The role of the cord blood platelet gel in the management of a diabetic foot with tendon exposure

2021 ◽  
Author(s):  
Mafalda Massara ◽  
Giulia Pucci ◽  
Giuseppe Stilo ◽  
Antonino Alberti ◽  
Rosangela Surace ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Cord Blood ◽  
Diabetic Foot ◽  
Healing Process ◽  
Limb Ischemia ◽  
Blood Platelet ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Platelet Gel ◽  
Vital Functions

Diabetic foot infection is frequent in diabetic patients and is due to neuropathy, trauma or peripheral arterial disease. The presence of an abscess requires urgent drainage and specific antibiotic therapy. Patients with critical limb ischemia need revascularization and, subsequently the intervention of a plastic surgeon is often required in cases of exposure of tendons and ligaments. During the COVID-19 pandemic, a patient was refered to our department with an abscess on the dorsum of the left foot. After urgent drainage with tendon exposure, he started specific antibiotic therapy and underwent tibial vessels angioplasty. After infection healing cord blood platelet gel was applied, accelerating the healing process, with injection of its liquid part into the exposed tendons, thus retaining the vital functions of the tendons.

Pro- and Anti-Angiogenic Factors: Their Relevance in Diabetic Foot Syndrome—A Review

Angiology ◽  
2021 ◽  
pp. 000331972110426
Author(s):  
Martyna Schönborn ◽  
Patrycja Łączak ◽  
Paweł Pasieka ◽  
Sebastian Borys ◽  
Anna Płotek ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Arterial Disease ◽  
Angiogenic Factors ◽  
Diabetic Foot Syndrome ◽  
Tissue Loss ◽  
Comprehensive Treatment ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Peripheral Arterial

Peripheral arterial disease can involve tissue loss in up to 50% of patients with diabetic foot syndrome (DFS). Consequently, revascularization of narrowed or occluded arteries is one of the most common forms of comprehensive treatment. However, technically successful angioplasty does not always result in the healing of ulcers. The pathomechanism of this phenomenon is still not fully understood, but inadequate angiogenesis in tissue repair may play an essential role. Changes in pro- and anti-angiogenic factors among patients with DFS are not always clear and conclusive. In particular, some studies underline the role of decreased concentration of pro-angiogenic factors and higher levels of anti-angiogenic mediators. Nevertheless, there are still controversial issues, including the paradox of impaired wound healing despite high concentrations of some pro-angiogenic factors, dynamics of their expression during the healing process, and their mutual relationships. Exploring this process among diabetic patients may provide new insight into well-known methods of treatment and show their real benefits and chances for improving outcomes.

Efficacy of cord blood platelet gel application for enhancing diabetic foot ulcer healing after lower limb revascularization

2017 ◽  
Vol 30 (4) ◽  
pp. 106-112 ◽  
Author(s):  
Pietro Volpe ◽  
Daniela Marcuccio ◽  
Giuseppe Stilo ◽  
Antonino Alberti ◽  
Giovanni Foti ◽  
...  
Keyword(s):  
Cord Blood ◽  
Ulcer Healing ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Blood Platelet ◽  
Platelet Gel

Influence of diabetes on diagnostic performance of computed tomography angiography of the calf arteries in acute limb ischemia

2021 ◽  
pp. 028418512110069
Author(s):  
Talha Butt ◽  
Leena Lehti ◽  
Jan Apelqvist ◽  
Anders Gottsäter ◽  
Stefan Acosta
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Diagnostic Performance ◽  
Intraclass Correlation ◽  
Arterial Occlusion ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Acute Limb Ischemia ◽  
Below The Knee

Background Patients with diabetes mellitus (DM) have a more extensive distal arterial occlusive disease compared to non-diabetic patients. Diagnostic imaging is a necessity to identify the location and extent of the arterial occlusion in acute limb ischemia (ALI). Computed tomography angiography (CTA) is the most commonly used modality and the diagnostic performance with CTA of calf arteries may be questioned. Purpose To evaluate diagnostic performance of CTA of calf arteries in ALI and to compare patients with and without DM. Material and Methods All thrombolytic treatments performed during 2001–2008 in patients with ALI were included. Initial digital subtraction angiography (DSA) and CTA of all patients were classified according to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) below-the-knee arteries and compared to CTA. Two raters assessed the CTA images independently. Inter-rater reliability was expressed as intraclass correlation (ICC) with 95% confidence intervals (CI). Results Patients with (n = 23) and without (n = 85) DM had lower ( P = 0.006) glomerular filtration rate. ICC between CTA and DSA was 0.33 (95% CI –0.22 to 0.56) and 0.71 (95% CI 0.38–0.68) in patients with and without DM, respectively. Sensitivity with CTA for TASC D lesions in patients with and without DM was 0.14 (95% CI –0.12 to 0.40) and 0.64 (95% CI 0.48–0.80), respectively. Conclusion The sensitivity of CTA for assessment of infra-popliteal TASC D lesions in patients with ALI was not acceptable in patients with DM in contrast to those without DM. Another imaging option at present times should be considered for patients with DM.

scholarly journals The efficacy of platelet gel derived from umbilical cord blood on diabetic foot ulcers: A double-blind randomized clinical trial

2020 ◽  
Vol 28 ◽  
pp. 100178
Author(s):  
Seyedeh Esmat Hosseini ◽  
Behnam Molavi ◽  
Alireza Goodarzi ◽  
Ahad Alizadeh ◽  
Alireza Yousefzadeh ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cord Blood ◽  
Randomized Clinical Trial ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Platelet Gel ◽  
Double Blind

scholarly journals Cord blood platelet gel treatment of dystrophic recessive epidermolysis bullosa

2015 ◽  
Vol 2015 (jan08 1) ◽  
pp. bcr2014207364-bcr2014207364 ◽  
Author(s):  
G. Tadini ◽  
L. Pezzani ◽  
S. Ghirardello ◽  
P. Rebulla ◽  
S. Esposito ◽  
...  
Keyword(s):  
Cord Blood ◽  
Epidermolysis Bullosa ◽  
Blood Platelet ◽  
Platelet Gel ◽  
Gel Treatment

Diabetic Foot and Footwear

2015 ◽  
Vol 19 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Luximon Ameersing ◽  
Ganesan Balasankar ◽  
Younus Abida
Keyword(s):  
Diabetic Foot ◽  
Plantar Pressure ◽  
Arterial Disease ◽  
Sensory Loss ◽  
Foot Deformities ◽  
Diabetic Patients ◽  
Body Parts ◽  
Foot Ulceration ◽  
Materials Used ◽  
Peripheral Arterial

Diabetes mellitus is one of the most common diseases around the world, and mainly affects the foot among the human body parts. The main causes of the diabetic foot are neuropathy, peripheral arterial disease and foot deformities; it leads to foot ulceration. Generally, sensory loss, high plantar pressure, foot deformities, inappropriate footwear, blindness, and age are the causing risk factors for developing foot ulceration in diabetic patients. Foot ulceration will result in prolonged hospitalization, high medical expenses, and serious complications with lower extremity amputation. For a long time, appropriate footwear has been recommended by physicians for reducing plantar pressure to prevent foot ulceration, the risk of amputation, and re-ulceration. A review is provided in this article towards the existing literature on the causes and prevalence of the diabetic foot, foot ulceration, off-loading pressure, footwear modification for different types of diabetic foot deformities, and types of footwear and textile materials used in footwear insoles for healing purposes.

scholarly journals Long-Term Outcomes of Diabetic Patients With Critical Limb Ischemia Followed in a Tertiary Referral Diabetic Foot Clinic

Diabetes Care ◽  
2010 ◽  
Vol 33 (5) ◽  
pp. 977-982 ◽  
Author(s):  
L. Uccioli ◽  
R. Gandini ◽  
L. Giurato ◽  
S. Fabiano ◽  
E. Pampana ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Long Term Outcomes ◽  
Tertiary Referral ◽  
Foot Clinic

scholarly journals A comparative study of foot infections in diabetic and non-diabetic patients with reference to etiopathogenesis, clinical features and outcome

2020 ◽  
Vol 7 (5) ◽  
pp. 1496
Author(s):  
Venkata Reddy M. ◽  
Varun Deep K. ◽  
Inamdar P.
Keyword(s):  
Hospital Stay ◽  
Clinical Features ◽  
Diabetic Foot ◽  
Healing Process ◽  
Significant Proportion ◽  
Diabetic Patients ◽  
Group A ◽  
Wagner’S Grade ◽  
Group B ◽  
Prolonged Hospital

Background: Infections in the foot are more common with significant proportion of world’s population remaining bare foot, minor skin trauma is a frequent cause of local infection. The present study was conducted with an aim to study various foot infections and compare the findings in diabetic and non diabetic patients with reference to etiopathogenesis, clinical features, management, duration of hospital stay and outcome.Methods: The present study was conducted in Mamata General Hospital, Khammam, Telangana state from October 2016 to September 2018. A total of 50 cases were divided into 2 groups, Group A included 25 patients with diabetic foot infection and Group B included 25 patients with non diabetic foot infections.Results: In diabetics 6th decade and in non-diabetics 4th-6th decade was the most common age group presenting with foot infections. Cellulitis of the foot was the most common in both diabetics (40%) and non-diabetics (52%). Wagner’s grade 4 lesions were more common in diabetics (28%) than in non-diabetics (8%). The most common site of lesion in diabetics was dorsum (40%) and in non-diabetics was toes (40%). The incidence of neuropathy was significantly higher in diabetics (72%) than in non-diabetics (20%). Rate of amputation was high in diabetics (12%) compared to non-diabetics (8%). The average number days in a hospital stay in diabetics was 42.27 days and in non-diabetics it was 28.96 days.Conclusion: Diabetic patients have increased severity of infections, delayed healing process, need more active interventions. As compared to the non-diabetic patients, they do show high risk of amputations and prolonged hospital stay.

Use of cord blood platelet gel to enhance healing of deep surgical site dehiscences after peripheral bypass

2020 ◽  
Author(s):  
Pietro Volpe ◽  
Giulia Pucci ◽  
Giuseppe Stilo ◽  
Antonino Alberti ◽  
Giovanni Foti ◽  
...  
Keyword(s):  
Cord Blood ◽  
Outpatient Surgery ◽  
Blood Platelet ◽  
Major Amputation ◽  
Vacuum Assisted Closure ◽  
Platelet Gel ◽  
Early Graft ◽  
Vacuum Assisted Closure Therapy ◽  
Early Graft Failure ◽  
Subsequent Risk

Surgical site dehiscence after lower limb revascularization through bypass represents a serious postoperative complication, especially in diabetic and obese patients, with subsequent risk of early graft failure, infection, sepsis, hemorrhage, major amputation and sometimes death. To prevent bypass exposure and subsequent complications, physicians recur to reoperation, antibiotic therapy, advanced dressing and vacuum-assisted closure therapy. To improve the process of wound healing, cord blood platelet gel can be used to fill deep and large wounds. Growth factors released from platelets in the cord blood platelet gel stimulate the process of healing and allow patients to be followed up in Outpatient Surgery, thus reducing hospital stay and costs, while providing excellent results.

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