scholarly journals Pathogenesis and management of diabetic foot ulcers

2018 ◽  
Vol 5 (11) ◽  
pp. 4953 ◽  
Author(s):  
Yousif Alsanawi ◽  
Hassan Alismail ◽  
Mustafa AlabdRabalnabi ◽  
Hattan Alturki ◽  
Abdullah Alsuhaibani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Management Strategies ◽  
Blood Glucose Control ◽  
Disease Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Wound Debridement ◽  
Significant Impairment

Diabetes mellitus is a major healthcare issue worldwide, and the trends keep rising. Diabetic foot ulcer is a morbidity associated with the disease process and causes significant impairment in quality of life due to its severe complications including infection, gangrene, and amputation. In this study, we aim to understand the pathogenesis of diabetic foot ulcer, its complications, and management strategies. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1970 to March 2017. The following search terms were used: diabetic foot ulcer, complications of diabetes mellitus, foot gangrene, surgical debridement of foot ulcer, osteomyelitis. Diabetic foot ulcer is a common morbidity in patients with diabetes mellitus, which can lead to lower limb amputation unless a prompt, rational, multidisciplinary approach to therapy is taken. Proper management can ensure successful and fast healing which includes patient education, blood glucose control, wound debridement, advanced dressing, offloading, and surgery.

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.

Treatment Strategies Against Diabetic Foot Ulcer: Success so far and Road Ahead

2020 ◽  
Vol 16 ◽  
Author(s):  
Ankit Awasthi ◽  
Sachin Kumar Singh ◽  
Bimlesh Kumar ◽  
Monica Gulati ◽  
Rajesh Kumar ◽  
...  
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Treatment Strategies ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Current Status ◽  
Limb Amputation ◽  
Bibliographic Databases ◽  
Inflammatory Phase

Background: Diabetic foot ulcer (DFU) is one of the leading complications of type-2 diabetes mellitus. It isassociated with neuropathy and peripheral arterial disease of the lower limb in patients with diabetes. Basically, there are four stages of wound healing namely hemostasis phase, inflammatory phase, proliferative phase and maturation phase. In case of DFU, all these stages are disturbed which lead to delay in healing and consequently to lower limb amputation. Traditionally the dosage forms like tablets, creams, ointments, gels and capsules have been used for the treatment of diabetic foot ulcer from many years. Introduction: In this review the global prevalence as well as etiopathogenesis related to diabetic foot ulcer has been discussed. Potential role of various synthetic and herbal drugs as well as their conventional dosage form for the effective management of diabetes foot ulcer has been highlighted. Methods: Structured search of bibliographic databases for previously published peer-reviewed research papers was explored and data was culminated in terms of various approaches that are used for the treatment of diabetic foot ulcer. Results: About 142 papers including both, research and review articles, were included in this review in order to produce a comprehensive as well as readily understandable article. A series of herbal and synthetic drugs have been discussed along with their current status of treatment in terms of dose and mechanism of action. Conclusion: DFU has become one of the most common complications in patients having more than ten years of diabetes. Hence, understanding the root cause and its successful treatment is a big challenge because it depends upon multiple factors such as judicious selection of drug as well as proper control of blood sugar level. Most of the drugs that have been used so far either belong to the category of antibiotics, antihyperglycaemics or, they have been repositioned. Moreover, in clinical practice, much focus has been given towards dressings that have been used to cover the ulcer. The complete treatment of DFU is still a farfetched dream to be achieved and it is expected that a combination therapy of herbal and synthetic drug with multiple treatment pathway could be able to overcome the disease.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

scholarly journals Microbiological Study of Diabetic Foot Ulcer

2019 ◽  
Vol 10 (1) ◽  
pp. 50-55
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin
Keyword(s):  
Diabetes Mellitus ◽  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Proteus Mirabilis ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Klebsiella Pneumonia ◽  
Coagulase Negative Staphylococci

Background: Diabetic foot is one of the most feared complications of diabetes and is the leading cause of hospitalization in diabetic patients. Limb-threatening diabetic infections are usually polymicrobial involving multiple aerobic and anaerobic organisms. Methodology: The present study was a cross sectional study, conducted in the department of surgery and microbiology at BIRDEM General Hospital, Dhaka, over a period of 9 months during January 2017- September' 2017. The study included a total of 77 adult patients of clinically diagnosed diabetic foot patients presenting to outpatient department and emergency ward. The standard case definition of diabetic foot is 'any pathology occurring in the foot of a patient suffering from diabetes mellitus or as a result of long term complication of diabetes mellitus'. Results: Majority 17(22.1%) patients had Klebsiella pneumonia, 14(18.2%) had Pseudomonas aeruginosa, 11(14.3%) had Staphylococcus aureus, 10(13.0%) had Escherichia coli, 6(7.8%) had Coagulase-negative staphylococci and 8(10.4%) had Providencia spp. In Escherichia coli 100% sensitivity to imipenem, 70% to amoxicillin-clavulanic acid, amikacin, piperacillin-tazobactam. In Coagulasenegative Staphylococci 83.3% sensitivity to tetracycline, 66.7% to ceftriaxone. In Proteus mirabilis 100% sensitivity to tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam. In Enterococcus spp.75.0% sensitivity to tetracycline. In Citrobacter spp. 100% sensitivity to imipenem. Conclusion: Common organism found in diabetic foot ulcer patients were Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Coagulase-negative staphylococci and Providencia spp. In tetracycline, amikacin, ceftriaxone, imipenem, piperacillin-tazobactam was 100% sensitive in Proteus mirabilis and only imipenem found in Escherichia coli and Citrobacter spp. Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 50-55

scholarly journals Factors Affecting Hospital Length of Stay in Patient with Diabetic Foot Ulcer

2019 ◽  
Vol 47 (2) ◽  
pp. 3-16
Author(s):  
Patrianef Darwis ◽  
Bakti H Simanjuntak ◽  
Grace Wangge ◽  
Deddy Pratama ◽  
Ahmad Bakri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Smoking History ◽  
Ulcer Size

Background. Foot ulcer is one of the most common complications in diabetes mellitus patients. This condition prolongs hospital length of stay (LOS) and increases hospitalization cost. This study aims to assess factors that affect the LOS in patients with the mentioned condition. Methods. This is a retrospective cohort study of diabetes mellitus patients with foot ulcer who were hospitalized in Cipto Mangunkusumo General Hospital from January 2015 to April 2016. There were 120 patients recruited and then divided into two groups according to their hospitalization duration, which was short and long. Univariate analysis was conducted in predicted factors including gender, ankle-brachial index, ulcer size, ulcer depth, leukocyte count, treatment, cardiovascular comorbidity, blood pressure, smoking history, septicemia, ketoacidosis, hypoalbuminemia, and upper respiratory tract infection. Chi-Square tests were performed to analyze the association of those factors with LOS. The odds ratio of each variable was evaluated using logistic regression analysis. Result. In this study, the mean of LOS was 26 days (2 – 87 days). Factors that significantly correlated with LOS were ankle-brachial index (p 0.041, OR 2.275, CI 95 % 1.025 – 5.041), ulcer size (p 0.044, OR 3.038, CI 95 % 1.032 – 9.942), smoking history (p 0.022, OR 2.434, CI 95 % 1.125 – 5.265), sepsis (p < 0.001, OR 4.240, CI 95 % 1.908 – 9.423), and ketoacidosis (p < 0.001, OR 8.611, CI 95 % 3.396 – 21.835) In multivariate analysis, the most significant factor was ketoacidosis (p < 0.001, OR 8.360, CI 95 % 3.209 – 21.780). Conclusion. Ketoacidosis is the most significant factor that prolonged hospital stays in a patient with diabetic foot ulcer. Keywords: Diabetic foot ulcer, Length of stay

scholarly journals Risk factor and Outcomes of Diabetic Foot Ulcer among Diabetes Mellitus Patients Admitted to Nekemte Referral Hospital, Western Ethiopia:Prospective cohort study

2020 ◽  
Author(s):  
Firomsa Bekele ◽  
Legese Chelkeba ◽  
Ginenus Fekadu ◽  
Kumera Bekele
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Cohort Study ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Referral Hospital

Abstract The authors have withdrawn this preprint from Research Square

scholarly journals A study on diabetes mellitus among diabetic foot ulcer patients in a tertiary care centre

2017 ◽  
Vol 4 (5) ◽  
pp. 1555
Author(s):  
Vinu Gopinath ◽  
S. Soundara Rajan
Keyword(s):  
Diabetes Mellitus ◽  
Blood Sugar ◽  
Diabetic Foot ◽  
Blood Sugar Level ◽  
Tertiary Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
The Body ◽  
Care Centre ◽  
Tertiary Care Centre

Background: Diabetes mellitus is a chronic disease which occurs either when the pancreas does not reproduce enough insulin, the hormone that regulates blood sugar level or when the body cannot effectively use the insulin it produces. Hyperglycemia or raised blood sugar level is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the system of the body especially nerves and blood vessels. Diabetes mellitus has become the cause for growing public health concern in developing countries as it has been for a long time in most developed ones. The reason for increase in prevalence of diabetes mellitus in developing countries may include unhealthy life style, rapid westernization, poor knowledge, negative attitude and poor practice towards diabetes mellitus among general population. Objective of the study was to find out the knowledge, and awareness towards diabetes mellitus among diabetic foot ulcer patients attending in a tertiary care Centre.Methods: A cross sectional study was carried out in the surgical outpatient department of a tertiary care Centre. All diabetic foot ulcer patients attending surgical outpatient department for the period of two months was included. Juvenile diabetic patients, Type II diabetes mellitus patients with co morbidities are excluded.Results: Out of the 100-study participant’s majority are males (61%). 55% of the study participants are not aware of the major cause of diabetes mellitus. 92% of the population knew the accurate method of monitoring diabetes mellitus. 70.6% of people are aware of normal blood sugar level. 51% of people are aware of the complications of diabetes mellitus and 84.3% of people know the symptoms of diabetes mellitus. 68.6% of the population knew regular exercise can control diabetes mellitus yet only 50.8% of population exercise regularly.Conclusions: This study reflects that there is a need to improve diabetic knowledge among the patients which can be achieved through health education.

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