scholarly journals Effectiveness of Topical Insulin Dressing in Healing of Diabetic Foot Ulcer among Diabetic Patients

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 158-161
Author(s):  
Meena P ◽  
Monisha V

Diabetes is previously known as the disease of the rich people, but now there is  no partiality between the rich and poor and it has become the third leading cause of  death. Diabetic Mellitus (DM) is a metabolic issue that is characteristics by  chronic hyperglycemia; it is a typical and conceivably persistent disease. The  aims of the present study to assess the effectiveness of insulin dressing of the diabetic foot ulcer among diabetic patients. A quasi-experimental research design with  purposive sampling technique was adopted to conduct a study among 30 diabetic foot ulcer patients. Demography data was collected and wound was measured and insulin dressing was done. After one week the wound was measured. Confidentiality was maintained throughout the procedure. The collected data were analyzed by using descriptive and inferential statistics. Among 30 samples pretest mean score of wound healing among patients with diabetic foot ulcer in the topical insulin dressing was 2.67±0.66 and the post test mean score was 1.43±0.57. The calculated paired ‘t’ test  value of t = 15.703 was found to be statistically highly significant at p<0.001 level.  The above finding clearly infers that topical insulin dressing to patients with diabetic foot ulcer had significant effect which resulted in the improvement in the level of  wound healing among patients with diabetic foot ulcer.

2021 ◽  
Vol 10 (7) ◽  
pp. 1495
Author(s):  
Yu-Chi Wang ◽  
Hsiao-Chen Lee ◽  
Chien-Lin Chen ◽  
Ming-Chun Kuo ◽  
Savitha Ramachandran ◽  
...  

Diabetic foot ulcers (DFUs) are a serious complication in diabetic patients and lead to high morbidity and mortality. Numerous dressings have been developed to facilitate wound healing of DFUs. This study investigated the wound healing efficacy of silver-releasing foam dressings versus silver-containing cream in managing outpatients with DFUs. Sixty patients with Wagner Grade 1 to 2 DFUs were recruited. The treatment group received silver-releasing foam dressing (Biatain® Ag Non-Adhesive Foam dressing; Coloplast, Humlebaek, Denmark). The control group received 1% silver sulfadiazine (SSD) cream. The ulcer area in the silver foam group was significantly reduced compared with that in the SSD group after four weeks of treatment (silver foam group: 76.43 ± 7.41%, SSD group: 27.00 ± 4.95%, p < 0.001). The weekly wound healing rate in the silver foam group was superior to the SSD group during the first three weeks of treatment (p < 0.05). The silver-releasing foam dressing is more effective than SSD in promoting wound healing of DFUs. The effect is more pronounced in the initial three weeks of the treatment. Thus, silver-releasing foam could be an effective wound dressing for DFUs, mainly in the early period of wound management.


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 54 (3) ◽  
pp. 207-216
Author(s):  
Ignatius U. Ezeani ◽  
Ejiofor T. Ugwu ◽  
Funmi O. Adeleye ◽  
Ibrahim D. Gezawa ◽  
Innocent O. Okpe ◽  
...  

AbstractObjective. The high amputation rates from diabetic foot ulcer (DFU) in Nigeria and prolonged hospitalization due to poor wound healing is a source of concern. Furthermore, factors that affect wound healing of DFUs have not yet been well studied in Nigeria, whereas knowing these factors could improve DFU outcomes. Therefore, the objective of this study was to determine the factors that are associated with the wound healing in patients hospitalized for DFU.Methods. The Multi-Center Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN) was an observational study involving 336 diabetic patients hospitalized for DFU and managed by a multi-disciplinary team until discharge or death. Demographic, clinical, and biochemical characteristics were documented. Test statistics used were chi square, t-test, univariate, and multivariate logistic regression. The study endpoints were ulcer healing, LEA, duration of hospitalization, and mortality. Here we present data on wound healing.Results. The mean ± SD age was 55.9±12.5 years. Univariate predictors of wound healing were ulcer duration more than 1 month prior to hospitalization (p<0.001), peripheral arterial disease (PAD) (p<0.001), foot gangrene (p<0.001), Ulcer grade ≥3 (p=0.002), proteinuria (p=0.005), anemia (p=0.009), renal impairment (p=0.021), glycated hemoglobin ≥7% (0.012), and osteomyelitis (p<0.001). On multivariate regression, osteomyelitis was the strongest independent predictor of wound healing after adjusting for all other variables (OR 0.035; 95% CI 0.004–0.332). This was followed by PAD (OR 0.093; 95% CI 0.028–0.311), ulcer duration >1 month (OR 0.109; 95% CI 0.030–0.395), anemia (OR 0.179; 95% CI 0.056–0.571).Conclusion. Presence of osteomyelitis, duration of ulcer greater than 1 month, PAD, Wagner grade 3 or higher, proteinuria, presence of gangrene, anemia, renal impairment, and HbA1c ≥7% were the significant predictors of wound healing in patients hospitalized for DFU. Early identification and prompt attention to these factors in a diabetic foot wound might significantly improve healing and reduce adverse outcomes such as amputation and death.


Author(s):  
Nuh Huda ◽  
Dini Mei Widayanti

Increasing the number of patients with DM, complications are also increasing, one of them is ulceration of the lower limbs, with or without infection and cause damage to the underlying tissue, hereinafter referred to as diabetic foot (KD) or diabetic foot wound. In the world, the number of diabetic foot patients is expected to continue to rise. Diabetic wound care also creates difficulties for the nurse. The purpose of this study is to analyze the level of ease of simple foot elevator (SFE) tools in the treatment of diabetic wounds. This type of research is quasi experimental Pre and Post Test Without Control Design by creating a prototype called SFE. This tool was then tested on 12 diabetic patient nurses with diabetic ulcer complications in the lower extremity area. The variable of this study is to measure the degree of ease of nurses in performing the treatment of Diabetic Injuries through the questionnaire. Data processing research with Mann Withney test with significance level (α = 0,05) or CI = 95%. The result of statistical test by using Mann-Whitney test is 0.014, the result p is less than α, meaning that statistically shows that the use of SFE (Simple Foot Elevator) tool is easy to be used by nurses when performing diabetic foot ulcer treatment in Room 3 Rumkital Dr. Ramelan Surabaya. The use of SFE is easy to use. So it can be recommended as one alternative tool that can be used in wound care.Keyword : Diabetes Mellitus, Diabetic Foot Wounds, SFE


2021 ◽  
Author(s):  
Mariarosa Ruffo ◽  
Ortensia Ilaria Parisi ◽  
Marco Dattilo ◽  
Francesco Patitucci ◽  
Rocco Malivindi ◽  
...  

Abstract In diabetic patients, the presence of neuropathy, peripheral vascular diseases and ischemia, leads to the formation of foot ulcerations with a higher risk of infection because the normal response to bacterial infection is missing. In the aim to control and treat Diabetic Foot Ulcerations (DFUs), wound dressings able to absorb exudate, to prevent infections and to promote wound healing, are needed. For this reason, the aim of the present research was to synthetize a biocompatible hydrogel composed by Carboxymethylcellulose (HyDrO-DiAb) loaded with Silver nanoparticles (AgNPs) for the treatment of diabetic foot ulcer. In this study, AgNPs were obtained by a green synthesis and, then, were dissolved in CMC hydrogel that, after freeze drying process become a flexible and porous structure. The in vitro and in ex-vivo wound healing activity of the obtained HyDrO-DiAb hydrogel was evaluated.


2018 ◽  
Vol 108 (5) ◽  
pp. 419-429
Author(s):  
Isabelle J. Dumont ◽  
Marc Lepeut ◽  
Coralie Segalen ◽  
Yannis Guillemin ◽  
Jean Noel Gouze

The number of people with diabetes is expected to reach 592 million in the year 2035. Diabetic foot lesions are responsible for more hospitalizations than any other complication of diabetes. The aims of this study were to examine for the first time a new biocompatible and biodegradable tridimensional collagen-based matrix, GBT013, in humans for diabetic foot ulcer wound healing and to evaluate its ease of use to better define a protocol for a future clinical trial. Seven adult patients with a diabetic foot ulcer of grade 1A to 3D (University of Texas Diabetic Wound Classification) were treated using GBT013, a new collagen-based advance dressing and were monitored in two specialized foot care units for a maximum of 9 weeks. Five of seven wounds achieved complete healing in 4 to 7 weeks. Nonhealed ulcers showed a significant reduction of the wound surface (&gt;44%). GBT013 was well tolerated and displayed positive wound healing outcomes as a new treatment strategy of chronic foot ulcers in diabetic patients.


2021 ◽  
Vol 12 ◽  
Author(s):  
Ye Liu ◽  
Yiqiu Liu ◽  
Junyu Deng ◽  
Wei Li ◽  
Xuqiang Nie

Diabetic foot ulcer (DFU) is a combination of neuropathy and various degrees of peripheral vasculopathy in diabetic patients resulting in lower extremity infection, ulcer formation, and deep-tissue necrosis. The difficulty of wound healing in diabetic patients is caused by a high glucose environment and various biological factors in the patient. The patients’ skin local microenvironment changes and immune chemotactic response dysfunction. Wounds are easy to be damaged and ulcerated repeatedly, but difficult to heal, and eventually develop into chronic ulcers. DFU is a complex biological process in which many cells interact with each other. A variety of growth factors released from wounds are necessary for coordination and promotion of healing. Fibroblast growth factor (FGF) is a family of cell signaling proteins, which can mediate various processes such as angiogenesis, wound healing, metabolic regulation and embryonic development through its specific receptors. FGF can stimulate angiogenesis and proliferation of fibroblasts, and it is a powerful angiogenesis factor. Twenty-three subtypes have been identified and divided into seven subfamilies. Traditional treatments for DFU can only remove necrotic tissue, delay disease progression, and have a limited ability to repair wounds. In recent years, with the increasing understanding of the function of FGF, more and more researchers have been applying FGF-1, FGF-2, FGF-4, FGF-7, FGF-21 and FGF-23 topically to DFU with good therapeutic effects. This review elaborates on the recently developed FGF family members, outlining their mechanisms of action, and describing their potential therapeutics in DFU.


2020 ◽  
Vol 11 (SPL4) ◽  
pp. 134-138
Author(s):  
Ruban David ◽  
Nandhini Rajkumar

Diabetic foot ulcer (diabetic foot ulcer) is an injury entering through the profound vascular and collagenous (dermis) layers of the skin in diabetic patients. Helpless information by walking care and helpless foot care rehearses were distinguish as significant danger factors for foot issues in diabetes. The principle target of the investigation was to survey the effectiveness of topical insulin dressing versus saline dressing and analyze the degree of diabetic injury healing. Quasi-experimental with comparative research design was embraced for the investigation. Convenience sampling technique was utilized to choose 60 examples. Structured interview was used to collect background variable and Wagner diabetic wound assessment scale for assessing diabetic wound. The diabetic wound was dressed with topical insulin dressing and normal saline dressing for 6 days. The calculated paired 't' test value of t = 15.703 was found to be statistically highly significant at p<0.001 level whereas the calculated paired 't' test value of t = 3.247 was found to be statistically highly significant at p<0.01 level. There was significant that the topical insulin dressing is the more effective and improving the level of wound healing than normal saline dressing.


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


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