scholarly journals The use of NPWT in combination with silver dressing in diabetic foot syndrome – case report

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Dominik Andrzej Walczak ◽  
Rajmund Jaguścik ◽  
Karolina Ptasińska ◽  
Leokadia Kozaczek ◽  
Piotr Wojciech Trzeciak
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Healthy Individuals ◽  
Wound Therapy ◽  
Present Case Report ◽  
Increased Risk ◽  
Patients With Diabetes

Patients with diabetes mellitus are at increased risk of angiopathy, neuropathy and infection compared with healthy individuals and that may lead to foot disorders. Treatment is difficult challenging and if it is not successful it often run to lower limbs amputations.We present case report of 63 years old man after amputation of big toe and part of metatarsus due to diabetic foot syndrome, successfully treated with negative pressure wound therapy in combination with silver dressing. The literature regarding this issue was also reviewed.

scholarly journals Negative pressure wound therapy use in diabetic foot syndrome-from mechanisms of action to clinical practice

2019 ◽  
Vol 49 (4) ◽  
pp. e13067 ◽  
Author(s):  
Sebastian Borys ◽  
Jerzy Hohendorff ◽  
Claudia Frankfurter ◽  
Beata Kiec-Wilk ◽  
Maciej T. Malecki
Keyword(s):  
Clinical Practice ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Mechanisms Of Action ◽  
Diabetic Foot Syndrome ◽  
Wound Therapy

Application of irrigation and negative pressure wound therapy (INPWT) to treat diabetic foot gangrene: a case report

WCET Journal ◽  
2019 ◽  
Vol 39 (3) ◽  
pp. 20-25
Author(s):  
Ai-hua Chen ◽  
Huiling Liu ◽  
Chunmei Zhang ◽  
Ping Zou
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Blood Sugar ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Treatment Process ◽  
Wound Therapy ◽  
Spread Of Infection

This case study summarises the treatment of a patient with diabetic foot gangrene. By undergoing irrigation and negative pressure wound therapy (INPWT) with moist dressing, foot amputation was avoided. The treatment process included: the comprehensive assessment of systemic and local condition; choosing suitable debridement such as sharp surgical debridement; preventing the spread of infection; applying INPWT to reduce endotoxin absorption; and active treatments of primary disease such as controlling blood sugar and blood pressure, and improving microcirculation and nutrition. After 2 months of vigorous INPWT, the patient’s wound bed improved. After the application of a moist dressing, the wound closed and healed successfully at 3 months.

Negative-pressure wound therapy and diabetic foot in the treatment of diabetic foot syndrome

Leczenie Ran ◽  
2014 ◽  
Vol 11 (1) ◽  
pp. 5-9
Author(s):  
Beata Mrozikiewicz-Rakowska ◽  
Adriana Nowak ◽  
Ewelina Bucior ◽  
Joanna Kania ◽  
Karolina Głodała-Jakoniuk ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Diabetic Foot Syndrome ◽  
Wound Therapy

scholarly journals Use of Negative Pressure Wound Therapy after Endovascular Revascularization in a Patient with Diabetic Foot Syndrome Complicated by Sepsis

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Krzysztof Karaś ◽  
Krzysztof Wachal ◽  
Tomasz Kościński ◽  
Grzegorz Oszkinis
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Diabetic Foot Syndrome ◽  
Wound Therapy ◽  
Endovascular Revascularization

Pacjent lat 60, przyjęty do szpitala z powodu ostrego niedokrwienia kończyny dolnej prawej z martwiczymi zmianami po stronie grzbietowej i zewnętrznej stopy. Zmiany martwicze o szybko postępującym charakterze - owrzodzenia III/IV stopień według klasyfikacji Wagnera. Pacjent choruje na cukrzycę typu drugiego oraz na nadciśnienie tętnicze. Chory pali papierosy w ilości 1,5 paczki dziennie od 40 lat, prowadzi siedzący tryb życia. Leczenie zachowawcze polegało na miejscowym zastosowaniu maści z antybiotykiem o szerokim spektrum działania. Chorego poddano operacji rewaskularyzacyjnej i leczeniu opatrunkiem podciśnieniowym. Niewłaściwa pielęgnacja opatrunku V.A.C. i niekorzystne warunki zewnętrzne w oddziale chirurgicznym przyczyniły się prawdopodobnie do rozwoju zakażenia miejscowego i posocznicy co w konsekwencji było przyczyną amputacji kończyny.

scholarly journals Sepsis as a cause of fatal cases after the lower limbs amputation at the hip level due to gangrene in patients with a diabetic foot syndrome

2019 ◽  
Vol 41 part 1 (2) ◽  
pp. 29-35
Author(s):  
A. V. Kapshitar ◽  
A. A. Kapshitar
Keyword(s):  
Myocardial Infarction ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Limb Amputation ◽  
Pathological Changes ◽  
Educational Work ◽  
Severe Diabetes ◽  
Patients With Diabetes

Purpose of the study. To study frequency of fatal sepsis, the causes and severity of diabetes patients complicated by diabetic foot syndrome of the gangrene limb, after amputation of the lower limb at the hip level. Material and methods. Amputation of the lower limb at the hip level was performed in 180 patients with diabetic foot, gangrene of the limb. 15 (8,3%) died. Results. From the 15 patients who died, 9 died from sepsis. The age was 54–78 years old. On admission, sepsis was diagnosed in 5 and septic shock – in 4 patients. After examination and preparation, emergency surgeries were performed in 4 patients and urgent surgeries – in 5. Two- and three-step surgeries were performed in 5 patients. They first performed the removal of the toes of the gangrene, osteomyelitis, opened deep phlegmon of the foot and the lower leg was completed by amputation of the lower limb. Primary amputations were performed in 4 patients. Sepsis was the cause of death in 5 patients from 11 to 60 days and the combinations of sepsis with acute myocardial infarction or repeated myocardial infarction – in 4 from 5 to 17 days. During the autopsy, pathological changes of severe diabetes, complicated diabetic foot syndrome, its mixed form, sepsis with manifestations of septicemia or septicopyjemia, and all organs and systems were revealed. Conclusions. The unsatisfactory organization of medical care for patients with diabetes and diabetic foot syndrome at the pre hospital stage, ineffective sanitary and educational work, systemic pathological changes led to sepsis and death after the amputation of the lower limb at the hip level. Keywords: sepsis, diabetic foot syndrome, limb amputation, mortality.

scholarly journals Epidermis of amputated limbs in patients with diabetes mellitus - immunohistochemical study

2014 ◽  
Vol 95 (2) ◽  
pp. 244-249
Author(s):  
G N Gorshunova ◽  
R A Dzamukov ◽  
V V Valiullin
Keyword(s):  
Diabetic Foot ◽  
Epidermal Cells ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Nuclear Antigen ◽  
Healthy Controls ◽  
Color Intensity ◽  
Patients With Diabetes ◽  
Apoptotic Activity ◽  
Skin Samples

Aim. To examine the skin morphological changes in different areas of the amputated lower limbs of patients with diabetes mellitus. Methods. Skin samples of lower limbs of 6 patients with diabetic foot syndrome were studied using immunohistochemistry methods. Proliferation of epidermal cells, their resistance to apoptosis, as well as the degree of cells differentiation (using antibodies to proliferating сell nuclear antigen, Bcl-2 anti-apoptotic activity marker, epidermal cells terminal differentiation marker cytokeratin 1) were assessed. The color intensity was assessed using ImageJ software and was displayed as «mean greyscale intensity» (an integral value summarizing color intensity of three basic colors - red, green and blue - by V=0,299R+0,587G+0,114B formula, where V - mean intensity of a mean pixel, R, G, B - color intensity of red, green and blue pixels appropriately). Results. Patients with diabetic foot syndrome had reduced proliferative activity of epidermal cells as they approach the sphacelous area of the affected limb, together with decreased resistance to apoptosis in the same areas. The share of cells positive for proliferating cell nuclear antigen was 58.74±4.8% in skin samples from the area of necrosis (n=6) compared to 77.41±3% (p 0.005) in skin samples of the healthy controls. The study of Bcl-2 marker expression by cells of the sphacelous area (n=6) revealed that mean greyscale intensity in patients with diabetic foot syndrome was 57.74±4.3, which was significantly lower compared to skin samples of the healthy controls (n=6, 89.69±3.4, p 0.005). Based on the expression of cytokeratin, it was shown that suprabasal layers of the epidermis cells were less differentiated in case of diabetic foot syndrome compared to the same cells of the epidermis of the control group. Conclusion. In advanced stages of diabetes, the combined effect of the disease is reduced number of epidermis proliferating cells, the reduction of their anti-apoptotic activity and loss of skin as an organ.

scholarly journals Modern alternative or first-line treatment: How to safely use Negative Pressure Wound Therapy in Diabetic Foot Syndrome?

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Beata Mrozikiewicz-Rakowska ◽  
Ewelina Bucior ◽  
Joanna Kania ◽  
Adrianna Nowak ◽  
Marek Chojnowski ◽  
...  
Keyword(s):  
Side Effects ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Science Studies ◽  
Treatment Method ◽  
Diabetic Foot Syndrome ◽  
First Line ◽  
Wound Therapy ◽  
Wound Debridement

Clinical experience and basic science studies show that Negative Pressure Wound Therapy (NPWT) is a promising yet still under-used treatment method for patients with diabetic foot syndrome (DFS). Despite its advantages, it may carry the risk of serious side effects if the indications and contraindications are not strictly observed. The aim of this article is to discuss myths and facts about NPWT in conditions such as: inadequate blood supply, insufficient wound debridement, osteomyelitis or the necessity to monitor laboratory parameters during the therapy. We will try to define the optimal conditions for NPWT in order to obtain better results and eliminate the risk of side effects.

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