scholarly journals DIABETIC FOOT INFECTIONS;

2008 ◽  
Vol 15 (01) ◽  
pp. 153-161
Author(s):  
MUHAMMAD SAEED AKHTAR ◽  
MAQSOOD AHMAD ◽  
MUHAMMAD BADAR BASHIR ◽  
Muhammad Irfan ◽  
Zahid Yasin Hashmie
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Surgical Department ◽  
Diabetic Foot Infections ◽  
Group A ◽  
Hospital Stays ◽  
Male Patients ◽  
Group B

Objective: (1) To evaluate the effects of G-CSF in eliminating infection in diabetic foot wound (2) Tocompare the effects with conventional diabetic foot management. Design: Prospective, open, randomized comparativestudy. Setting: Medical&Surgical Department of Allied, DHQ Hospital & Nawaz Medicare Faisalabad. Period: FromJan 2000 to Nov 2000 Patients & Methods: Fifty diabetic patients with foot infections were included in this study. Themean age was 52 years ranging from 27 to 60 years. They were divided into two equal groups(Group A and Group B).Results: The male patients were 41(82%) and female 9(18%). Forty six percent of patients were on oral hypoglycaemicdrugs, and 54% on insulin. The trauma preceding infection was 20%, Peripheral neuropathy 94% and peripheralvascular disease 34%. Thirty two percent of patients were smoker. Group A were subjected to G-CSF ( Neupogen )therapy (n=25) subcutanously daily for 5days in addition to conventional measures. Whereas patients in Group Breceived only conventional therapy. Both groups received similar antibiotic and insulin treatment. G-CSF therapy wasassociated with earlier eradication of pathogens from the infected ulcer (median 5 [range 2-11] vs11 [6-31] days in thegroup B; (p=<O.000I), quicker resolution of cellulitis (6 vs l4 days; p<O.0001), shorter hospital stay (8 vsl6 days;p<O.000l), and a shorter duration of intravenous antibiotic treatment (7 vs l4 days ;p—0.0001).No G-CSF treatedpatient needed surgery, whereas three patients in group B underwent toe amputation and six had extensivedebridement under anaesthesia (p=0.00 1). G-CSF therapy was generally well tolerated. Conclusion: Granulocytecolony stimulating factor (G-CSF) may be used as a good adjuvant therapy along with conventional measures for themanagement of diabetic foot infection, as it promotes the healing of diabetic foot ulcer/cellulitis and consequentlyprevents many hazardous complications like amputation of limbs, long hospital stays, extensive and prolonged antibioticuse and last but not the least the total misery of the patients.

scholarly journals Heat Shock Protein 70 Gene Single Nucleotide Polymorphism and Diabetic Foot Ulcer. Is There Any Relationship?

2018 ◽  
Vol 7 (8) ◽  
pp. 187 ◽  
Author(s):  
Mohammad Zubair ◽  
Jamal Ahmad
Keyword(s):  
Single Nucleotide Polymorphism ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Nucleotide Polymorphism ◽  
Single Nucleotide ◽  
Ulcer Group ◽  
Group A ◽  
Group B

Objective: The study aims to investigate the potential role of C2437T (Met493Thr) single nucleotide polymorphism (SNP) of the heat shock protein (HSP) 70 in diabetic foot ulcer patients. Methods: In this prospective cohort study, SNP of the HSP70 hom gene, also called HSPA1L, was studied among diabetic patients with an ulcer (Group A: n = 50), diabetic patients without an ulcer (Group B: n = 50), and healthy subjects (Group C: n = 50). Results: There was a higher frequency of T/T genotype in group A (76%) as compared to group B (44%) and group C (14%). Moreover, the frequency of T allele was 7.3% in group A, 5.5% in group B, and 3.9% in group C. C allele frequency was 2.6%, 4.4%, and 6.1% in group A, group B, and group C, respectively. In group A, the odds ratio and risk ratio were 19-fold and 5-fold, respectively, for the HSP70 hom T/T homozygous gene compared to B (OR 19.45; RR 5.42; X2 38.8, p < 0.0001). Moreover, 4-fold and 1.75-fold ratios have been compared with group C (OR 4.03; RR 1.72; X2 10.6, p < 0.001). No significant difference in genotype was observed in group B and group C. Conclusions: There is a significant and positive association of hspHSP70 hom polymorphism restricted to T allele in homozygous and heterozygous states among diabetic foot ulcer (DFU) patients.

scholarly journals Diabetes a risk for antimicrobial resistance?

2017 ◽  
Vol 6 (12) ◽  
pp. 2811 ◽  
Author(s):  
Vasavi Gedela ◽  
Sree Lakshmi Gosala
Keyword(s):  
Antimicrobial Resistance ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Resistance Pattern ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Diabetic Foot Infections ◽  
Significant Difference ◽  
Resistance Rates

Background: Diabetic foot infections can cause substantial morbidity. The role of Diabetes mellitus in the antimicrobial resistance of pathogens in patients with foot infections is not well clarified. So, we compared the profile of antibiotic resistance in diabetic and non-diabetic foot ulcer infections. Objectives were to compare the antimicrobial resistance pattern in diabetic and non-diabetic lower limb infections.Methods: T Pus was isolated in 50 Diabetic and 50 non-diabetic foot ulcer infections. The organisms were isolated on specific media and antibiotic susceptibility was done by using Kirby-Bauer disc diffusion method.Results: The most frequent causative organism in diabetic and non-diabetics is Pseudomonas 27.5% vs 27.1%, Staphylococcus 24.1% vs 27.1%, Klebsiella 24.1% vs 22.03%, E. coli 10.3% vs 10.16%, Proteus 5.17% vs 5.08%. No significant differences in resistance rates to Amikacin, Penicillin, Ofloxacin, Vancomycin, Piperacillin + Tazobactum were observed between diabetic and non-diabetic patients. There is significant difference in resistance to Ampicillin (p=0.017).Conclusions: Diabetes per se does not seem to influence the susceptibility pattern to antimicrobials in our group of patients with foot ulcer infections.

scholarly journals Comparison of angiosome based incision with conventional aggressive debridement for the treatment of diabetic foot ulcers.

2020 ◽  
Vol 27 (06) ◽  
pp. 1097-1102
Author(s):  
Naveed Akhtar ◽  
Muhammad Ilyas Anjum ◽  
Shafiq Ullah ◽  
Shahid Mansoor Nizami ◽  
Uzma Rasheed ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Controlled Trial ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Sampling Technique ◽  
University Hospital ◽  
Foot Ulcers ◽  
Group A ◽  
Group B ◽  
Aggressive Debridement

Objectives: To compare the efficacy of angiosome based incisions versus aggressive debridement for the treatment of diabetic foot ulcer. Study Design: Randomized Controlled Trial. Setting: Surgical Unit 1 Nishtar Medical University/ Hospital Multan. Period: 9 months duration, from 1st January 2017 to 30th September 2017. Material & Methods: Sample Size: Total 210 patients, 105 in each group. Sampling Technique: Non-probability, consecutive sampling. 210 patients of both genders with history of diabetes mellitus having Grade II diabetic foot ulcer below the ankle. Before the procedure, foot ulcers were measured and ulcer dimensions equal or greater than 4 cm2 were included in the study. 105 patients were in angiosome based incision group (Group A), while105 patients were in aggressive debridement group (Group B). Patients were called for follow up after every 5 days. Regular dressings were done to allow more regular wound inspection and cleansing to avoid infection. Efficacy of treatment was finally determined after 30 days by measuring the ulcer dimension by similar procedure as done before the start of procedure. Data was noted on especially designed proforma. Results: Age range in this study was from 30 to 60 years with mean age of 45.971± 4.89 years in Group A while 46.457± 6.22 years in Group B. Mean duration of diabetes was 10.171±4.09 years in Group A and 10.561±5.58 years in Group B. Mean duration of foot ulcer was 3.895±2.72 months in Group A and 3.790±2.03 months in Group B. Mean size of foot ulcer was 5.047±1.52 cm2 in Group A and 4.895±1.67 cm2 in Group B. Mean weight of the patients was 68.238±10.44 kg in Group A and 67.742±9.53 Kg in Group B. Majority of the patients were of 46-60 years in  group A (63.8%) and in group B  (66.7%). Male gender was dominant in both group (73.3% and 55.25). In group A efficacy was seen in 96 (91.4%) patients as compare to 47 (44.8%) patients in group B, (P=0.000). Conclusion: Angiosome based incision in the treatment of diabetic foot ulcer has shown outstanding outcome with respect to wound healing compared with aggressive debridement.

scholarly journals Clinical study in management of infected diabetic foot ulcers: superoxidised solution versus povidine iodine solution

2018 ◽  
Vol 5 (7) ◽  
pp. 2406
Author(s):  
Ramalingeshwara Kantly ◽  
Abhijit Medikeri
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Controlled Study ◽  
Solution Versus ◽  
Ulcer Area ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Povidine Iodine

Background: Diabetic foot ulcer is a one of the major challenging problem to every surgeon in day to day practice. Superoxidised solution is an effective concept in the wound management. The present study was aimed to compare the efficacy of dressings with superoxidised solution versus povidine iodine in the management of infected diabetic ulcers.Methods: This is a randomized controlled study conducted over a period of one year. In our study, total of 60 patients presenting with infected diabetic ulcers are included. Patients were randomly divided into two groups of 30 each, group A (Topical superoxidised solution dressing) and group B (Topical povidine iodine dressing). Wound was observed for decrease in size of the ulcer, granulation, tissue quality and discharge from the wound at the end of each week for two weeks.Results: In the present study, 76.67% of patients in group A and B were males and the male to female ratio was 3.2:1. The mean age in group A was 55.90±14.27 years compared to 51.50±13.18 years in group B. The mean initial ulcer area in group A was 3882±1890 mm2 compared to 3992±2000 mm2 in group B. The mean post treatment final area in group A was significantly low (1607±862 mm2) compared to group B (2351±1240 mm2; p=0.009) and the comparison of mean change in ulcer area was significantly high in group A compared to group B (2215±1060 mm2 vs 1641±856 mm2; p=0.024). The mean percentage reduction in ulcer area among patients with group A was significantly high (58.90±5.21 percent vs. 40.90±8.76 percent; p=0.024). The commonest organism isolated in group A was Escherichia coli (26.67%) and in group B, it was staphylococcus. The culture was positive in 26% of the patients in group A compared to 50% in group B (p=0.063).Conclusions: Overall, topical superoxidised solution dressing for diabetic foot ulcer accelerated the healing process resulting in faster recovery through reduction in ulcer area compared to topical povidine iodine dressing.

scholarly journals To study the effect of oral vitamin D supplements on wound healing in patient with diabetic foot ulcer and its effect on lipid metabolism

2020 ◽  
Vol 11 (2) ◽  
pp. 2701-2706
Author(s):  
Ajoinish Kamble ◽  
Ranjit S. Ambad ◽  
Mangesh Padamwar ◽  
Anupam Kakade ◽  
Meenakshi Yeola
Keyword(s):  
Vitamin D ◽  
Wound Healing ◽  
Diabetic Foot ◽  
Density Lipoprotein ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Vitamin D Levels ◽  
Group A ◽  
Vitamin D Supplements ◽  
Group B

To Critically Assess the effect of oral vitamin D supplements on wound healing in a patient with diabetic foot ulcer and its impact on lipid metabolism. This is a single-Centre prospective randomised, control-controlled study was conducted in Department of Surgery Datta Meghe Medical College, Hingna, Nagpur, in collaboration with Datta Meghe Institute of Medical Sciences (DMIMS) Deemed to be University from June 2019 TO March 2020. A total of sixty patients were included in this study. A randomised grouping was done, group A vitamin d supplements and group B as an x-control group. In the group, A vitamin D levels were significantly increased after 12 weeks of intervention as compared to baseline while in group B, no change was seen after the intervention. There was a significant change in HbA1c level after intervention as group A vs group B. similar results were seen in total cholesterol levels after intervention in group A, and group B. Wound surface area was (29.83±15.02 vs 21.76±11.30, p=0.02) in group A and (25.06±14.02 vs 21.3±13.19, p=0.28) in group B respectively. The level of high-density lipoprotein in the group was significantly lower in level when compared to group A after 12 weeks of intervention. No significant changes were seen in the triglycerides level in group A and group B., A comparison of group A vs group B after 12 weeks of intervention, was done. It revealed that Vitamin D Glycosylated total haemoglobin cholesterol, High-density lipoprotein and Wound surface area, significantly improved. At the same time, there was no change seen in triglycerides levels in both the group.After intervention with vitamin D supplements for 12 weeks among patients with diabetic foot ulcer had a good result and beneficial effect on glucose metabolism, vitamin D levels, lipid profile and wound healing

scholarly journals A prospective study on effectiveness of use of papain urea based preparation in dressings compared with regular conventional dressings in diabetic foot ulcers

2017 ◽  
Vol 4 (6) ◽  
pp. 1984 ◽  
Author(s):  
Balasubrahmanya K. S. ◽  
Praveen M. Pawar ◽  
Srinidhi M. ◽  
Shruthi S. ◽  
Jinumon K. V. ◽  
...  
Keyword(s):  
Prospective Study ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Necrotic Tissue ◽  
Group A ◽  
Group B ◽  
A Prospective Study

Background: Diabetic foot ulcer is a very common condition encountered in surgical practise. Wound management pose a good challenge for a treating surgeon due to its physical, mental and social implications. The devitalised necrotic tissue present in ulcer does not favour the wound healing as it increases the chance of infection and delays appearance of granulation tissue. Hence debriding of devitalised tissue plays a key role in wound care. In present study ,we used papain urea based preparation in dressings which is a autolytic agent. This study was conducted to evaluate the effectiveness of use of papain urea based preparations compared with regular conventional dressing in diabetic foot ulcer management.Methods: This was a prospective study conducted in K. R. Hospital, Mysore, Karnataka, India. 60 eligible subjects with diabetic foot ulcers were selected and subjects were randomly allocated into two groups Group A and Group B with 30 subjects in each group. Subjects in Group A underwent dressing with papain urea based preparation and in Group B underwent regular conventional dressing. Results were assessed with respect to percentage decrease in necrotic tissue, incidence of infection, appearance of granulation and hospital stay.Results: Among Group A subjects percentage reduction of necrotic tissue was more, granulation appeared early and the hospital stay was less compared to Group B subjects which were statistically significant. However, there was no significant difference with respect to incidence of infection in both groups.Conclusions: Papain urea based preparation is effective in diabetic foot ulcer care.

Treatment of Diabetic Foot Infections

2020 ◽  
Author(s):  
Shimpo Aoki ◽  
Lauren R Bayer ◽  
Dennis P Orgill
Keyword(s):  
Diabetic Foot ◽  
Multidisciplinary Approach ◽  
New Technologies ◽  
Wound Care ◽  
Full Range ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Diabetic Foot Infections ◽  
Biomechanical Changes

Thirteen percent of diabetic patients will develop a foot ulcer, often associated with infection, vascular disease and biomechanical changes. Limb salvage offers the potential to restore function but does not correct the underlying metabolic disturbance. We review the surgical approach to diabetic foot infections including debridement, skin grafts, local flaps and a variety of new technologies. A comprehensive multidisciplinary approach is beneficial to optimize outcomes. The full range of reconstructive options available to plastic surgeons may be used in the treatment of diabetic foot ulcers. This review has 5 figures, 2 tables, and 20 references. Key words: Diabetic Foot Infection (DFI), Diabetic Foot Ulcer (DFU), Diabetes Mellitus (DM), wound care, foot infection, bacterial infection, surgical management, neuropathy, surgery of the lower extremity, deformities

scholarly journals Risk factors of amputation in diabetic foot infections

2018 ◽  
Vol 5 (4) ◽  
pp. 1399 ◽  
Author(s):  
Quraysh Shabbir Sadriwala ◽  
Bapuji S. Gedam ◽  
Murtaza A. Akhtar
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Glycemic Control ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Factors Associated ◽  
Diabetic Foot Infections

Background: Diabetes is the most common underlying cause of foot ulcers, infection, and ischemia, leading to hospitalization and the most frequent cause of non-traumatic lower extremity amputation. Despite well-defined risk factors for diabetic foot ulcer development, limited data are available as to which factors predict amputation in a diabetic foot ulcer episode. Therefore, to predict lower limb amputation occurrence and to determine the factors associated with the risk of amputation in diabetic patients, we conducted this study.Methods: A hospital based longitudinal study was carried out to assess the risk factors associated with amputation in diabetic foot infection. Patients with foot infections, who were either a diagnosed case of diabetes mellitus or were diagnosed at the institute were included in the study. We excluded patients receiving immunosuppressive therapy or radiotherapy, and infections at or above the ankle joint. Study factors were demographic details, biochemical parameters, Wagner grading, peripheral neuropathy as evaluated by nerve conduction test and vasculopathy as assessed by Ankle brachial index. The primary outcome factor was amputation. The data was presented as descriptive statistics and analyzed by dividing the patients into amputation and non-amputation group, and univariate and multivariate analysis was done.Results: A total of 64 patients were included in the study, out of which the amputation rate was 39.1%. Poor glycemic control, osteomyelitis, vasculopathy, peripheral neuropathy and Wagner grading were statistically significant.Conclusions: In the present study, poor glycemic control, vasculopathy, peripheral neuropathy and higher Wagner grade are significant risk factors for amputation in diabetic foot infections.

scholarly journals Comparison Low-Level Laser Therapy (LLLT) of 10J/cm2 and 5 J/cm2 Energy Density for Healing Diabetes Foot Ulcer

2020 ◽  
Vol 70 (2) ◽  
pp. 16-22
Author(s):  
Purwitasari Darmaputri ◽  
Nury Nusdwinuringtya ◽  
Nyoman Murdana ◽  
Tri Juli Edi Tarigan ◽  
Dewi Friska
Keyword(s):  
Energy Density ◽  
Laser Therapy ◽  
Diabetic Foot ◽  
Standard Treatment ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Low Level Laser Therapy ◽  
Level Laser ◽  
Group A ◽  
Group B

Background: Diabetic foot ulcer is a problem in patients with diabetes mellitus (DM). One adjuvant therapy that can enhance wound healing is Low-Level Laser Therapy (LLLT), but there is no established guideline regarding the dosage. In Indonesia, there has been no study comparing the energy density of LLLT on diabetic ulcer healingMethods: This is an experimental study on 28 subjects with a randomized diabetic foot ulcer. Group A received standard treatment of ulcer and LLLT 5J/cm2. Group B received standard treatment of ulcer and LLLT 10J/cm2.Results: The difference in wound size between group A and group B were 4.15 mm2 and 7.5 mm2 (p=0.178). The healing rate of group A and group B were 4.15 (-10-34.5) mm2/4 weeks and 7.5 (-2.8-34) mm2/4weeks (p=0.168). Conclusions: There was no statistically significant difference between the group receiving LLLT 5J/cm2 or 10 J/cm2 in diabetic foot ulcer healing.

scholarly journals DIABETIC FOOT ULCERS;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
SOHAIL Farooq ◽  
Shaukat Javed ◽  
Nazish Jahan
Keyword(s):  
Granulation Tissue ◽  
Diabetic Foot ◽  
Controlled Trial ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Size ◽  
Group A ◽  
Group B

Introduction: Traditionally, moist dressings are being in used routinely by surgeons for management of diabetic foot ulcers. Recently, there is an encouraging trend of using VAC dressings in such patients. This study aimed to compare the outcome of VAC with moist dressing for management of diabetic foot ulcer. Study Design: Prospective randomized controlled trial. Setting: Department of Surgery, Al-Bukyriah General Hospital, Al-Bukayriah, Alqaseem KSA. Period: June 2012 to 07 December 2016. Methods and Material: 200 patients with diabetic foot ulcers. The patients were divided in two equal groups containing 100 patients each. In group A, 100 patients received VAC dressing treatment while in group B, 100 patients received wet dressings. Wound size, % reduction in wound size, appearance of granulation tissue and fate of wound were main outcome measured which were noted at start of study and at the end of study (4th week of therapy). Results: In group A, there were 73 (73%) men and 27 (27%) women with a mean age of 54.98+7.68 years and in group B, there were there were 75 (75%) men and 25 (25%) women with a mean age of 55.23+6.98 years. Size of wound before treatment in group A was 14.23± 6.78 cm2 which reduced to 5.11±1.91 cm2 at 4th wee and in group B it was 14.41±5.93 cm2 in the start which reduced to 11.29±3.63 cm2 at 4th week (p<0.05). Mean %reduction in wound size in group A was 63.22±9.19 and 22.92±7.18 in group B (p<0.05). In group A, 43 (43%) wounds healed spontaneously with shrinkage and group B only 2(2%) healed spontaneously (p<0.05). Conclusions: VAC therapy is superior to moist dressing in terms of achieving early granulation tissue, reduction in wound size and spontaneous wound shrinkage.

Sign in / Sign up

Export Citation Format

Share Document