainsy Goldlin T. J.
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Vitamin E ◽  
Vitamin C ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Study Group

Background: Diabetes mellitus is a major cause of increased morbidity and mortality in developing countries. Foot ulcer is one of the long term complications of diabetes. Oxidative stress plays a major role in pathogenesis of diabetes mellitus and its long term complications. Impaired wound healing in diabetic individuals is due to ischemia and hypoxia occurring as a consequence of oxidative stress. Vitamin C and E have antioxidant property. This study aims to assess their efficacy in healing of diabetic ulcer. Objective of the study was to evaluate the efficacy of Vitamin C and E in healing diabetic foot ulcer.Methods: 60 adult patients with diabetic foot ulcer were randomized to test and control groups (30 in each). Treatment period was 12 weeks + 4 weeks follow up per patient. After obtaining written informed consent, patients in test group received Vitamin C (500mg BD) and Vitamin E (400mg BD) for 12 weeks along with standard treatment for diabetes and antibiotics for foot ulcer.Results: At the end of 12 weeks, increase in healing of foot ulcer assessed by percent reduction of ulcer area in study group 72.50% than control group 39.67% (p<0.001) was observed. There was a significant reduction of fasting blood glucose, Oxidative stress induced damage to RBCs and BP in the study group compared to control group. No serious adverse effects occurred.Conclusions: Vitamin C and E reverse oxidative stress induced morphological changes in RBCs, improve anemia and increase blood flow to ulcer area. Hence they are highly effective in healing diabetic foot ulcer along with standard therapy. 

scholarly journals A study of the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds

2019 ◽  
Vol 6 (3) ◽  
pp. 669
Author(s):  
Byomokesh Patro ◽  
Pankaj Surana ◽  
Kailash Chandra Mahapatra
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Working Environment ◽  
Lower Limbs ◽  
Control Group ◽  
Study Group

Background: Infection of a diabetic foot wound heralds a poor outcome, early diagnosis and treatments are important. The aim of the study was to study the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds.Methods: 50 patients with diabetic foot ulcer considered for the present study. Out of this 50 cases 25 are selected for external fixations (study group), after fulfilling the inclusion criteria and rest 25 cases are managed by posterior slab support. After reducing the infective load, the external fixator was applied as per application of external fixator procedure. The fixator is kept for 4 to 6 weeks. Daily dressings are done with advance dressing materials. Posterior slab group 25 patients are included having large, deep ulcers and unstable joints, to which posterior slabs were supported after proper and extensive debridement of wound under SA/LA.Results: DFU predominantly affects right lower limb than left lower limb. Both lower limbs affected in 4% cases. Because of different working environment males are more vulnerable to foot ulcerations. Out of 50 cases 48 (96%) of DFU are unilateral and 32 no of cases (64%) are predominantly occurs in right lower limb (Table 2). Out of 50 cases 38 no. of patient are males and 12 no. of patient are females. External fixator in exposed joint decreases the wounds in 52 days where as by posterior slab support 59 days. The mean surfaces are of the wound after therapy in study group is 75 cm2 and in control group it was 78 cm2.Conclusions: Large ulcers and exposed joints due to diabetic foot can be managed by external fixator for better prognosis than posterior slab method.

Research on the Treatment of Diabetic Foot with Ulcer Based on Nano-Silver Antibacterial Dressing

2021 ◽  
Vol 21 (2) ◽  
pp. 1220-1229
Author(s):  
Lumeng Yang ◽  
Fang Liu ◽  
Yijun Chen ◽  
Zhangyi Liu ◽  
Guowu Zhang
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Morphological Characterization ◽  
Healing Time ◽  
Control Group ◽  
Nano Silver ◽  
Great Pain

The incidence of diabetes has been increasing year by year. Long-term growth in blood sugar causes complications such as diabetic foot ulcer and infections, which will increase the difficulty of ulcer treatment. The diabetes brings great pain and heavy economic burden to patients and their families. In view of the above problems, a nano-silver antibacterial dressing is synthesized in this paper to control bacterial infection on the ulcer surface and promote wound healing. This paper describes the preparation process and morphological characterization of nano-silver antibacterial dressings. 100 patients were selected, which divided into two groups for comparative experiments. The conventional group used conventional vaseline dressing, and the control group was nano-silver antibacterial dressing. The ulcer surface healing time, the number of dressing changes, and the control of infection were analyzed separately, and statistical analysis was performed with SPSS19.0. The experimental results are as follows. The use of nano-silver antibacterial dressing can significantly reduce the incidence of infection in diabetic foot patients, which is helpful to reduce the number of dressing changes, shorten the healing time of ulcer, and accelerate the turnover rate. It helps to shorten the course of diabetic foot, and it is recommended to promote its clinical application.

Efficacy of Intra-Lesional Platelet Rich Plasma in Diabetic Foot Ulcer

2020 ◽  
Author(s):  
Ajay Gupta ◽  
Chethan Channaveera ◽  
Satyaranjan Sethi ◽  
Sunil Ranga ◽  
Vijender Anand
Keyword(s):  
Normal Saline ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Platelet Rich Plasma ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Study Group ◽  
Ulcer Area ◽  
Total Contact Casting

Background: Diabetic foot ulcer (DFU) is well managed by infection control, euglycemic state, debridement of ulcer followed by appropriate dressing and off-loading of the foot. Studies have reported that when DFU is properly off-loaded, about 90% of these would heal in nearly six weeks. Platelet rich plasma (PRP) serves as a growth factor agonist and has mitogenic and chemotactic properties which help in DFU healing. To evaluate the efficacy of local application of PRP with respect to healing rate and ulcer area reduction in treating diabetic foot ulcer. Materials and Methods: Sixty non-infected DFU patients with plantar ulcer of size less than 20cm2 and Wagner's Grade 1 & 2 were randomized to receive normal saline dressing (Control group - CG) or PRP dressing (Study group - SG) in conjunction with total contact casting for 6 weeks (or till complete ulcer healing), whichever was earlier. Evaluation was done at weekly interval for healing rate and change in ulcer area.Results: Mean ulcer area of study participants at baseline was 4.96 {plus minus} 2.89cm2 (CG) and 5.22 {plus minus} 3.82cm2 (SG) (p=0.77) which decreased to 1.15{plus minus}1.35cm2 (CG) and 0.96{plus minus}1.53cm2 (SG) (p=0.432) at 6wks. Percent reduction in mean healing area at 6wks was 81.72{plus minus}17.2% and 85.98{plus minus}13.42% in control group and study group respectively (p=0.29). Average rate of healing achieved at 6 weeks was 0.64{plus minus}0.36cm2 and 0.71{plus minus}0.46cm2 in control group and study group respectively (p=0.734). Conclusions: PRP dressing is no more efficacious than normal saline dressing in management of DFU in conjunction with total contact casting.

scholarly journals THE EFFECT OF INFRARED RAY AND COUNSELING ON DIABETIC FOOT ULCER HEALING PROCESS

2019 ◽  
Vol 8 (2) ◽  
pp. 134-139
Author(s):  
Mokh Sujarwadi ◽  
Mukhammad Toha ◽  
Nurul Huda
Keyword(s):  
Diabetes Mellitus ◽  
Ulcer Healing ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Capillary Refill Time ◽  
Capillary Refill ◽  
Significance Level

Background: Diabetic foot ulcer is one of the chronic complications of diabetes mellitus caused by neuropathy, angiopathy and decreased endurance. The risk of amputation in patient with diabetes mellitus fifteen times greater compared to non-diabetic. Various efforts on diabetic foot wound care have been carried out but the results are still far from satisfactory. Until now, infrared and counseling effect on wound healing in diabetic foot cannot be explained.Objective: The purpose of this study was to examine the effect of infrared ray and counseling on diabetic foot ulcer healing process.Method: The research design was quasi-experimental design with posttest control group design, the population in this study were patients with grade 3 diabetic foot wounds, blood sugar 100-200 g/ dl, BMI 18.5 to 24.9, aged 35-55 years. Large sample in this study as many as 20 were divided into two groups, the control random sampling. The collection of data for the dependent variable using the observation sheet after the tenth day of treatment, which consists of the rate of growth of granulation, ankle brachial index and capillary refill time. Furthermore, the data were processed using non-parametric statistical significance level < 0.05.Result: The results showed that the infrared and counseling effect on the growth of granulation with a significance level (p = 0.0003), infrared and counseling influence ankle brachial index (p = 0.024), infrared and counseling effect on capillary and counseling effect on capillary refill time (p = 0.024).Conclusion: It can be concluded from this study that applying infrared and counseling has any impact on healing in diabetic foot ulcer, on the growth of granulation and improved blood in diabetic foot ulcers. Key words: Infrared Ray, Counseling, Foot Ulcer Healing.

scholarly journals Therapeutic and Ameliorative Effects of Active Compounds of Combretum molle in the Treatment and Relief from Wounds in a Diabetes Mellitus Experimental Model

Coatings ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 324
Author(s):  
Reham Z. Hamza ◽  
Shaden E. Al-Motaani ◽  
Tarek Al-Talhi
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Rats ◽  
Male Rats ◽  
Foot Ulcers ◽  
Control Group ◽  
Combretum Molle

Foot ulcers are one of the leading causes of severe and high mortality in diabetics. It is known that wound healing in diabetics is a very complicated process due to the direct severe effect of diabetes mellitus on blood vessels, causing difficulty in wound healing. Many methods of treatment have recently been employed for novel dressings for the promotion of tissue regeneration and rapid wound closure. Combretum molle is composed of chemical compounds, such as lignin, gallic acid, and ellagic acid. Twenty male rats that were 4 months of age were divided into a I-a diabetic foot ulcer group as the control group and a II-a diabetic group (wound + Combretum molle). This study investigated the antioxidant and excellent healing effects of the extract of Combretum molle in repairing skin damaged by diabetes. This was confirmed by elevated antioxidant enzymes in the animals’ tissues in diabetic rats treated with this extract. The recovery of the alterations in the skin layers led to great improvements, which proved the Combretum molle’s promising capacity for wound healing in diabetics with wounds that mimic diabetic foot ulcers. This treatment can be considered a promising opportunity for patients with severe foot ulcers and may open the door to more discoveries about this plant’s medical capabilities.

scholarly journals Pengaruh kombinasi vitamin c dan vitamin e terhadap Kadar malondialdehid plasma pasien diabetes mellitus tipe 2

2016 ◽  
Vol 4 (1) ◽  
pp. 1-8
Author(s):  
Yade Kurnia Yasin ◽  
Martha Irene Kartasurya ◽  
RA Kisdjamiatun RMD
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Vitamin E ◽  
Treatment Group ◽  
Vitamin C ◽  
Fasting Blood Glucose ◽  
Control Group ◽  
Double Blind ◽  
Control Group Design ◽  
Before And After

Background: Malondialdehyde (MDA) levels produced by oxidative stress in type 2 diabetes mellitus (T2DM) is higher than in non diabetes patients. Vitamin C and E inhibit oxidative stress and MDA production. The purpose of this study was to prove the effects of combined vitamin C and vitamin E on MDA plasma levels in T2DM patients.Methods: This double blind randomized pre post test control group design was carried out on 35 patients with T2DM without complication (age 40-60 yr) in Makassar. The treatment group (n=18) received vitamin C 250 mg/day plus vitamin E 400 IU/day and the control group (n=17) received placebo (seaweed powder 250 mg), for six weeks. Vitamin C was consumed before meal and vitamin E after meal. MDA levels were measured before and after supplementation by using TBARs method. Food intake and activity were derived from 24-hour recall method.Results: There was no different on MDA levels at baseline (p=0.151). At the end of the study, MDA levels increased in control group (5.8±2.74 to 7.2±3.00 nmol/ml; p=0.044) but not in the treatment group (7.2±2.88 to 7.7±2.02 nmol/ml; p=0.490). There was no difference in MDA alteration between the goups (p=0.316). There was no different in MDA levels at the end of the study (p=0.061) and confirmed after controlling the confounding variables: vitamin E intake and fasting blood glucose (p=0.809). Conclusion: Combined vitamin C 250 mg and vitamin E 400 IU for 6 weeks did not reduce MDA levels, but inhibit MDA production in T2DM patients.

A COMPARATIVE STUDY OF PLATELET RICH PLASMA DRESSING VS NORMAL SALINE DRESSING IN THE MANAGEMENT OF DIABETIC FOOT ULCER

2021 ◽  
pp. 19-22
Author(s):  
Vijay kumar Siddalingappa ◽  
Mohan kumar Kariyappa ◽  
Subhashish Das
Keyword(s):  
Diabetic Foot ◽  
Platelet Rich Plasma ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Diabetic Patients ◽  
Study Group ◽  
Diabetic Ulcer ◽  
Plantar Aspect ◽  
Diabetic Wounds

90 patients with diabetic foot ulcer admitted in Department of General Surgery R. L. JALAPPA HOSPITAL, TAMAKA, KOLAR, in between the study period of December 2017 to June 2019. The study is estimated to include diabetic foot ulcer patients satisfying inclusion criteria who are admitted in surgical wards of RLJH and RC. A complete detailed history, as per standard proforma will be obtained and documented. All patients will undergo clinical examination with relevant investigations after obtaining an informed consent. Patients are divided into 2 groups using even-odd method to include similar type of cases in both groups, where even group is study group and odd group is control group. RESULTS: Predisposition of diabetic foot ulcer was common among males than in females, More number of diabetic patients presented with diabetic foot ulcer arising from trauma than those occurring spontaneously. The spontaneous onset ulcers healed better with PRP than those arising due to traumatic onset. The ulcers on dorsal aspect heal faster than on plantar aspect, PRP dressing improved the rate of healing in lower Wagner grade ulcer than in higher grade ulcer, Patients who were on insulin alone showed better healing than those on OHA. Over all PRP dressing group showed higher rate of ulcer size reduction than those on saline dressing. CONCLUSION: The diabetic ulcer in the study group treated with PRP dressing contracted in wound size more than in the control group. This indicates that PRP dressing is an effective method to facilitate wound contraction in diabetic patients with foot ulcer. PRP dressing is found to be more effective, cost efcient and safe promoter of ulcer wound healing and can be used as an adjunct to saline dressings for enhanced healing of diabetic wounds.

scholarly journals Pengaruh Range of Motion (ROM) Aktif Kaki terhadap Risiko terjadinya Ulkus Kaki Diabetik pada Pasien Diabetes Mellitus Tipe 2 di Desa Kaliwining Kabupaten Jember

2018 ◽  
Vol 6 (2) ◽  
pp. 305
Author(s):  
Yulfa Intan Lukita ◽  
Nur Widyati ◽  
Wantiyah Wantiyah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Range Of Motion ◽  
Diabetic Foot ◽  
Intervention Group ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Significant Difference

Diabetic foot ulcer is one of serious complications in diabetic patients which can lead to amputation.Active Leg range of motion (ROM) exercise is one of physical activities which can improve bloodcirculation in lower extremities. The objective of this research was to analyze the effect of active legROM on the risk of diabetic foot ulcer. This research employed non randomized control group pretestpostest design. The sampling technique was purposive sampling involving 30 repondents whichwere divided into 15 respondents as intervention group and 15 respondents as control group. Thedata were analyzed using dependent t test and independent t test with significant level of 0.05. Theresult revealed a significant difference between pretest and posttest in the intervention group (p =0.000) but no significant difference in the control group (p = 0.582). Furthemore, independent t testshowed a significant difference between intervention group and control group (p = 0.000). This resultindicates that there is a significant effect of active leg ROM on the risk of diabetic foot ulcer in clientwith type 2 diabetes mellitus. Nurse is expected to apply range of motion as one of intervention toprevent diabetic foot ulcer in diabetes mellitus patients.Keywords: type 2 diabetes mellitus, active leg range of motion, risk of diabetic foot ulcer

Efficacy of Aloe vera/ Plantago Major Gel in Diabetic Foot Ulcer: A Randomized Double-Blind Clinical Trial

2019 ◽  
Vol 16 (2) ◽  
pp. 223-231 ◽  
Author(s):  
Younes Najafian ◽  
Zahra M. Khorasani ◽  
Mona N. Najafi ◽  
Shokouh S. Hamedi ◽  
Marjan Mahjour ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Diabetic Foot ◽  
Intervention Group ◽  
Aloe Vera ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Plantago Major ◽  
Double Blind ◽  
Significant Difference

Background:Diabetic foot ulcer (DFU) is one of the most common complications of diabetic patients. Mostly, non-healing DFU leads to infection, gangrene, amputation and even death. High costs and poor healing of the wounds need a new treatment such as alternative medicine. So, the aim of this study was to evaluate the efficacy of Aloe vera/ Plantago major gel (Plantavera gel) in healing of DFUMethods:Forty patients with DFU enrolled in a double-blind randomized clinical trial. The patients who were randomly assigned into the intervention group (n = 20), received topical Plantavera gel in addition to the routine cares, whereas the patients in the control group (n = 20), received topical Placebo gel in addition to the routine cares. Intervention was done twice a day for 4 weeks in the both groups. Photography and an evaluation of DFU healing were conducted by a checklist and then were scored at baseline and at the end of each week. The collected data was analyzed by SPSS software.Results:At the end of the study, there was a significant difference between the two groups in terms of total ulcer score (P<0.001) and Plantavera gel significantly reduced the ulcer surface comparing with the control group (P=0.039). However, there was not a significant difference between the two groups (P=0.263) in terms of the ulcer depth. During this study, no side effect was observed for Plantavera gel in the intervention group.Conclusion:Topical Plantavera gel seems to be an effective, cheap and safe treatment. Of course, further studies are required to confirm the properties of the wound healing of this gel.

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.

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