Correlation of HDL cholesterol serum and Wagner’s severity level of diabetic foot ulcers

2017 ◽  
Vol 5 (12) ◽  
pp. 5129 ◽  
Author(s):  
Tommy Kartono ◽  
Muhammad Nuralim Mallapasi ◽  
Mulawardi Mulawardi ◽  
Sachraswaty R. Laidding ◽  
Meiliati Aminyoto ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Hdl Cholesterol ◽  
Foot Ulcers ◽  
P Value ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional ◽  
Severity Level ◽  
Before And After

Background: Diabetic foot ulcers are one of the leading causes of amputation in non-traumatic patients. This research aimed to investigate the correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification. The study conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia.Methods: This is an observational study with the cross-sectional design. The data collected before and after the treatment. The change of the levels of HDL cholesterol and the severity level of the diabetic foot ulcer based on Wagner classification during the treatment were analyzed. Data analyzed using Spearman Correlation test, the paired t-test to assess the change in the levels of HDL cholesterol and the levels of severity of diabetic foot ulcer based on Wagner classification at the time admission and after the treatment.  ANOVA test was used to observe the reduction significance of the severity of diabetic foot ulcer based on Wagner classification, and it was categorized as significant if p<0.05.Results: The results indicated that there is a correlation between the level of HDL cholesterol and the severity level of diabetic foot ulcer based on Wagner classification either at the early treatment with p-value = 0.003 (r = - 0.448) and the end of the treatment with p-value = 0.001(r = - 0.477).  The lower of the level of cholesterol HDL, the higher was the severity level of the diabetic foot ulcer. Meanwhile, the correlation between the increase of the level of HDL cholesterol and the reduction of Wagner classification during the treatment was statistically insignificant with p-value = 0.100 (r = - 0.215).Conclusions: there was a correlation between elevated HDL cholesterol levels during treatment with Wagner classification decrease during treatment, the higher the HDL change, the higher the Wagner classification, but this was weak correlation and statistically insignificant.

scholarly journals A one year cross sectional study on role of Wagner’s classification in predicting the outcome in diabetic foot ulcer patients

2018 ◽  
Vol 5 (7) ◽  
pp. 2537
Author(s):  
Praveena D. L. ◽  
Shashi M. Uppin ◽  
S. S. Shimikore
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional ◽  
Grade Ii ◽  
One Year

Background: Diabetes mellitus-related foot ulceration is very common. Several classification systems for diabetic foot ulcers have been proposed. The present study was intended to assess the role of Wagner wound classification in predicting the outcome of diabetic foot ulcer and also know the grade of Wagner’s classification to which majority of diabetic foot ulcer patients.Methods: This present one year cross sectional study was carried out at the Department of General Surgery. A total of 100 patients with diabetic foot ulcer who presented during the study period were included. The diabetic foot ulcers were graded according to the Wagner’s classification. The relative risk of amputation in different grades of diabetic foot ulcer based on Wagner classification was determined.Results: In this study majority of the patients were males (79%) and the male to female ratio was 3.76:1. The mean age was noted as 55.8±10.45 years. Majority of the patients had duration of ulcer less than one month (88%). Surrounding skin was inflamed in 60% of the patients, necrosis was present in 40% and slough was noted in 98% while 44% of the patients had necrotic tissue. Based on Wagner’s Classification, most of the patients (48%) had Grade II diabetic foot ulcers. With regard to management, in 44% of the patients’ debridement was done and 36% of the patients had disarticulation or amputation in 36%. Of the 48 patients with grade II ulcer, 79% of the patients had healing without amputation. Of the 58 patients with grade I and II diabetic foot ulcers, 82.76% had healing without amputation compared to 17.24% of the patients who needed amputation. Patients with Grade III, IV and V had 3.59 times higher risk of amputation compared to patients with grade I and II. (p<0.001; 95% CI- 1.95 to 6.62).Conclusions: Grading of diabetic foot ulcer based on Wagner’s classification affects and predicts the outcome and the risk of amputation increases with increasing grade. Most of the patients admitted for diabetic foot ulcers in our hospital belonged to Wagner’s grade II (48%).

scholarly journals PEDIS Score Analysis in Diabetic Foot Ulcer following Angioplasty Revascularization Procedure

2021 ◽  
Vol 2 (1) ◽  
pp. 20-25
Author(s):  
Ridho Sinaga ◽  
Djony Tjandra ◽  
Richard Sumangkut ◽  
Billy Karundeng ◽  
Fima Langi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Tissue Loss ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Vascular Disorders ◽  
Score Analysis ◽  
Before And After ◽  
Artery Disease

Background: Diabetic foot ulcers (DFU) is one of the major health care problems. Diabetic foot ulcers are a combination of vascular and non-vascular disorders. Vascular disorders that occur in the form of diabetic angiopathy which can be in the form of macro angiopathy if the condition occurs in large blood vessels, and micro angiopathy if it occurs in arterioles and capillaries. Revascularization can be done minimally invasive and has become the gold standard in the management of chronic limb ischemic (CLI). WHO recommends Perfusion, Extent / Size, Depth / Tissue Loss, Infection, Sensation (PEDIS) classification to diagnose and to determine the management of diabetic foot. We conduct a study to find out whether there are improvements in the PEDIS score of diabetic foot ulcer patients post angioplasty Methods: This study was designed in the form of a quasi-experiment, in which measurements before and after treatment were carried out on patients with diabetic foot ulcers (DFU) who underwent revascularization angioplasty without any measurement for control patients. From November 2019 to September 2020, there were 48 cases of diabetic foot ulcer with peripheral artery disease (PAD) who underwent angioplasty. Before the procedure, a clinical evaluation and calculation of the PEDIS score were carried out then angioplasty was performed, after the procedure the PEDIS score was calculated and evaluated in the first, second and third weeks. Results: The PEDIS scores of the patients prior to angioplasty had a median score of 8 (IQR 7; 9). Post-procedure the median quantity fell to 6 on both the immediate post angioplasty and two weeks afterward measurement with the width of the IQR narrowing slightly at the last measurement. The male patients’ PEDIS scores did not differ relatively from those of the female patients at the three measurement times, and their scores were almost identical to the scores for the patients as a whole. Conclusion: The results of this study indicate that there is an improvement in the PEDIS score in diabetic foot ulcer patients after revascularization angioplasty.

scholarly journals Frequency of Most Prevalent Bacteria in Wound of Diabetic Foot Ulcers and their Antimicrobial Susceptibility to Antibiotics

2021 ◽  
Vol 15 (9) ◽  
pp. 2223-2225
Author(s):  
Ashfaq Nasir ◽  
Muhammad Najam Iqbal ◽  
Ghulam Hassan ◽  
Muhammad Arshad Abbas ◽  
Hafiz Jawad Abdul Raheem ◽  
...  
Keyword(s):  
Emergency Department ◽  
Antimicrobial Susceptibility ◽  
Diabetic Foot ◽  
Antibiotic Susceptibility ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional

Background: Most of the diabetic patients present as diabetic foot in surgical outdoor and emergency department. Diabetic Foot infections are common and take long duration to be treated. Both Gram positive and Gram negative aerobic bacteria are involved in diabetic foot infection. Aim: To determine the frequency of most prevalent bacteria in wound of diabetic foot ulcers and to determine the antimicrobial susceptibility of isolated bacteria from diabetic foot ulcers so that an empirical antibiotics can be started before the report of culture and sensitivity. Methods: This cross sectional study was conducted in surgical unit 1 of Bahawal Victoria Hospital (BVH) Bahawalpur from 01-08-2020 to 31-07-2021. This study was conducted on 145 patients with diabetic foot ulcer from outdoor and emergency department of BVH. Data about patient’s demography, duration of diabetes, duration of DFUs, type of pathogen and its antibiotic susceptibility was entered on a proforma. Pus sample was obtained from wound under aseptic measures. Culture sensitivity to assess presence of type of pathogen and its antibiotic susceptibility of all the samples was done from the pathology department of the hospital. Results: The mean age of patients was 52.02±10.14 years. There were 77(53.1%) males and 68(46.9%) females. The foot ulcer’s mean duration was 3.81±1.43 months. There were 15(10.3%) patients with St. aureus, 12(8.3%) with E.coli, 12(8.3%) with Proteus mirabilis, 15(10.3%) with P. aeruginosa, 12(8.3%) with Enterobacter spp., 9(6.2%) with Morganella spp., 19(13.1%) with P. vulgaris, 18(12.4%) with P. Mirabilis, 16(11%) with K. pneumonia and 17(11.75) with Morganella pathogen in this study. There were 74(51%) patients sensitive to Amikacin, 73(50.3%) sensitive to Amoxicillin, 66(45.5%) sensitive to Aztreonam, 74(51%) sensitive to Ceftriaxone, 75(51.7%) sensitive to Cefuroxime and 68(49.6%) sensitive to Cephazolin. Conclusion: The most frequent organisms in DFUs, regardless of age, gender and comorbidity, were P. vulgaris, St. aureus and P. aeruginosa. The most sensitive antibiotic in these ulcers was Piperacillin and Meropenem and the most resistant was Cephazolin. Keywords: Diabetic Foot Ulcers, Antimicrobial Susceptibility, St. aureus, P. vulgaris, P. aeruginosa, Piperacillin

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 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.

scholarly journals Characterization Of Phyto-Synthesized Silver Nanoparticles And Their Antimicrobial Activity Against Diabetic Foot Ulcer Bacterial Isolates

2021 ◽  
Vol 11 (6) ◽  
pp. 88-96
Author(s):  
Chhajed Shweta ◽  
Arora Asha
Keyword(s):  
Antimicrobial Activity ◽  
Silver Nanoparticles ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Limbs ◽  
Diffusion Method ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Bacterial Isolates

Diabetic Foot Ulcer (DFU) is one of the major complications of Diabetes. Patients with Diabetic Foot ulcers have a high susceptibility to microbial infections and are the leading cause of hospitalization and amputation of lower limbs. In the era of increased prevalence of bacterial resistance and outbreak of resistant infectious diseases, it is very essential to develop effective therapeutic strategies towards multi-drug resistant pathogens. The antimicrobial properties of silver nanoparticles have been well studied, therefore their use in biomedicine and pharmacology is a trend. Herein we present the use of Phyto-mediated synthesized AgNPs for the treatment of diabetic foot ulcers by topical administration. The nanoparticles were synthesized by reducing silver nitrate using Terminalia chebula fruit extract. The nanoparticles were analyzed and characterized using UV-Visible Spectrophotometer, FTIR, XRD, SEM with EDAX, TEM, and DLS. The synthesized silver nanoparticles were assayed for antimicrobial activity against five Diabetic Foot Ulcer bacterial isolates i.e. Escherichia coli, Klebsiella Pneumoniae, Pseudomonas aeruginosa, Streptococcus aureus, and Bacillus subtilis. The bactericidal property of synthesized nanoparticles was analyzed by the Agar well diffusion method, which revealed the remarkable antimicrobial effects against all the selective pathogenic bacterial isolates of Diabetic foot ulcers in the present study. These results constituted the basis for further studies on the use of plant-based silver nanoparticles for the treatment of Diabetic Foot ulcers from different origins

scholarly journals Prevention and treatment of diabetic foot ulcers

2017 ◽  
Vol 110 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Jonathan Zhang Ming Lim ◽  
Natasha Su Lynn Ng ◽  
Cecil Thomas
Keyword(s):  
Diabetic Foot ◽  
Healthcare Access ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Healthcare Provision ◽  
Foot Complications

The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

Inter-rater reliability assessment of new diabetic foot ulcers (The Diabetic Foot Ulcer Assessment Scale) based on photograph

2020 ◽  
Vol 30 ◽  
pp. 433-438 ◽  
Author(s):  
Hasniati Haeruddin ◽  
Saldy Yusuf ◽  
Ilhamjaya Patellongi ◽  
Kaharuddin Abdul Rasid ◽  
Harbaeni Harkam ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Reliability Assessment ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Assessment Scale ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Rater Reliability
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