scholarly journals Case Study: Diabetic Foot Ulcer Nursing Management Using Ozone Regional Non-Invasive (ORNI)Therapy as A Combination Of Care

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Irma Puspita Arisanty ◽  
Debie - Dahlia

<p><strong><em>Background: </em></strong><em>DFU patients must be treated properly less than 30 days to prevent infection spread to the bone, causes smaller opportunity to recovery and higher risk for amputation. Ozone therpay has a clearer clinical effect, affects the wound healing process, it can be seen by decreasing the length of stay.</em><strong><em> Method:</em></strong><em> Case studies of 3 DFU patients who were given ORNi therapy. Wound evaluation using </em><em>Bettes-Jenssen Assessment tool skoring system. </em><strong><em>Results: </em></strong><em>There were significant improvement in these cases after given a noninvasive regional ozone therapy (ORNi) as a combination in standard treatment for 5 – 7 times. There are no sign of infection, granulation and epithelization processes were running optimal and exudate production was controlled. </em><strong><em>Conclusions and recommendation: </em></strong><em>Using ORNi therapy as an adjunct to standard care has shown a significant improvement. The rate of granulation and epithelization during 15 days of treatment has an average growth rate of granulation and epithelization up to 22%. Researchers recommend to do more research with suficcient sample size related to the use of ozone therapy as an adjunct in wound care. </em></p>

2019 ◽  
Vol 11 (2) ◽  
pp. 110
Author(s):  
Ekanova R. N. Sumarauw ◽  
Mendy J. Hatibie ◽  
Djony E. Tjandra ◽  
Fredrik G. Langi

Abstract: Diabetic foot ulcer (DFU) is still a health problem related to the extent amount of time in wound healing process hence increasing the treatment cost. Given any methods that are not sat-isfying, encourage the search of other methods that would increase the wound healing rate, in which hyperbaric oxygen therapy (HBOT) is amongst them. The DFU patient that receives HBOT shows a significant increase in angiogenesis process markedly by faster epithelialization and granulation process. This study was aimed to prove that HBOT could accelerate the wound healing process among DFU patients measured by wound size and depth of PEDIS score. This was a ran-domized controlled trial study, conducted at Surgery Department of Prof. Dr. R. D. Kandou Gen-eral Hospital from September 2018 to March 2019. There were 20 DFU patients divided into two groups, each of 10 patients. The control group received a holistic treatment, meanwhile the HBOT group received a holistic treatment added with the inclusion of HBOT. PEDIS score assessment of DFU in HBOT group was measured before and after the third HBOT session, meanwhile the con-trol group was measured on the first and the third day. The results showed that the difference in PEDIS score value was markedly found in HBOT group compared to the control group (2 vs. 0, P=0.001). Conclusion: HBOT could enhance the wound healing process in DFU patients based on the declined PEDIS score.Keywords: HBOT, PEDIS score, diabetic foot ulcerAbstrak: Ulkus kaki diabetik (UKD) masih merupakan masalah kesehatan terkait proses penyembuhan lama sehingga biaya pengobatan meningkat. Belum adanya metode penanganan yang memuaskan, mendorong pencarian metode percepatan penyembuhan luka, salah satunya ialah terapi oksigen hiperbarik (TOHB). Penderita UKD yang menjalani tambahan TOHB diketahui mengalami peningkatan proses angiogenesis yang menghasilkan proses epitelialisasi dan granulasi yang lebih cepat. Tujuan penelitian ialah untuk membuktikan bahwa TOHB dapat mempercepat proses penyembuhan UKD, dinilai berdasarkan ukuran dan kedalaman luka melalui skor PEDIS. Penelitian ini menggunakan randomized controlled trial dan dilaksanakan di Bagian Bedah RSUP Prof. Dr. R.D. Kandou Manado sejak September 2018 sampai dengan Maret 2019. Subyek penelitian sebanyak 20 penderita UKD, dibagi dalam dua kelompok, masing-masing 10 penderita. Kelompok kontrol menjalani penanganan holistik UKD, sedangkan kelompok TOHB menjalani penanganan holistik UKD dengan TOHB. Penilaian skor PEDIS terhadap UKD pada kelompok TOHB dilakukan sebelum dan sesudah TOHB sesi ke-3, sedangkan pada kelompok kontrol dilakukan penilaian pada hari ke-1 dan hari ke-3 sesudahnya. Hasil penelitian mendapatkan bahwa perubahan skor PEDIS yang terjadi antara kedua pengukuran terlihat lebih besar pada kelompok TOHB dibandingkan kelompok kontrol (2 vs 0, P=0,001). Simpulan. TOHB mempercepat proses penyembuhan UKD dinilai dari penurunan skor PEDIS.Kata kunci: TOHB, skor PEDIS, ulkus kaki diabetik


2017 ◽  
Vol 16 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Kanokwan Kulprachakarn ◽  
Sakaewan Ounjaijean ◽  
Jukkrit Wungrath ◽  
Raj Mani ◽  
Kittipan Rerkasem

The diabetic foot ulcer (DFU) is an invariably common complication of diabetes mellitus, it is also a significant cause of amputation as well as extended hospitalization. As most patients with DFU suffer from malnutrition, which has been related to improper metabolic micronutrients status, alterations can affect impaired wound healing process. Micronutrients and herbal remedies applications present a wide range of health advantages to patients with DFU. The purpose of this review is to provide current evidence on the potential effect of dietary supplementations such as vitamins A, C, D, E, magnesium, zinc, copper, iron, boron, and such naturally occurring compounds as Aloe vera, Naringin, and Radix Astragali (RA) and Radix Rehmanniae (RR) in the administration of lower extremity wounds, especially in DFU, and to present some insights for applications in the treatment of DFU patients in the future.


2014 ◽  
Vol 63 (10) ◽  
pp. 1377-1385 ◽  
Author(s):  
Thokur S. Murali ◽  
Shettigar Kavitha ◽  
Jain Spoorthi ◽  
Deepika V. Bhat ◽  
Alevoor S. Bharath Prasad ◽  
...  

While virulence factors and the biofilm-forming capabilities of microbes are the key regulators of the wound healing process, the host immune response may also contribute in the events following wound closure or exacerbation of non-closure. We examined samples from diabetic and non-diabetic foot ulcers/wounds for microbial association and tested the microbes for their antibiotic susceptibility and ability to produce biofilms. A total of 1074 bacterial strains were obtained with staphylococci, Pseudomonas, Citrobacter and enterococci as major colonizers in diabetic samples. Though non-diabetic samples had a similar assemblage, the frequency of occurrence of different groups of bacteria was different. Gram-negative bacteria were found to be more prevalent in the diabetic wound environment while Gram-positive bacteria were predominant in non-diabetic ulcers. A higher frequency of monomicrobial infection was observed in samples from non-diabetic individuals when compared to samples from diabetic patients. The prevalence of different groups of bacteria varied when the samples were stratified according to age and sex of the individuals. Several multidrug-resistant strains were observed among the samples tested and most of these strains produced moderate to high levels of biofilms. The weakened immune response in diabetic individuals and synergism among pathogenic micro-organisms may be the critical factors that determine the delicate balance of the wound healing process.


2020 ◽  
Vol 10 (1) ◽  
pp. 1273-1284
Author(s):  
Endang Subandi ◽  
Kelvin Adam Sanjaya

Luka Diabetes merupaka luka kronis yang susah disembuhakan. Luka diabetes berasal dari komplikasi penyakit diabetes. Luka diabetes sebagian besar dilakukan tindakan amputasi dan memiliki dampak kepada psikologi pasien. Sudah lama perawatan luka menggunakan konvensional yang memiliki kekurangan, seperti: menimbulkan rasa nyeri, menimbulkan luka baru, resiko infeksi lebih tinggi. Metode yang baru teknik perawatan luka  modern dressing dimana luka akan dibuat moisture balance atau lembab karena akan memfasilitasi chemokines dan cytokines untuk pertumbuhan sel pada luka.  Penelitian ini bertujuan untuk mengetahui efektifitas modern dressing terhadap proses penyembuhan luka diabetes mellitus tipe 2. Jenis penelitian menggunakan Pre-Postest With Control Group Desain terhadap suatu kelompok. Pengambilan sampel menggunakan  accidental sampling dengan jumlah sampel sebanyak 15 responden intervensi dan kontrol. Pengumpulan data dilakukan dengan observasi, Instrument penelitian yang digunakan lembar observasi Betes-Jensen Wound Assessment Tool (BWAT). Penelitian dilakukan selama 45 hari. Analisa data yang digunakan adalah uji shapiro-wilk. Data analisa dengan uji statistik Wilcoxon test. Hasil penelitian didapatkan ada perbedaan skor luka sebelum dan sesudah pada kelompok pada kelompok perlakuan dengan p-value =0.005 (≤ 0.05) dan pada kelompok kontol dengan p-value =1.000 (≥ 0,05). Lalu hasil uji beda antar kelompok dengan p-value=0,001(≤ 0,05).  Jadi dapat disimpulkan bahwa modern dressing memiliki efektifitas terhadap proses penyembuhan luka diabetes bellitus tipe 2.Kata kunci: Luka, DM Tipe 2, Modern Dressing   ABSTRACTDiabetic wound are the chronic wounds that are difficult to cure. Diabetic wounds originate from complications of diabetes mellitus. Diabeteic wound are mostly implementation is amputation  and have impact on the psychology of patients. Long time a wound treatment has deficiencies, causes pain, raises new wound, high risk of infection. New methods of modern dressing wound care tecniques where wound will be made moisture balance or moiist because it will facilitate chemokines and cytokines for cell growth in wounds. Therefore this study aims to determine the effectiviness of modern dressing on the wound healing process of  type 2 diabetes mellitus.  This type of research uses the Pre Postest With Control Group Desig for a sampling group conducted at Cirebon Wound Care Center using accidental sampling. The samples was 15 respondents treatments and control. Research instrument used were sheets observation Betes Jensen Wound Assessment Tool. The Study was conducted for 45 days. The data analysis used is the shapiro wilk test and data analysis sattistic with wilcoxon test. The result are obtained before and after in the treatment group with p value=0.005 (≤ 0.05 and in the control group with p value =1.000 (≥ 0,05). Then the result of different test between groups with a p value =0,001(≤ 0,05).The conclusion is a modern dressing has the effectiviness of the wound healing process of type 2 diabtes mellitus.Kata kunci: Diabetic Wound, Type 2 Diabetes Mellitus, Modern Dressing


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Navid Faraji ◽  
Rasoul Goli ◽  
Babak Choobianzali ◽  
Soheyla Bahrami ◽  
Ali Sadeghian ◽  
...  

Abstract Background Diabetic foot ulcer (DFU) is one of the most important complications of diabetes that can lead to amputation. Treatment of DFUs is a major challenge and places a heavy economic and social burden on patients and their families. Case presentation The present case report is of a 52-year-old kurdish male patient with a 7-year history of type 2 diabetes. While on a bike ride, he sustained a traumatic injury to his right leg, which caused a deep gash measuring 14 × 5 cm on the tibia. During the hospital stay, no improvement was observed after routine wound care including suturing, antibiotic therapy, and dressing change. The patient was referred to our wound-care team. In the first step, the necrotic tissues of his foot ulcer were irrigated and then debrided using mechanical debridement and saline. Next, the patient underwent a 70 μg/dL dose of ozone therapy over a 30-day period in 10 sessions (one 20-minute session every 3 days). Between each session, the patient's wound was wrapped in silver-containing gauze bandages. After 1 month of wound-care using ozone therapy, the patient's foot ulcer had healed and he was discharged from our wound-care service with a stable and good general condition. Conclusion Considering the effectiveness of ozone therapy along with silver-containing dressing in the treatment of DFUs, wound-care teams can utilize it as an adjunct to the standard methods of DFU treatment.


Author(s):  
Mrudul Mohan ◽  
Sanjay Sharma ◽  
Shyam Prasad M. ◽  
Rajneesh V. Giri ◽  
Gururaja D.

Context: The diabetic foot ulcer, being chronic in nature involves various tissues, it can be considered as Dushtavrana in Ayurveda. Proper Care for diabetic foot with medication and procedures that has hastened the healing process with less complication is the need of the hour. Aim: To evaluate the Vrana Shodhana action of Gomutra Arka in Dushtavrana w.s.r. to diabetic foot ulcers. Settings and Design: It is a clinical study with pre-test and post-test design. Total number of patient’s taken for the study was 40 excluding dropouts. The patients selected for the study were divided in to 2 groups, Group-A and Group-B, consisting of 20 patients each. Materials and Methods: The wound is examined, exudates, debris, slough were removed, the surrounding area was cleaned and pad soaked in Gomutra Arka was placed and wound dressing was done once in a day. Duration of study was 45 days or till the formation of granulation tissue whichever is earlier, assessment was done every 7 days. For healing Jatyadi Taila was applied after the Shodhana Kriya with Gomutra Arka. Conclusion: Gomutra Arka was having good results in reducing burning sensation, itching, smell, size, depth, discharge, edge, floor and presence of granulation tissues compared to Betadine. Both drugs have equal effect in reducing pain. Both drugs have Shodhana, Lekhana properties, hastens the wound healing process which helps in reduction of wound size. It can be concluded that Gomutra Arka application is effective in all types of Diabetic foot ulcer by their faster, effective Shodhana, Lekhana, Vedana Shamaka, Kandu Shamaka, Daha Shamaka properties compared to Betadine.


2019 ◽  
Vol 19 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Hasan Fallah Huseini ◽  
Amir Hossein Abdolghaffari ◽  
Maryam Ahwazi ◽  
Eghbal Jasemi ◽  
Maryam Yaghoobi ◽  
...  

Diabetic foot ulcer is one of the major complications among diabetic patients. Several studies have shown that the extract of Teucrium polium (T. polium) is effective in the treatment of diabetic and non-diabetic wounds, as well as burn wounds. The aim of current study was to assess the wound healing activity of T. polium extract ointment in diabetic rats. Sixty-four male Wistar rats were induced diabetes with alloxan injection (125 mg/kg) and surgical wound induced. The rats were divided into 8 groups of eight rats each: control group, eucerin group, phenytoin group, 2%, 3%, 4%, 5% and 10% T. polium groups. The ointment was dressed on the wound twice a day. The process of wound healing was screened by macroscopy and digitalization on days 14 and 21 and until complete wound healing. There was no infection in the wounds of rats in any groups. The process of wounds healing of the 2%, 3%, 4%, 5%, and 10% T. polium ointments, with phenytoin ointment and base ointment (eucerin) on day 14 and 21, showed that the significant difference between the treatment groups with 4% (P = 0.003), 5% (P = 0.001), 10% (P = 0.001) T. polium ointment and phenytoin ointment group (P = 0.001) compared to eucerin group. The results of this study showed that T. polium extract ointment with a 10% ointment accelerates the wound healing process in diabetic rats and is comparable to the phenytoin group.


2018 ◽  
Vol 1 (1) ◽  
pp. 21-23
Author(s):  
Fahrianto Selamet ◽  
Andi Mayasari Usman ◽  
Rian Adi Pamungkas

Diabetic foot ulcer (DF) is a chronic complication of diabetes mellitus (DM), which impact on the morbidity, mortality and quality of patients’ lives.Of those patients with diabetes mellitus, approximately 15% to 25% developed to the foot ulcer. Beside has the infection and debridement of devitalized tissue downloading; the moisture imbalance becomes the factors of recalcitrant to healing. Moist wound healing is often contraindicated to the non-healable wounds. While wound care involves the debridement, bacterial reduction, and moisture balance in order to achieve the good granulation of the tissue development and adequate blood supply.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S773-S775
Author(s):  
Alexander A Ozoria Loveras ◽  
Jacques Paré Espinal ◽  
David de luna ◽  
Noemi Acevedo

Abstract Background In 2018, a review of the scientific literature identifed biofilm studies in the past 3 years. Wherein, the role of the biofilm in the progression of the diabetic foot ulcer with the presence of biofilm is reviewed. As a result, tissue sampling is more effective than transcure, Levin, and aspiration. A study in Cuba evaluate the effectiveness of a new proposal for antimicrobial treatment in patients with diabetic foot infection in 2017. The method used was a experimental type of two groups. The control group, was treated with the treatment scheme proposed in the Comprehensive Care Program for the patient with diabetic foot ulcer (PAIPUPD). Instead, the other experimental group was treated according to the scheme based on the local microbial map. They used a random distribution. Using the Wagner classification, there were patients classificate with a grade of W2 (13% of patients), W3 (66%) and W4 (12%). The most frequent germs found were Staphylococcus aureus, Escherichia coli and Enterobacter sp. The experimental group required less days with hospitalization. Methods This is an observational study of primary source with a non-probability sample with 58 patients. Adult patients diagnosed with type 2 diabetes mellitus, with diabetic foot, Wagner classification 1, 2 and 3, who attended the healing area of the Institute of Diabetes of Santiago were included. After identifying the colonized pathogen, its cicatrization process was evaluate for four weeks. Results Of the total sample, 12.07% belonged to Wagner 1, 43.1% to Wagner 2 and 44.83% to the Wagner 3 classification. In the case of the Wagner 3 group, S. aureus and Pseudomona aeruginosa were present in 6 cases. Despite the infectious processes detected by the culture, the patients showed a successful cicatrization process after four weeks of evaluation. Graph 1: Isolated Microorganism Vs Wagner’s Degree (n=60) Graph 2: Gram positive microorganism vs. healing process per week in patients with diabetic foot (n=22) Graph 3: Gram-negative microorganism vs. healing process (n=33) Conclusion During the four weeks of clinical evaluation, more than 88% of patients progressed positively to clinical recovery, regardless of the type of bacteria colonized and/or their resistance to antibiotics. Disclosures All Authors: No reported disclosures


2021 ◽  
Vol 18 ◽  
Author(s):  
Xinchi Feng ◽  
Jinsong Hao

: Chronic wounds remain a significant public problem and the development of wound treatments has been a research focus for the past few decades. Despite advances in the products derived from endogenous substances involved in a wound healing process (e.g. growth factors, stem cells, and extracellular matrix), effective and safe wound therapeutics are still limited. There is an unmet need to develop new therapeutics. Various new pathways and targets have been identified and could become a molecular target in designing novel wound agents. Importantly, many existing drugs that target these newly identified pathways could be repositioned for wound therapy, which will facilitate fast translation of research findings to clinical applications. This review discusses the newly identified pathways/targets and their potential uses in the development of wound therapeutics. Some herbs and amphibian skins have been traditionally used for wound repairs and their active ingredients have been found to act in these new pathways. Hence, screening these natural products for novel wound therapeutics remains a viable approach. The outcomes of wound care using natural wound therapeutics could be improved if we can better understand their cellular and molecular mechanisms and fabricate them in appropriate formulations, such as using novel wound dressings and nano-engineered materials. Therefore, we also provide an update on the advances in the wound therapeutics from natural sources. Overall, this review offers new insights into novel wound therapeutics.


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