scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

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.

scholarly journals “ ASSESSMENT OF SEVERITY OF DIABETIC FOOT ULCERS USING DIABETIC ULCER SEVERITY SCORE.”

2020 ◽  
pp. 19-21
Author(s):  
Aarushi Mishra ◽  
Anilkumar P. Bellad ◽  
M.I. Uppin
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Severity Score ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
The Past

INTRODUCTION : Diabetes mellitus is a common metabolic disorder, prevalence steadily increasing over the past few decades. The complications associated with it , hence , has also increased. Diabetic foot ulcer is one of the most serious complications , utilizing resources, significantly contributing to the morbidity of the patient. There is hence, a need to correctly identify the severity of the diabetic foot ulcer so as to plan the appropriate management and to help in counselling of such patients. AIM : To assess severity in diabetic foot ulcer using diabetic ulcer severity score. MATERIAL AND METHODOLOGY : This is a hospital based longitudinal study , conducted on 93 study subjects admitted with diabetic foot ulcers. Diabetic ulcer severity score was calculated for each patient . The score was calculated by adding scores of the respective parameters constituting site of ulcer, number of ulcers, presence/absence of pedal pulsations, presence/ absence of bone involvement. Each patient was followed up for a period of 6 months , or earlier in case of patient undergoing minor/major amputation. After the study was conducted , analysis was done by calculating various percentages of healing /amputation with respect to the score. RESULTS : Out of the total 93 study subjects , 74.2% were males. The mean age was calculated to be 59.6 years with maximum number of subjects being in 55-60 years of age group range. Majority of them had diabetic ulcer severity score of 2 (42%). Out of the total study subjects , 58% had a complete healing , 28% underwent minor amputation whereas 14% underwent major amputation. 100% of the study participants with score 0 had healing of ulcer which decreased to 85% for score 1 , 53.8% for score 2 , 6.25% for score 3 and 0% for score 4. This was suggestive of poorer chances of healing as the diabetic ulcer severity score increases. CONCLUSION : With the increasing incidence of patients diagnosed with diabetes mellitus , the rate of complications of diabetes has also increased over the past few decades including the risk and occurence of diabetic foot ulcers There is an increasing need for diabetic foot ulcer prognostication systems and universal use of the same. Thus ,we recommend the use of diabetic ulcer severity score as a prognostic tool to assess the severity of the diabetic foot which will further enhance communication and counselling of the patient and will help in providing the appropriate treatment to such patients.

scholarly journals Monitoring and Prevention the Risk of Diabetic Foot Ulcer Infection during Coronavirus Disease-19 Pandemic: A Narrative Review and Perspective Algorithm

2021 ◽  
Vol 9 (B) ◽  
pp. 577-582
Author(s):  
Mariya Dmitriyeva ◽  
Saken K. Kozhakhmetov ◽  
Dulat K. Turebayev ◽  
Saltanat N. Urazova ◽  
Talgat M. Omarov ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Number Of Patients ◽  
Increased Risk

BACKGROUND: The coronavirus disease (COVID)-19 pandemic leads to significant changes in the healthcare system and undermining best practices for maintaining a diabetic limb. A large number of patients with diabetic foot are left without timely medical care and are at increased risk of complications, hospitalization, lower limb amputation, and death. A new paradigm must be adopted for the transition from inpatient care to community-based care. The introduction of a pandemic remote management for patients with diabetic foot ulcer includes an assessment of the risk of complications through telemedicine and further stratification of patients according to the developed algorithm. METHODS: A literature review was performed for articles related to telemedicine. We used PubMed, Google Scholar, Cochrane Library, and Ovid MEDLINE to search published articles. We used the following keywords: “Telemedicine,” “diabetes mellitus,” “COVID-19,” “diabetic foot ulcer,” and “remote monitoring.” RESULTS: Implementation of the proposed pandemic care includes telemedicine for remote monitoring and treatment of patients with diabetic foot ulcers, as well as an algorithm for determining the risk of diabetic ulcer infection and patient management tactics according to the identified risk. CONCLUSION: The management of patients with diabetic foot ulcers during a pandemic includes the following goals – to reduce the burden on the health-care system, maintain the safety and functionality of diabetic foot at home, and reduce the risk of COVID-19 in patients with diabetic foot ulcers.

scholarly journals Correlation of Peak Systolic Velocity Value with Wagner Score in Diabetic Foot Ulcer patients in RSUP Dr. M. Djamil Padang

2021 ◽  
Vol 5 (4) ◽  
pp. 1206-1211
Author(s):  
Fernando Laroza ◽  
Raflis Rustam ◽  
Vendry Rivaldy
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Peak Systolic Velocity ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Negative Direction ◽  
Correlation Strength ◽  
Normally Distributed

Background: Diabetic foot ulcers are one of the chronic complications of diabetes mellitus (DM) in the form of wounds on the skin surface of the feet of DM patients accompanied by internal tissue damage or tissue death, either with or without infection, which is associated with the presence of neuropathy and or peripheral arterial disease in patients with DM. The World Health Organization (WHO) states that at least 422 million people suffer from DM A new alternative parameter for assessing the degree of peripheral ischemia is ankle peak systolic velocity (PSV). The rationale for PSV is based on the observation that in the ischemic limb, blood travels at a much slower rate in the distal leg arteries than in the nonischemic limb. PSV is a quick and easy test to assess the patient's vascular status and monitor the development of diabetic foot ulcers, and can assess the degree of ischemia and predict healing of diabetic foot ulcers. This study aims to determine the Correlation of Peak Systolic Velocity Value with Wagner Score in Diabetic Foot Ulcer patients in RSUP Dr. M. Djamil Padang. Methods: This research is analytic observational with cross sectional design, the research uses primary data. This research will be conducted at the RSUP Dr. M. Djamil Padang from July 2021 to October 2021. The population in this study were diabetic foot ulcer patients who came for treatment at Dr. M. Djamil Padang. A sample of 32 patients Diabetic foot ulcer met the inclusion criteria. Univariate analysis was conducted to describe each of the variables studied. Numerical data is normally distributed, then it is presented in the form of mean ± standard deviation (SD), whereas if the numerical data is not normally distributed then it is presented in the form of median, minimum and maximum. Categorical data is presented in the form of frequency and percentage of each category. Bivariate analysis was started by using the data normality test using the Shapiro Wilk test (n<50). In testing the correlation between Peak Systolic Velocity and Wagner Score in diabetic foot ulcer patients, the Pearson correlation test is used if the data is normally distributed. Data analysis using SPSS version 22.0. Results: more than half of the subjects (65.6%) are male. The mean age of the subjects was 60.46±10.06 years. More than half of the subjects (62.5%) had a normal body mass index. The average length of suffering from diabetes mellitus was 5.48 ± 2.26 years. Half had a history of smoking (59.4%), a small proportion of subjects had hypertension (21.9%), hypercholesterolemia (6.3%) and neuropathy (12.5%). More than half of the subjects (53.1%) had immunopathies. There is a correlation between the popliteal PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.463) and a negative direction. There is a correlation between the PSV dorsali pedis value and the Wagner score in diabetic ulcer patients (p<0.05), with a strong correlation strength (r=-0.720) and in a negative direction. Furthermore, there is a correlation between the posterior tibial PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.530) and a negative direction. Conclusion: There is a correlation between the popliteal, tibialis posterior, dorsalis pedis PSV value and the Wagner score in diabetic foot ulcer patient

Potential Biomolecules and Current Treatment Technologies for Diabetic Foot Ulcer: An Overview

2018 ◽  
Vol 15 (1) ◽  
pp. 2-14 ◽  
Author(s):  
Zenith Khashim ◽  
Shila Samuel ◽  
Nallusamy Duraisamy ◽  
Kathiravan Krishnan
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Impaired Wound Healing ◽  
Advanced Therapies ◽  
Dressing Materials

Background:Diabetic foot ulceration remains a major challenge and is one of the most expensive and leading causes of major and minor amputations among patients with diabetic foot ulcer. Hence the purpose of this review is to emphasize on potential molecular markers involved in diabetic foot ulcer physiology, the efficacy of different types of dressing materials, adjunct therapy and newer therapeutic approach like nanoparticles for the treatment of diabetic foot ulcer.Methods:We conducted a systematic literature review search by using Pubmed and other web searches. The quality evidence of diabetic foot ulcer biomolecules and treatments was collected, summarized and compared with other studies.Results:The present investigation suggested that impaired wound healing in diabetic patients is an influence of several factors. All the advanced therapies and foot ulcer dressing materials are not suitable for all types of diabetic foot ulcers, however more prospective follow ups and in vivo and in vitro studies are needed to draw certain conclusion. Several critical wound biomolecules have been identified and are in need to be investigated in diabetic foot ulcers. The application of biocompatible nanoparticles holds a promising approach for designing dressing materials for the treatment of diabetic foot ulcer.Conclusion:Understanding the cellular and molecular events and identifying the appropriate treatment strategies for different foot ulcer grades will reduce recurrence of foot ulcer and lower limb amputation.

scholarly journals Identification of biofilm-producing microorganism’s and drug susceptibility pattern from diabetic foot ulcer patients at Puducherry

2020 ◽  
Vol 11 (4) ◽  
pp. 7353-7357
Author(s):  
Jayarani Manikandan ◽  
Jaikumar S ◽  
Sandhya Rani T
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Isolation And Identification ◽  
Diabetic Ulcer ◽  
Biofilm Production

Diabetes mellitus is a significant health problem worldwide that affects approximately 171 million people; severe complications lead to the development of diabetic foot ulcers. Diabetic ulcer infections are mainly polymicrobial in nature and multidrug-resistant (MDR), which is capable of forming a biofilm, which is the important virulence factor results in treatment failure. The main objectives of this study to investigate the etiologic agents of diabetic foot infections, their antimicrobial resistance and biofilm formation. A total of 200 patient samples were taken from diabetic foot ulcer patients between September 2015 and February 2016. Isolation and identification of microorganism were made according to standard microbiological procedures. Antibiotic Susceptibility testing performed by Kirby Bauer disc diffusion method and the biofilm production was performed by the tube method and Congo Red Method. Out of 200 samples processed,  110 (55%) were polymicrobial, 50 (25%) monomicrobial and 40(20 %)culture Sterile. The most common organism isolated were 82(39%) Pseudomonas aeruginosa,45(21%) Staphylococcus aureus, 48(23%) Candida sp followed by others. Biofilm production was seen in 112 (53%) of the isolates. Antimicrobial drug  resistance was higher among 92(82%) biofilm producers than non-biofilm 20(18%) producing microorganisms. Organisms isolated from chronic diabetic foot ulcers cases were multidrug-resistant and biofilm producers. Our study shows the importance of biofilm screening with the usual antibiogram, as a routine technique in diabetic foot ulcers patients for effective treatment.

scholarly journals Outcome of patients undergoing amputation for diabetic foot ulcer

2018 ◽  
Vol 6 (1) ◽  
pp. 88
Author(s):  
Ashokkumar D. ◽  
Vinothkumar S. ◽  
Heber Anandan
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Care Center ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Ulcer ◽  
Delay In Diagnosis

Background: Foot ulcers are the principal cause of severe complications and hospitalization among patients with diabetes, substantially increasing the costs with this disease. Peripheral neuropathy, ulceration, infection, and peripheral vascular disease are the principal factors for ulcer complications and loss of a lower limb in diabetic patients. The aim of the present endeavor was to study the patients undergoing amputation for the diabetic foot ulcer.Methods: Total 150 patients with diabetic foot ulcer were included in this study. The variables investigated were related to diabetes, infection, and surgical treatment. In our series amputation were done at different levels anatomical levels ranging from toe level ranging from toe level to above knee amputation.Results: Pus culture and sensitivity done for diabetic foot ulcers reveal E. coil as the most common organism (40%). Skin biopsy done in these patients reveal neuropathic changes in 102 patients. 40% of patients had vaso-occlusive disease. Nine out of 150 patients showed osteomyelitis changes emphasizing those diabetic ulcer patients are prone for osteomyelitis of the underlying bone. 46% of patients with diabetic foot ulcer needed either minor or major amputation, which correlates with the standard study.Conclusions: Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center are all factors which led to the occurrence of diabetic foot ulcer.

scholarly journals First experimental Results of an Observational study on the application of Electrical Stimulation in Diabetic Foot Ulcers.

2021 ◽  
Vol 4 (5) ◽  
pp. 01-03
Author(s):  
Suen Enrique
Keyword(s):  
Electrical Stimulation ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
World Health ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
The World ◽  
Electrical Stimulator

Aims: According to the World Health Organization, between 1980 and 2014 the total number of people with diabetes in the world increased from 108 million to 422 million and by the end of 2020, the total number was approximately 463 million. The most frequent complication in this type of patient is diabetic foot ulcer, where conventional treatments generally fail to solve the problem and in many cases the condition ends with amputation. In 1998, an electrical stimulator was developed, called Stimul W, whose application in the healing of pressure and venous ulcers has yielded satisfactory results, allowing not only to obtain the Medical Registry by health entities in Cuba and other countries and even patent the mentioned equipment, but it has been achieved, in more than two decades of work, the healing of 1,191 ulcers of both types, with 94.5% effectiveness, a healing time that ranges between 21 and 42 days , according to the characteristics of the ulcer and without recurrence in any case treated. Starting in 2015, the application of this technique began in diabetic foot ulcers with the objectives of measuring the effectiveness and achieving an alternative treatment for this type of injury. In the present work a brief compilation of the results achieved in the treatment of diabetic foot ulcer using electrical stimulation is shown. Statistical Model: 31 diabetic patients, over 40 years old, with a total of 38 diabetic foot ulcers (some patients had more than one lesion) were treated, with times with the ulcer ranging between 1 and 6 months. The treatment consisted of a daily application for 30 minutes, using the Stimul W electrical stimulator, through the use of self-adhesive electrodes, conveniently placed around the affected area and on healthy skin, with current values ​​corresponding to scale 8 of the stimulator, approximately 1.5 mA and using the two stimulation channels Results: Results: In 27 of the 31 patients treated, the ulcer was healed with an effectiveness of 87%. In relation to ulcers, 33 ulcers healed in total, for 86.8% effectiveness. Average healing times were between 30 and 42 days, considering a daily session. Conclusion: Acceleration of healing was achieved with respect to conventional treatments, reducing healing times, and not producing adverse events during and after the application of the treatment.

Lachesis mutus and Calendula officinalis Q in Diabetic Foot Ulcer Treatment–Two Case Reports

2021 ◽  
Vol 34 (02) ◽  
pp. 164-174
Author(s):  
K. C. Muraleedharan ◽  
Pooja Prakash
Keyword(s):  
Diabetic Foot ◽  
Case Reports ◽  
Financial Burden ◽  
Bipolar Affective Disorder ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Calendula Officinalis ◽  
Diabetic Ulcer

AbstractDiabetic foot ulcers and its complications are to be dealt cautiously in general medical practice. Most cases of diabetes mellitus have multiple comorbidities which add more difficulty in ulcer management. The chances of complete wound healing are low even after amputation, which may be required in >15% of patients with diabetic ulcer. Furthermore, it leaves behind mental, physical and financial burden to people. In this case report, two cases of diabetic foot ulcers are presented, one with bipolar affective disorder and the other one with his toes amputated, which were treated with homoeopathic medicines Lachesis mutus and Calendula officinalis Q along with standard care in an inpatient department facility. It shows the effectiveness of homoeopathy in managing such challenging cases without complication.

Inflammatory Biomarkers as Predictors of Infected Diabetic Foot Ulcer

2021 ◽  
Vol 17 ◽  
Author(s):  
Mariya Dmitriyeva ◽  
Zhanar Kozhakhmetova ◽  
Saltanat Urazova ◽  
Saken Kozhakhmetov ◽  
Dulat Turebayev ◽  
...  
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Limb Amputation ◽  
Inflammatory Biomarkers ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

: Diabetic foot ulcer infection is a crucial complication associated with lower-limb amputation and postoperative mortality in individuals with diabetes mellitus. Deciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point-of-care tests. Early detection of infected diabetic foot ulcers can reduce the frequency of hospitalizations, the occurrence of disability, and chances of mortality. Inflammatory biomarkers are predictors of infected diabetic foot ulcers and lower-limb amputation. Procalcitonin, CRP, pentraxin-3, interleukin-6, and calprotectin may help to distinguish uninfected from mildly infected diabetic foot ulcers and diagnose soft tissue infections, bone lesions, and sepsis in diabetic patients. Moreover, these biomarkers may be predictors of lower-limb amputation and postoperative mortality. The current management of infected diabetic foot ulcers is disappointing and unsatisfactory, both in preventing its development and in halting and modifying its progression. The use of new (molecular) techniques for the identification of the IDFU have not yet proven superior to classic cultural techniques for the management of such patients. For clinicians, if the risk stratification of DFU can be obtained earlier in diabetic patients the hospitalization, disability, and mortality rate will be reduced. For practical application of these biomarkers, it is important to correlate these quantitative parameters with clinical symptoms. Based on clinical observations and inflammatory biomarker evaluation, it can be used to guide clinical treatment methods. This review details clinical information published during the past several decades and discusses inflammatory biomarkers that may determine the risk and level of infection of diabetic foot ulcers.

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