scholarly journals The Effectiveness of the 15 Psi Irrigation Technique in Wound Cleansing to Reduce the Number of Bacteria on Patients with Diabetic Foot Ulcers

2018 ◽  
Vol 1 (1) ◽  
pp. 88-97
Author(s):  
Lestari Makmuriana (Corresponding author) ◽  
Suriadi ◽  
Yani Sofiani ◽  
Fitrian Rayasari
Keyword(s):  
Normal Saline ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Clinical Test ◽  
Diabetic Foot Ulcers ◽  
Double Blind ◽  
Saline Irrigation ◽  
Number Of Bacteria

The increasing population of diabetic patients leads to the increasing number of diabetic foot ulcer (DFU) cases. To avoid the expansion of the infection, the wound cleansing is conducted through the irrigation and pressure methods. The aim of this research was to identify the effectiveness of wound cleansing using 0.9% normal saline technique with the pressure of 15 Psi in reducing the number of bacteria. This research used the randomized control trial method with a double blind design which had been approved by the ethnical committee of Muhammadiyah University of akarta with the ethnical committee number 261/PMK-UMJ/IV/2017. There were as many as 31 samples in each group collected through consecutive sampling technique with randomization. It had been found that there was a signi fi cant difference in the number of bacteria before and after wound cleansing. Thus, it could be concluded that from the statistical test and clinical test, wound cleansing with normal 0.9% saline technique with the pressure of 15 Psi could decrease the number of bacteria in diabetic foot ulcers. Wound cleansing with 0.9% normal saline irrigation technique pressurized at 15 Psi was recommended as a safe wound cleansing method for diabetic foot ulcers.

scholarly journals Staphylococcus aureus strains isolated from diabetic foot ulcers. Identification of the antibiotic resistant phenotypes

2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Resistance Pattern ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Bacterial Strains ◽  
Diabetes Clinic

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.

scholarly journals Prevention and treatment of diabetic foot ulcers

2017 ◽  
Vol 110 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Jonathan Zhang Ming Lim ◽  
Natasha Su Lynn Ng ◽  
Cecil Thomas
Keyword(s):  
Diabetic Foot ◽  
Healthcare Access ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Healthcare Provision ◽  
Foot Complications

The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

scholarly journals DIABETIC FOOT ULCERS;

2017 ◽  
Vol 24 (05) ◽  
pp. 707-712
Author(s):  
Imran Ali Shaikh ◽  
Naila Masood ◽  
Fouzia Aijaz Shaikh ◽  
Munir A Shaikh
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Serum Calcium ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
P Value ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

Objectives: To know the correlation of foot ulcers to the nutritional status oftype 2 Diabetic patients of Hyderabad. Study Design: Cross sectional study. Place of Study:Private clinics of consultants of Hyderabad, Sindh, Pakistan. Duration of study: February 2015to June 2016. Methodology: 387 diabetic type 2 patients were selected from different clinicsof physicians, orthopedics and diabetic consultants of sadder Hyderabad Sindh Pakistan. Themean age was 40±11.5 years. All patients were enrolled on prescribed proforma. Thoroughclinical examination was done. Wagner’s classification was used to categorize diabetic footulcers. Nutritional status was classified on Mini Nutritional Assessment score and patients weredivided into three groups according to Mini nutritional score. Blood samples were obtained forHemoglobin%, blood sugar, serum calcium and serum albumin estimation. All patients wereassessed radiologically by x-rays of involved foot. ANOVA test was used and p value <0.05was considered statically significant. Results: There was linear correlation in between Mininutritional assessment and severity of diabetic foot ulcer (p <0.03). Biochemical parameterwere also significantly associated with the severity of ulcers. Serum albumin was decreasedin grade 4 ulcer significantly (p value <0.04), while hemoglobin was also decreased in grade4 ulcer, p value (<0.05). There was no association of serum calcium to severity of foot ulcer,(p value >0.07). Conclusion: Diabetic foot ulcers are common in type 2 diabetic patients andnutritional status is strongly associated with grade of severity. It is important to assess nutritionalstatus of all diabetic patients.

Potential Biomolecules and Current Treatment Technologies for Diabetic Foot Ulcer: An Overview

2018 ◽  
Vol 15 (1) ◽  
pp. 2-14 ◽  
Author(s):  
Zenith Khashim ◽  
Shila Samuel ◽  
Nallusamy Duraisamy ◽  
Kathiravan Krishnan
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Impaired Wound Healing ◽  
Advanced Therapies ◽  
Dressing Materials

Background:Diabetic foot ulceration remains a major challenge and is one of the most expensive and leading causes of major and minor amputations among patients with diabetic foot ulcer. Hence the purpose of this review is to emphasize on potential molecular markers involved in diabetic foot ulcer physiology, the efficacy of different types of dressing materials, adjunct therapy and newer therapeutic approach like nanoparticles for the treatment of diabetic foot ulcer.Methods:We conducted a systematic literature review search by using Pubmed and other web searches. The quality evidence of diabetic foot ulcer biomolecules and treatments was collected, summarized and compared with other studies.Results:The present investigation suggested that impaired wound healing in diabetic patients is an influence of several factors. All the advanced therapies and foot ulcer dressing materials are not suitable for all types of diabetic foot ulcers, however more prospective follow ups and in vivo and in vitro studies are needed to draw certain conclusion. Several critical wound biomolecules have been identified and are in need to be investigated in diabetic foot ulcers. The application of biocompatible nanoparticles holds a promising approach for designing dressing materials for the treatment of diabetic foot ulcer.Conclusion:Understanding the cellular and molecular events and identifying the appropriate treatment strategies for different foot ulcer grades will reduce recurrence of foot ulcer and lower limb amputation.

scholarly journals Prevalence and associated factors of foot ulcer among diabetic patients in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tadesse Tolossa ◽  
Belayneh Mengist ◽  
Diriba Mulisa ◽  
Getahun Fetensa ◽  
Ebisa Turi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Diabetic Foot ◽  
Meta Analysis ◽  
Self Care ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Care Practice ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

Abstract Background Diabetes and its complications including foot ulcer constitute a global public health challenge attributing to a significant cause of morbidity and mortality. Foot ulcer is one of the long-term complication of diabetes mellitus which lead to infection and amputation of lower extremities. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of foot ulcer in diabetics and factors contributing to it. Methods We identified articles through electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science and Google Scholar. Accordingly, we identified 95 published and one unpublished article. Finally, eleven studies which fullfilled eligibility criteria were included in final systematic review and meta-analysis. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity. Results The overall magnitude of foot ulcer was 12.98% (95%CI: 7.81–18.15) in diabetic patients in Ethiopia. Sub-group analyses revealed highest prevalence in Addis Ababa (19.31% (95%CI: 2.7. 41.37)). Foot ulcer was significantly associated with rural residence (OR = 2.72, 95%, CI: 1.84–4.01)), presence of callus on the feet ((OR = 12.67, 95%, CI: 6.47–24.79)), a body mass index of ≥24.5 ((OR = 2.68, 95%, CI: 1.58–4.56)), poor self- care practice ((OR = 1.47, 95%CI: 1.25–1.73)), type I diabetes mellitus ((OR = 0.42, 95%, CI: 0.22–0.79)), staying with DM for < 10 years ((OR = 0.23, 95%, CI: 0.11–0.50)), and age < 45 years ((OR = 0.44, 95%, CI: 0.21–0.92)). Conclusion The prevalence of diabetic foot ulcers in Ethiopia is relatively low, although its trend is increasing from time to time. Socio-demographic factors, body weight, and healthcare practice contribute to the development of diabetic foot ulcers. Appropriate interventions towards patient self-care practice, lifestyle modification and follow-up are wanted to prevent diabetic foot ulcers.

scholarly journals Safety and clinical efficacy of the secretome of stressed peripheral blood mononuclear cells in patients with diabetic foot ulcer—study protocol of the randomized, placebo-controlled, double-blind, multicenter, international phase II clinical trial MARSYAS II

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alfred Gugerell ◽  
Ghazaleh Gouya-Lechner ◽  
Helmut Hofbauer ◽  
Maria Laggner ◽  
Franz Trautinger ◽  
...  
Keyword(s):  
Phase I ◽  
Diabetic Foot ◽  
Mononuclear Cells ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Double Blind ◽  
Peripheral Blood Mononuclear ◽  
Blood Mononuclear Cells

Abstract Background Diabetes and its sequelae such as diabetic foot ulcer are rising health hazards not only in western countries but all over the world. Effective, yet safe treatments are desperately sought for by physicians, healthcare providers, and of course patients. Methods/design APOSEC, a novel, innovative drug, is tested in the phase I/II study MARSYAS II, where its efficacy to promote healing of diabetic foot ulcers will be determined. To this end, the cell-free secretome of peripheral blood mononuclear cells (APOSEC) blended with a hydrogel will be applied topically three times weekly for 4 weeks. APOSEC is predominantly effective in hypoxia-induced tissue damages by modulating the immune system and enhancing angiogenesis, whereby its anti-microbial ability and neuro-regenerative capacity will exert further positive effects. In total, 132 patients will be enrolled in the multicenter, randomized, double-blind, placebo-controlled, parallel group, dose-ranging phase I/II study and treated with APOSEC at three dose levels or placebo for 4 weeks, followed by an 8-week follow-up period to evaluate safety and efficacy of the drug. Wound area reduction after 4 weeks of treatment will serve as the primary endpoint. Conclusion We consider our study protocol to be suitable to test topically administered APOSEC in patients suffering from diabetic foot ulcers in a clinical phase I/II trial. Trial registration EudraCT 2018-001653-27. Registered on 30 July 2019. ClinicalTrials.gov NCT04277598. Registered on 20 February 2020. Title: “A randomized, placebo-controlled, double-blind study to evaluate safety and dose-dependent clinical efficacy of APO-2 at three different doses in patients with diabetic foot ulcer (MARSYAS II)”

scholarly journals SELF CARE PADA PASIEN DIABETES MELITUS DENGAN PENYULIT ULKUS KAKI DIABETIK

2021 ◽  
Vol 5 (1) ◽  
pp. 13
Author(s):  
Sri Dewi Megayanti ◽  
Ns. Putu Inge Suantika, S.Kep.,M.Kep
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Self Care ◽  
Foot Ulcer ◽  
Sampling Technique ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Convenience Sampling

ABSTRAKLatar Belakang: Diabetes self-care merupakan perilaku perawatan diri pasien diabetes yang meliputi pengaturan diet, penggunaan insulin, olahraga dan perawatan kaki. Diabetes self-care memiliki efek langsung pada kontrol glikemik dalam terjadinya ulkus kaki diabetic. Skor PEDIS merupakan form pemeriksaan yang digunakan perawat dalam menilai keparahan ulkus kaki. Keterbatasan intervensi ulkus kaki yang diberikan oleh perawat saat ini disebabkan oleh terbatasnya data tentang self-care pada pasien diabetes. Tujuan penelitian mengetahui self-care pasien diabetes dengan komplikasi ulkus kaki menggunakan metode pengukuran skor PEDIS yang teridiri dari pemeriksaan perfusi, luas luka, kedalaman luka, keberadaan infeksi dan sensasi kaki.Metode: Penelitian ini termasuk penelitian kuantitatif, dimana penentuan responden menggunakan teknik Convenience sampling dengan jumlah sampel adalah 125, analisa data yang digunakan dengan metode  deskriptif.Hasil: Pada penelitian ini 53,8 % reponden memiliki diabetes self-care yang adekuat dan rata- rata responden memiliki Skor PEDIS 2,08.Kesimpulan: dalam penelitian ini sebagian besar responden memiliki diabetes self-care yang tidak adekuat.  Nilai Diabetes self-care dapat digunakan oleh perawat untuk mengetahui tingkat kualitas perawatan diri pasien selama ini sehingga memudahkan dalam menentukan intervensi yang tepat untuk mencegah terajadinya perburukan ulkus kaki. Kata kunci: diabetes mellitus tipe 2, diabetes self-care, dan ulkus kaki diabetik. ABSTRACTBackground: Diabetes self-care is a diabetes patient self-care behavior that includes diet management, insulin use, exercise and foot care. Diabetes self-care has a direct effect on glycemic control in the occurrence of diabetic foot ulcers. The PEDIS score is an examination form that nurses use in assessing the severity of foot ulcers. The limitations of the foot ulcer intervention given by nurses at this time are due to limited data on self-care in diabetic patients. The aim of this study was to determine the self-care of diabetic patients with complications of foot ulcers using the PEDIS score measurement method which consists of examination of perfusion, wound area, wound depth, presence of infection and foot sensation.Methods: This research is a quantitative study, where the determination of the respondents using the convenience sampling technique with a sample size of 125, the data analysis used is the descriptive method.Results: In this study 53.8% of respondents had adequate diabetes self-care and the mean of respondents had a PEDIS score of 2.08. Conclusion: in this study most of the respondents had inadequate self-care diabetes. The value of diabetes self-care can be used by nurses to determine the level of quality of patient self-care so far, making it easier to determine the right intervention to prevent worsening of foot ulcers. Keywords: type 2 diabetes mellitus, diabetes self-care, and diabetic foot ulcers. 

scholarly journals First experimental Results of an Observational study on the application of Electrical Stimulation in Diabetic Foot Ulcers.

2021 ◽  
Vol 4 (5) ◽  
pp. 01-03
Author(s):  
Suen Enrique
Keyword(s):  
Electrical Stimulation ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
World Health ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
The World ◽  
Electrical Stimulator

Aims: According to the World Health Organization, between 1980 and 2014 the total number of people with diabetes in the world increased from 108 million to 422 million and by the end of 2020, the total number was approximately 463 million. The most frequent complication in this type of patient is diabetic foot ulcer, where conventional treatments generally fail to solve the problem and in many cases the condition ends with amputation. In 1998, an electrical stimulator was developed, called Stimul W, whose application in the healing of pressure and venous ulcers has yielded satisfactory results, allowing not only to obtain the Medical Registry by health entities in Cuba and other countries and even patent the mentioned equipment, but it has been achieved, in more than two decades of work, the healing of 1,191 ulcers of both types, with 94.5% effectiveness, a healing time that ranges between 21 and 42 days , according to the characteristics of the ulcer and without recurrence in any case treated. Starting in 2015, the application of this technique began in diabetic foot ulcers with the objectives of measuring the effectiveness and achieving an alternative treatment for this type of injury. In the present work a brief compilation of the results achieved in the treatment of diabetic foot ulcer using electrical stimulation is shown. Statistical Model: 31 diabetic patients, over 40 years old, with a total of 38 diabetic foot ulcers (some patients had more than one lesion) were treated, with times with the ulcer ranging between 1 and 6 months. The treatment consisted of a daily application for 30 minutes, using the Stimul W electrical stimulator, through the use of self-adhesive electrodes, conveniently placed around the affected area and on healthy skin, with current values ​​corresponding to scale 8 of the stimulator, approximately 1.5 mA and using the two stimulation channels Results: Results: In 27 of the 31 patients treated, the ulcer was healed with an effectiveness of 87%. In relation to ulcers, 33 ulcers healed in total, for 86.8% effectiveness. Average healing times were between 30 and 42 days, considering a daily session. Conclusion: Acceleration of healing was achieved with respect to conventional treatments, reducing healing times, and not producing adverse events during and after the application of the treatment.

Inflammatory Biomarkers as Predictors of Infected Diabetic Foot Ulcer

2021 ◽  
Vol 17 ◽  
Author(s):  
Mariya Dmitriyeva ◽  
Zhanar Kozhakhmetova ◽  
Saltanat Urazova ◽  
Saken Kozhakhmetov ◽  
Dulat Turebayev ◽  
...  
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Lower Limb Amputation ◽  
Inflammatory Biomarkers ◽  
Limb Amputation ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers

: Diabetic foot ulcer infection is a crucial complication associated with lower-limb amputation and postoperative mortality in individuals with diabetes mellitus. Deciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point-of-care tests. Early detection of infected diabetic foot ulcers can reduce the frequency of hospitalizations, the occurrence of disability, and chances of mortality. Inflammatory biomarkers are predictors of infected diabetic foot ulcers and lower-limb amputation. Procalcitonin, CRP, pentraxin-3, interleukin-6, and calprotectin may help to distinguish uninfected from mildly infected diabetic foot ulcers and diagnose soft tissue infections, bone lesions, and sepsis in diabetic patients. Moreover, these biomarkers may be predictors of lower-limb amputation and postoperative mortality. The current management of infected diabetic foot ulcers is disappointing and unsatisfactory, both in preventing its development and in halting and modifying its progression. The use of new (molecular) techniques for the identification of the IDFU have not yet proven superior to classic cultural techniques for the management of such patients. For clinicians, if the risk stratification of DFU can be obtained earlier in diabetic patients the hospitalization, disability, and mortality rate will be reduced. For practical application of these biomarkers, it is important to correlate these quantitative parameters with clinical symptoms. Based on clinical observations and inflammatory biomarker evaluation, it can be used to guide clinical treatment methods. This review details clinical information published during the past several decades and discusses inflammatory biomarkers that may determine the risk and level of infection of diabetic foot ulcers.

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