Single Cell RNA-Seq Analyses of Healthy Lower Extremity Skin and Diabetic Foot Ulcers Uncover Distinct Immune Landscape of Diabetic Wound Healing

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 647-P ◽  
Author(s):  
GEORGIOS THEOCHARIDIS ◽  
SWATI S. BHASIN ◽  
KONSTANTINOS KOUNAS ◽  
MANOJ K. BHASIN ◽  
ARISTIDIS VEVES
Author(s):  
Ioanna A. Anastasiou ◽  
Ioanna Eleftheriadou ◽  
Anastasios Tentolouris ◽  
Georgia Samakidou ◽  
Nikolaos Papanas ◽  
...  

Diabetic foot ulcers are one of the most dreadful complications of diabetes mellitus and efforts to accelerate diabetic wound healing are of paramount importance to prevent ulcer infections and subsequent lower-limb amputations. There are several treatment approaches for the management of diabetic foot ulcers and honey seems to be a safe and cost-effective therapeutic approach on top of standard of care. The aim of this review was to summarize the therapeutic properties of honey and the data regarding its possible favorable effects on diabetic wound healing. A literature search of articles from 1986 until April 2021 was performed using MEDLINE, EMBASE, and the Cochrane Library to assess for studies examining the therapeutic wound healing properties of honey, it's in vitro effect, and the efficacy and/or mechanism of action of several types of honey used for the treatment of diabetic animal wounds. Honey has antioxidant, anti-inflammatory, and antibacterial properties and in vitro studies of keratinocytes and fibroblasts, as well as studies in diabetic animal models show that treatment with honey is associated with increased re-epithelialization and collagen production, higher wound contraction, and faster wound healing. The use of honey could be a promising approach for the management of diabetic foot ulcers.


2020 ◽  
Vol 3 (1) ◽  
pp. 265-271
Author(s):  
Dewi Astuti Pasaribu ◽  
Septian Mixrova Sebayang

Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus (DM) that can be slow to heal, result in repeated hospitalizations, require intense and costly treatment, and reduce the quality of life. The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. Quasi-experimental study using before and after changes to wound healing in between February until May 2019.Thirty patients from an inpatient rooms with ulcers who met study criteria agreed to participate. Subjects were recruited by the researchers in the hospital where they received treatment. Data were collected using investigator-developed forms: patient information form and the diabetic foot exercises log. Patients in the intervention group received standard wound care and performed daily foot exercises for 3 week. Diabetic wound healing of the patients in the intervention were examined and measured at the 3rd weeks. To analyze and compare the data, frequency distribution, mean (standard deviation), and the paired samples t test were used. The mean of diabetic wound healing were 3.50, 2.90, and 2.40 in the study intervention group in 1st, 2nd, and 3rd weeks, respectively. Significant differences were found between diabetic wound healing in pre-test and post-test group (p=0.041). An important finding in this study was the DFU area decreased more in those who exercised more. Findings suggest foot exercises should be included in the treatment plan when managing patients with diabetic foot ulcers.     Abstrak Luka kaki diabetic adalah suatu komplikasi yang serius pada diabetes mellitus dimana dapat memperlambat penyembuhan, hospitalisasi berulang, membutuhkan pengobatan yang mahal dan menurunkan kualitas hidup. Tujuan penelitian ini adalah untuk mengetahui efek senam kaki terhadap penyembuhan luka pada pasien diabetes mellitus tipe 2. Jenis penelitian Quasi eksperimen digunakan untuk melihat perubahan sebelum dan sesudah penyembuhan luka dari Februari sampai Mei 2019. Tiga puluh pasien dari ruang inap dengan luka menjadi kriteria inklusi sebagai responden. Responden direkrut oleh peneliti di rumah sakit dimana pasien sedang menjalani perawatan. Pengumpulan data menggunakan kuesioner data demografi dan lembar observasi penyembuhan luka. Pasien akan diberikan latihan selama 3 minggu. Penyembuhan luka diabetic pada pasien akan dikaji dan diukur sampai minggu ke tiga. Untuk menganalisis dan membandingkan data, distribusi frekuensi, mean (standar deviasi), dan paired t test dilakukan. Mean penyembuhan luka diabetik diantaranya 3.50, 2.90 dan 2.40 pada kelompok intervensi pada minggu pertama, kedua, dan ketiga secara berurutan. Perbedaan signifikan penyembuhan luka diabetic antara kelompok pre-test dan post-test (p=0.041). Suatu temuan penting bahwa area luka kaki diabetic semakin menurun pada orang yang melakukan senam. Temuan ini juga senam kaki sebaiknya dimasukkan dalam rencana perawatan ketika merawat pasien dengan luka kaki diabetik.


2019 ◽  
Vol 12 (2) ◽  
pp. 79 ◽  
Author(s):  
Jeffrey I. Jones ◽  
Trung T. Nguyen ◽  
Zhihong Peng ◽  
Mayland Chang

Diabetic foot ulcers (DFUs) are significant complications of diabetes and an unmet medical need. Matrix metalloproteinases (MMPs) play important roles in the pathology of wounds and in the wound healing process. However, because of the challenge in distinguishing active MMPs from the two catalytically inactive forms of MMPs and the clinical failure of broad-spectrum MMP inhibitors in cancer, MMPs have not been a target for treatment of DFUs until recently. This review covers the discovery of active MMP-9 as the biochemical culprit in the recalcitrance of diabetic wounds to healing and targeting this proteinase as a novel approach for the treatment of DFUs. Active MMP-8 and MMP-9 were observed in mouse and human diabetic wounds using a batimastat affinity resin and proteomics. MMP-9 was shown to play a detrimental role in diabetic wound healing, whereas MMP-8 was beneficial. A new class of selective MMP-9 inhibitors shows clinical promise for the treatment of DFUs.


Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.


2021 ◽  
Vol 10 (2) ◽  
pp. 371
Author(s):  
Kor H. Hutting ◽  
Wouter B. aan de Stegge ◽  
Jaap J. van Netten ◽  
Wouter A. ten Cate ◽  
Luuk Smeets ◽  
...  

Diabetic foot ulcers, complicated by osteomyelitis, can be treated by surgical resection, dead space filling with gentamicin-loaded calcium sulphate-hydroxyapatite (CaS-HA) biocomposite, and closure of soft tissues and skin. To assess the feasibility of this treatment regimen, we conducted a multicenter retrospective cohort study of patients after failed conventional treatments. From 13 hospitals we included 64 patients with forefoot (n = 41 (64%)), midfoot (n = 14 (22%)), or hindfoot (n = 9 (14%)) ulcers complicated by osteomyelitis. Median follow-up was 43 (interquartile range, 20–61) weeks. We observed wound healing in 54 patients (84%) and treatment success (wound healing without ulcer recurrence) in 42 patients (66%). Treatment failures (no wound healing or ulcer recurrence) led to minor amputations in four patients (6%) and major amputations in seven patients (11%). Factors associated with treatment failures in univariable Cox regression analysis were gentamicin-resistant osteomyelitis (hazard ratio (HR), 3.847; 95%-confidence interval (CI), 1.065–13.899), hindfoot ulcers (HR, 3.624; 95%-CI, 1.187–11.060) and surgical procedures with gentamicin-loaded CaS-HA biocomposite that involved minor amputations (HR, 3.965; 95%-CI, 1.608–9.777). In this study of patients with diabetic foot ulcers, complicated by osteomyelitis, surgical treatment with gentamicin-loaded CaS-HA biocomposite was feasible and successful in 66% of patients. A prospective trial of this treatment regimen, based on a uniform treatment protocol, is required.


2021 ◽  
Vol 13 (585) ◽  
pp. eabe4839
Author(s):  
Simon Matoori ◽  
Aristidis Veves ◽  
David J. Mooney

Current treatment options for foot ulcers, a serious and prevalent complication of diabetes, remain nonspecific. In this Perspective, we present recent advances in understanding the pathophysiology of diabetic wound healing and the emergence of previously unidentified targets. We discuss wound dressings tailored to the diabetic wound environment currently under development.


2010 ◽  
Vol 6 (1) ◽  
pp. 93-103
Author(s):  
Hany M Abdel Aziz ◽  
Basim M Zaki ◽  
Nahed S Boughdadi ◽  
Karim El-Lamie ◽  
Ashraf Maher ◽  
...  

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