scholarly journals Nutritional Supplementation Concurrent with Nutrition Education Accelerates the Wound Healing Process in Patients with Diabetic Foot Ulcers

Biomedicines ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. 263 ◽  
Author(s):  
Raedeh Basiri ◽  
Maria T. Spicer ◽  
Cathy W. Levenson ◽  
Michael J. Ormsbee ◽  
Thomas Ledermann ◽  
...  
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Nutrition Education ◽  
Diabetic Foot ◽  
Healing Process ◽  
Standard Of Care ◽  
Control Group ◽  
Wound Age ◽  
Wound Area ◽  
Nutrition Supplementation

Trials on nutritional supplements for the treatment of diabetic foot ulcer (DFU) have only evaluated the effects of supplementation with specific nutrients. Additionally, nutrition education has not been a systematic part of these studies. The aim of this study was to evaluate the effects of a nutrient-dense formula combined with nutrition education on wound healing in DFU patients. Twenty-nine patients were randomly assigned to the treatment group (n = 15) receiving two servings of supplements daily plus nutrition education or control group (n = 14) that received the standard of care but no additional nutritional or educational intervention. Both groups were followed for a maximum of 12 weeks. Wound healing, as measured by planimetry, was examined at baseline and every four weeks until complete wound closure or up to 12 weeks. There were no significant differences between groups for BMI, age, duration of diabetes, wound age estimation, or wound area at baseline. The treatment group experienced a faster wound healing rate (6.43 mm2/week more reduction in the wound area) than the control group. The mean reduction in the wound area during the first four weeks of the study was almost 13-fold greater in the treatment group compared to the control group (18.0 mm2/week vs. 1.4 mm2/week, respectively). Our findings showed that nutrition supplementation plus nutrition education significantly accelerated wound healing in DFU patients compared to those who just received a standard-of-care regimen.

scholarly journals Nutritional Intervention Improves the Dietary Intake of Essential Micronutrients in Patients with Diabetic Foot Ulcers

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 8-8
Author(s):  
Raedeh Basiri ◽  
Maria Spicer ◽  
Joseph Munoz ◽  
Bahram Arjmandi
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Dietary Intake ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Standard Of Care ◽  
Nutritional Intervention ◽  
Food Sources ◽  
Control Group ◽  
Essential Nutrients

Abstract Objectives Diabetic foot ulcer (DFU) is a chronic wound and a common cause of lower limb amputation. A majority of DFU patients are suffering from undernutrition or malnutrition. The purpose of this randomized trial was to evaluate the combined effects of complete nutrition supplementation and education on the dietary intake of DFU patients. Methods A total of 29 patients with at least one grade 1 A foot ulcer based on the University of Texas Diabetic Wound Classification were assigned to the treatment or control. Aside from the standard of care for DFU, participants in the treatment group were provided with a dietary supplement twice a day between meals and were educated about consuming better food sources of essential nutrients for wound healing. The supplement provided 500 kcal of energy and at least 50% of RDA recommendations for protein, vitamin C, E, A, zinc, and copper. Participants in the control group only received standard of care for wound healing from the clinic. Dietary intake data were recorded at baseline and every four weeks up to 12 weeks or until the complete wound closure using 24-hour food recall questionnaire. Results The mean age of the study population was 53.3 ± 11.1 years. There were no significant differences in age, ethnicity, body mass index, hemoglobin A1C, duration of diabetes, wound age estimation, indicators of socioeconomic status and other factors involved in dietary intake including cultural and religious dietary restrictions, appetite problems, and previous unintentional weight loss between groups at baseline. Having routine visits with a registered dietitian was not part of the standard care for this population. When compared with RDA, dietary intake of zinc (33.2% to 89.2%, P = 0.02), copper (26% to 114%, P < 0.001), vitamins A (30.6 to 72.9, P = 0.001), C (117% to 403%, P = < 0.001), and E (7.29% to 306%, P = < 0.001) was significantly improved in the treatment group during the study period but there were no significant changes in dietary intake of protein or energy. There were also no significant changes in the dietary intake of the mentioned nutrients in the control group. Conclusions Our findings showed that the dietary intake of essential nutrients in wound healing was alarmingly low in DFU patients. Hence, nutritional intervention is essential and should be a part of routine care in this population. Funding Sources Florida State University.

Healing Rate of Diabetic Foot Wounds When Treated with Serial Debridement in the Presence of Antithrombotic Therapy

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Jack Route
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Antithrombotic Therapy ◽  
Healing Rate ◽  
Standard Of Care ◽  
Significant Negative Correlation ◽  
Arterial Disease ◽  
Wound Area ◽  
Negative Effect ◽  
Peripheral Arterial

Background Previous study indicates that pharmacologic antithrombotic therapy may be an inhibitory factor for wound healing and should merit consideration among the other core factors in wound healing optimization. Methods This study provides a retrospective analysis of the effect of antithrombotic therapy on wound healing rates of uncomplicated diabetic foot ulcerations. Wounds treated with standard of care in the presence of clinical anticoagulation were compared to control wounds. Results The results indicate a statistically significant negative correlation between antithrombotic therapy and diabetic foot wound healing rate. This represents the first study focusing on this correlation in the uncomplicated diabetic foot wound. Conclusions This retrospective study demonstrates that antithrombotic therapy has a statistically significant negative effect on healing rates of uncomplicated diabetic foot ulcerations. Both wound area and depth improvement over 4 weeks was significantly better in treated patients who were not on antithrombotic therapy for comorbidity not associated with peripheral arterial disease.

scholarly journals Efek Terapi Oksigen Hiperbarik (TOHB) pada Penyembuhan Ulkus Kaki DM Tipe 2 Berdasarkan Skor PEDIS

2019 ◽  
Vol 11 (2) ◽  
pp. 110
Author(s):  
Ekanova R. N. Sumarauw ◽  
Mendy J. Hatibie ◽  
Djony E. Tjandra ◽  
Fredrik G. Langi
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Controlled Trial ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Wound Healing Process ◽  
Holistic Treatment ◽  
The Third

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

Biological effects of amniotic membrane on diabetic foot wounds: a systematic review

2018 ◽  
Vol 27 (Sup2) ◽  
pp. S19-S25 ◽  
Author(s):  
André Oliveira Paggiaro ◽  
Andriws Garcia Menezes ◽  
Alexandra Donizetti Ferrassi ◽  
Viviane Fernandes De Carvalho ◽  
Rolf Gemperli
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Amniotic Membrane ◽  
Diabetic Foot ◽  
Biological Effects ◽  
Meta Analysis ◽  
Healing Process ◽  
Intervention Group ◽  
Risk Of Bias ◽  
Control Group

Objective: The amniotic membrane has biological properties that are beneficial to the wound healing process of diabetic foot ulcers (DFU). Our aim is to analyse the scientific evidence found in literature on the use of the amniotic membrane to stimulate DFU healing. Method: A systematic review of amniotic membrane's influence was undertaken, using the search terms ‘placenta’ ‘diabetic foot’ ‘amnion’ and biological dressing’, assessing the outcomes ‘wound healing’ and ‘wound healing time’, in DFU. Following the inclusion and exclusion criteria, randomised controlled trials (RCT) were identified, and the risk of bias was analysed according to the Cochrane risk of bias tool. We conducted a meta-analysis of the two outcomes to evaluate the level of evidence. Results: We identified six clinical trials, with a total of 331 patients. The most common risks of bias in the studies were selection, attrition, and detection biases. From the meta-analysis, the difference of the intervention group (amnion) in relation to the control group was statistically significant. We found that wound healing in the group treated with amniotic membrane occurs 2.32 times more often and is 32 days faster in comparison with the group that used conventional dressings. Conclusion: There is statistical evidence to support the effectiveness of amniotic membrane in comparison with other conventional dressings. In addition, there is a clear tendency for the use of amniotic membrane treatment to result in a larger number of DFUs healing at a quicker rate.

Topical Application of a Gentamicin-Collagen Sponge Combined with Systemic Antibiotic Therapy for the Treatment of Diabetic Foot Infections of Moderate Severity

2012 ◽  
Vol 102 (3) ◽  
pp. 223-232 ◽  
Author(s):  
Benjamin A. Lipsky ◽  
Michael Kuss ◽  
Michael Edmonds ◽  
Alexander Reyzelman ◽  
Felix Sigal
Keyword(s):  
Treatment Group ◽  
Antibiotic Therapy ◽  
Diabetic Foot ◽  
Clinical Cure ◽  
Standard Of Care ◽  
Collagen Sponge ◽  
Control Group ◽  
Moderate Severity ◽  
Diabetic Foot Infections ◽  
Systemic Antibiotic Therapy

Background: The aim of this pilot study was to determine the safety and potential benefit of adding a topical gentamicin-collagen sponge to standard of care (systemic antibiotic therapy plus standard diabetic wound management) for treating diabetic foot infections of moderate severity. Methods: We randomized 56 patients with moderately infected diabetic foot ulcers in a 2:1 ratio to receive standard of care plus the gentamicin-collagen sponge (treatment group, n = 38) or standard of care only (control group, n = 18) for up to 28 days of treatment. Investigators performed clinical, microbiological, and safety assessments at regularly scheduled intervals and collected pharmacokinetic samples from patients treated with the gentamicin-collagen sponge. Test of cure was clinically assessed 14 days after all antibiotic therapy was stopped. Results: On treatment day 7, we noted clinical cure in no treatment patients and three control patients (P = .017). However, for evaluable patients at the test-of-cure visit, the treatment group had a significantly higher proportion of patients with clinical cure than did the control group (22 of 22 [100.0%] versus 7 of 10 [70.0%]; P =.024). Patients in the treatment group also had a higher rate of eradication of baseline pathogens at all visits (P ≤ .038) and a reduced time to pathogen eradication (P < .001). Safety data were similar for both groups. Conclusions: Topical application of the gentamicin-collagen sponge seems safe and may improve clinical and microbiological outcomes of diabetic foot infections of moderate severity when combined with standard of care. These pilot data suggest that a larger trial of this treatment is warranted. (J Am Podiatr Med Assoc 102(3): 223-232, 2012)

scholarly journals Evaluation of Indonesian and two types of Japanese honey on the acceleration of cutaneous wound healing: an experimental study in mice

2019 ◽  
Vol 2 (2) ◽  
pp. 80-88
Author(s):  
Haryanto Haryanto ◽  
Kanae Mukai ◽  
Nakajima Yukari ◽  
Mayumi Okuwa ◽  
Cau Kim Jiu ◽  
...  
Keyword(s):  
Wound Healing ◽  
Healing Process ◽  
Control Group ◽  
Wound Healing Process ◽  
Wound Area ◽  
Hydrocolloid Dressing ◽  
Thickness Skin ◽  
Microscopic Evaluation ◽  
Acacia Honey ◽  
Macroscopic Findings

The purpose of this study is to evaluate and clarify the effect of Indonesian honey, two types of Japanese honey and hydrocolloid dressing on wound healing process. Four groups of male mice were treated to produce two circular full-thickness skin wounds on the dorsum. They were then randomly allocated to receive daily Indonesian honey, Japanese honey (Buckwheat and Acacia honey) or hydrocolloid dressing as a control for treatment application. Macroscopic findings were observed from day 0 to 14 after wounding. Microscopic evaluation was assessed using qualitative analysis. The ratios of wound areas for honey groups on day 3 and 7 were smaller than those of the control group. Wound areas of honey groups gradually decreased to almost the same wound area as the control group on day 14, while the wound area of the control group peaked on day 5 and rapidly decreased until day 14. Microscopic finding that Indonesian honey was different with Japanese honey especially Buckwheat honey.

scholarly journals The Effect of Educated Platelets on the Healing Process of Burn Wounds in Rats: Educated Platelets in Rat Burn Wound Healing

2021 ◽  
Vol 8 ◽  
Author(s):  
Orkun Ilgen ◽  
Sefa Kurt ◽  
Osman Yilmaz ◽  
Murat Celiloglu
Keyword(s):  
Wound Healing ◽  
Burn Injury ◽  
Healing Process ◽  
Recovery Period ◽  
Control Group ◽  
Study Group ◽  
Second Line ◽  
Burn Wound ◽  
Wound Area ◽  
Burn Wound Healing

Burns are serious life-threatening health problems. This study was performed to determine the effect of educated platelets on burn wound healing process. 28 female wistar albino 200-220 gr rats were randomly divided into four groups. Group A1 rats(n:7) were the first-line burnt group from which blood samples are extracted to develop platelet-rich plasma(PRP) with the educated platelets that have a response to burn injury. Group B1 rats(n:7) were the unburnt group with ordinary platelets. Group A2 rats(n:8) were the second-line burnt group which was given PRP with educated platelets. Group B2 rats(n:6), as control group, were the second-line burnt group which was given PRP with ordinary platelets. Photos of rats' dorsum were taken by digital camera on the first day and 21st day of the study. Wound healing was determined by scar surface area. In the study group (Group A2) mean wound area was  53±37 mm², in the control group (Group B2) mean wound area was 114±55 mm² on the last day of the experiment. The sizes of the wounded areas were significantly lower in the study group compared with the control group (p: 0.039). Educated platelets seem to facilitate the recovery period of burn wound healing in rats.

Effect of Family Empowerment on HbA1c Levels and Healing of Diabetic Foot Ulcers

2020 ◽  
pp. 153473462093012
Author(s):  
Rasnah Appil ◽  
Elly Lilianty Sjattar ◽  
Saldy Yusuf ◽  
Kasmawati Kadir
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Intervention Group ◽  
Foot Ulcers ◽  
Control Group ◽  
Wound Healing Process ◽  
Diabetic Foot Ulcers ◽  
Family Empowerment ◽  
Hba1c Levels

Objective. To evaluate the effectiveness of family empowerment through educational interventions against HbA1c level and healing progress of diabetic foot ulcers. Method. A quasi-experimental design was employed involving 33 participants from 4 wound care clinics in Makassar, eastern Indonesia. The intervention group consisted of 17 participants and their families; the control group was composed of 16 participants who received nonstructural education. Family empowerment was measured by the Indonesian version of the Family Empowerment Scale instrument. Glycemic control was evaluated with HbA1c levels, and the wound healing process was evaluated on the Diabetic Foot Ulcers Assessment Scale. Result. After 3 months, Family Empowerment Scale scores improved, particularly in the subdomain of family knowledge (16.59 ± 3.92 vs 13.38 ± 1.26; P = .005) and attitude (3.65 ± 0.93 vs 2.75 ± 0.45; P = .002). After 3 months of intervention, HbA1c decreased (from 10.47 ± 2.44% to 8.81 ± 1.83%), compared with the control group ( P = .048). Meanwhile, an independent t test further revealed that the wound healing process tended to be better with the intervention group (4.71 ± 7.74) compared with the control group (17.25 ± 17.06), with P = .010 at the third month. Conclusion. Family-based education intervention creates family empowerment to control HbA1c levels and accelerate wound healing of diabetic foot ulcer.

scholarly journals Ellagic Acid Activity in Healing Process of Incision Wound on Male Albino Rats (Rattus norvegicus)

2017 ◽  
Vol 3 (6) ◽  
pp. 224
Author(s):  
Hardany Primarizky ◽  
Wiwik Misaco Yuniarti ◽  
Bambang Sektiari Lukiswanto
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Ellagic Acid ◽  
Healing Process ◽  
Control Group ◽  
Albino Rats ◽  
Wound Healing Process ◽  
Treatment Groups ◽  
Significant Difference ◽  
Incision Wound

This study was conducted to prove whether ellagic acid can be used as a regulator of incision wound healing process in male albino rats as experimental animals. A total of 24 male healthy rats based on physical examination, aged at 3 months old and weight at 150-180 grams used in this study. Rats were divided into three groups and each group has 8 replications, group of control (P0) has no incision wound and no medication, treatment group (P1) has incision wound and treated with Betadine® and (P2) has incision wound and treated with 2,5 % ellagic acid. The variable that observed are histopathology changes (collagen, PMN, angiogenesis and fibrosis) from the male albino rats. The samples collection was taken at day 15 and data were collected and analyzed by Analysis of Variance (ANOVA) test. The result of collagen and PMN cells score in the control group (P0) were 1.80 ± 0.16 and 1.6 ± 0.08 with mild angiogenesis and no fibrosis. The results in the treatment (P2) group, where the collagen and PMN scores were 1.60 ± 0.08 and 1.5 ± 0.8, accompanied by mild angiogenesis and fibrosis. Meanwhile, in the treatment (P1) group, the results of scoring of collagen and PMN were lower than the other groups, 0, 80 ± 0.08 and 0.6 ± 0.16 accompanied by moderate angiogenesis and fibrosis. There was a significant difference of collagen scoring, PMN cells number, fibrosis and angiogenesis among the treatment groups (p<0.05). P1 treatment group has significant different with treatment groups P0 and P2 (p<0.05), but there is no significant difference between treatment groups P0 and P2 (p>0.05).  From the results, it can be concluded that the topical application of ellagic acid ointment was proved to provide healing process on incision wound. Topical administration of ellagic acid ointment for 14 days was able to improve the skin condition and promoted the wound healing.Keywords: Ellagic acid ; wound healing ; collagen ; angiogenesis ; fibrosis ; anti-inflammatory ; antioxidant ; antibacterial.

scholarly journals The effect of papaya leaf extract (Carica papaya L) on healing process of buccal traumatic ulcer in wistar rats

2019 ◽  
Vol 1 (1) ◽  
pp. 15
Author(s):  
Afryla Femilian ◽  
Dewi Agustina ◽  
Goeno Subagyo
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Buccal Mucosa ◽  
Wistar Rats ◽  
Carica Papaya ◽  
Healing Process ◽  
Herbal Medicines ◽  
Ethanolic Extract ◽  
Control Group ◽  
Wound Healing Process

Indonesians have been using herbal medicines for a long time to cure some illnesses. Carica papaya L is an example of an herb that contains papain enzymes, saponins, lysozymes, lipases, flavonoids, polyphenols and vitamin C. These  ingredients are believed to be beneficial for the wound healing process. The purpose of this study was to determine the effect of topical application of ethanolic extract of Carica papaya L to the healing process of rat mouth ulcer. Subjects were 32 Wistar rats divided into 2 groups (control group and treatment group), each group containing 16 rats. All subjects were made to suffer from ulcers using glacial acetyl acid applied for 40 seconds in the buccal mucosa. Treatment group was treated with papaya leaf ethanolic extract on ulcers twice a day using microbrush, while the ulcer in the control group was not treated with the extract. The ulcerated tissue was biopsied and stained with H&E. Observations were performed on the day 0, 3rd, 7th and 12th on HE slides. Data were observed by looking at three indicators of wound healing i.e. macrophage, angiogenesis and re-epithelisation. Number of macrophages and angiogenesis were analyzed using two-way ANOVA. Data of epithelial thickness were analyzed using Kruskal-Wallis test. The post hoc test in the treatment group and the control group on day 0 showed results of p = 1.00. On day 3, day 7 and day 12, the result of p was <0.05. In the treatment group on day 0 compared to the treatment group on the 3rd, 7th, 12th day, the results were p<0.05. In the treatment group on the 3rd day compared to the 7th and 12th days the results were p>0.05. The treatment group on the 7 day compared to the treatment group on the 12 day had p>0.05. In the control group, on day 0 compared to day 3, the results of p>0.05, while the control group day 0 with day 7, 12 had a result of p<0.05. The control group on the 3rd day was compared with the 7th day. The 12th also had a result of p<0.05. The comparison between the 7 day control groups showed p of >0.05. These data suggest that the papaya leaf ethanolic extract could accelerate the healing of oral ulcer on the buccal mucosa of wistar rats.

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