scholarly journals The Effects of Silver-Releasing Foam Dressings on Diabetic Foot Ulcer Healing

2021 ◽  
Vol 10 (7) ◽  
pp. 1495
Author(s):  
Yu-Chi Wang ◽  
Hsiao-Chen Lee ◽  
Chien-Lin Chen ◽  
Ming-Chun Kuo ◽  
Savitha Ramachandran ◽  
...  
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Early Period ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Management ◽  
Control Group ◽  
Diabetic Patients ◽  
High Morbidity

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.

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

scholarly journals Factors associated with wound healing outcome among Diabetic Foot patients- A cross sectional Study

2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Wound Management ◽  
Diabetic Patients ◽  
Foot Care ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
One Year

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.

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
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Sampling Technique ◽  
Diabetic Patients ◽  
Chronic Hyperglycemia ◽  
Post Test ◽  
Quasi Experimental ◽  
The Rich

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.

scholarly journals Observational study of the effects of silver-based dressing materials in 50 cases of diabetic foot ulcers

2019 ◽  
Vol 6 (2) ◽  
pp. 508
Author(s):  
Rushabh Maisuria ◽  
Jawansing Manza ◽  
Devendra Chaudhari ◽  
Divyang Dave
Keyword(s):  
Wound Healing ◽  
Observational Study ◽  
Granulation Tissue ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Foot Ulcer ◽  
Purulent Discharge ◽  
Diabetic Patients ◽  
Wide Range ◽  
Dressing Materials

Background: Diabetic foot remains the most common chronic medical problem being the most common cause of the hospital visit and/or admission, amongst the diabetic patients. Topical antimicrobial dressings, including those that contain silver are used to prevent or manage infection in a wide range of wounds.Methods: This is the prospective, observational study which included 50 cases of diabetic foot ulcer patients and effects of silver-based dressing materials will be evaluated.Results: After application of silver based dressing materials for two weeks, wound was evaluated on the basis of discharge from the wound, healing rate, appearance of the granulation tissue and culture and sensitivity report which showed that out of 50 cases studied, 3 cases (6%) had purulent discharge from the wound, absent granulation tissue, culture report showed presence of micro-organism and thus poor healing rate while other 47 cases (94%) had minimal/serous discharge, presence of healthy granulation tissue, no organism on culture report and thus good healing rate.Conclusions: Silver based dressing materials are effective in terms of promoting wound healing and more patient compliance.

scholarly journals Increased Mortality in Diabetic Foot Ulcer Patients: The Significance of Ulcer Type

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
N. K. Chammas ◽  
R. L. R. Hill ◽  
M. E. Edmonds
Keyword(s):  
Cause Of Death ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Premature Mortality ◽  
Control Group ◽  
Diabetic Patients ◽  
Age At Death ◽  
College Hospital ◽  
Neuropathic Foot

Diabetic foot ulcer (DFU) patients have a greater than twofold increase in mortality compared with nonulcerated diabetic patients. We investigated (a) cause of death in DFU patients, (b) age at death, and (c) relationship between cause of death and ulcer type. This was an eleven-year retrospective study on DFU patients who attended King’s College Hospital Foot Clinic and subsequently died. A control group of nonulcerated diabetic patients was matched for age and type of diabetes mellitus. The cause of death was identified from death certificates (DC) and postmortem (PM) examinations. There were 243 DFU patient deaths during this period. Ischaemic heart disease (IHD) was the major cause of death in 62.5% on PM compared to 45.7% on DC. Mean age at death from IHD on PM was 5 years lower in DFU patients compared to controls (68.2 ± 8.7 years versus 73.1 ± 8.0 years,P=0.015). IHD as a cause of death at PM was significantly linked to neuropathic foot ulcers (OR 3.064, 95% CI 1.003–9.366, andP=0.049).Conclusions.IHD is the major cause of premature mortality in DFU patients with the neuropathic foot ulcer patients being at a greater risk.

Efficacy of Intra-Lesional Platelet Rich Plasma in Diabetic Foot Ulcer

2020 ◽  
Author(s):  
Ajay Gupta ◽  
Chethan Channaveera ◽  
Satyaranjan Sethi ◽  
Sunil Ranga ◽  
Vijender Anand
Keyword(s):  
Normal Saline ◽  
Diabetic Foot ◽  
Healing Rate ◽  
Platelet Rich Plasma ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Control Group ◽  
Study Group ◽  
Ulcer Area ◽  
Total Contact Casting

Background: Diabetic foot ulcer (DFU) is well managed by infection control, euglycemic state, debridement of ulcer followed by appropriate dressing and off-loading of the foot. Studies have reported that when DFU is properly off-loaded, about 90% of these would heal in nearly six weeks. Platelet rich plasma (PRP) serves as a growth factor agonist and has mitogenic and chemotactic properties which help in DFU healing. To evaluate the efficacy of local application of PRP with respect to healing rate and ulcer area reduction in treating diabetic foot ulcer. Materials and Methods: Sixty non-infected DFU patients with plantar ulcer of size less than 20cm2 and Wagner's Grade 1 & 2 were randomized to receive normal saline dressing (Control group - CG) or PRP dressing (Study group - SG) in conjunction with total contact casting for 6 weeks (or till complete ulcer healing), whichever was earlier. Evaluation was done at weekly interval for healing rate and change in ulcer area.Results: Mean ulcer area of study participants at baseline was 4.96 {plus minus} 2.89cm2 (CG) and 5.22 {plus minus} 3.82cm2 (SG) (p=0.77) which decreased to 1.15{plus minus}1.35cm2 (CG) and 0.96{plus minus}1.53cm2 (SG) (p=0.432) at 6wks. Percent reduction in mean healing area at 6wks was 81.72{plus minus}17.2% and 85.98{plus minus}13.42% in control group and study group respectively (p=0.29). Average rate of healing achieved at 6 weeks was 0.64{plus minus}0.36cm2 and 0.71{plus minus}0.46cm2 in control group and study group respectively (p=0.734). Conclusions: PRP dressing is no more efficacious than normal saline dressing in management of DFU in conjunction with total contact casting.

Characteristics of microbial drug resistance and its correlates in chronic diabetic foot ulcer infections

2014 ◽  
Vol 63 (10) ◽  
pp. 1377-1385 ◽  
Author(s):  
Thokur S. Murali ◽  
Shettigar Kavitha ◽  
Jain Spoorthi ◽  
Deepika V. Bhat ◽  
Alevoor S. Bharath Prasad ◽  
...  
Keyword(s):  
Immune Response ◽  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Healing Process ◽  
Diabetic Patients ◽  
Bacterial Strains ◽  
Microbial Drug Resistance

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.

scholarly journals Determinants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study

2020 ◽  
Vol 54 (3) ◽  
pp. 207-216
Author(s):  
Ignatius U. Ezeani ◽  
Ejiofor T. Ugwu ◽  
Funmi O. Adeleye ◽  
Ibrahim D. Gezawa ◽  
Innocent O. Okpe ◽  
...  
Keyword(s):  
Wound Healing ◽  
Renal Impairment ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Adverse Outcomes ◽  
Diabetic Patients ◽  
Chi Square ◽  
Grade 3

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.

scholarly journals Bioactive Antimicrobial Peptides as Therapeutic Agents for Infected Diabetic Foot Ulcers

Biomolecules ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1894
Author(s):  
Jessica Da Silva ◽  
Ermelindo C. Leal ◽  
Eugénia Carvalho
Keyword(s):  
Wound Healing ◽  
Antimicrobial Peptides ◽  
Broad Spectrum ◽  
Diabetic Foot ◽  
Molecular Mechanisms ◽  
Antimicrobial Agents ◽  
Chronic Wounds ◽  
Foot Ulcer ◽  
Wound Management ◽  
Diabetic Patients

Diabetic foot ulcer (DFU) is a devastating complication, affecting around 15% of diabetic patients and representing a leading cause of non-traumatic amputations. Notably, the risk of mixed bacterial–fungal infection is elevated and highly associated with wound necrosis and poor clinical outcomes. However, it is often underestimated in the literature. Therefore, polymicrobial infection control must be considered for effective management of DFU. It is noteworthy that antimicrobial resistance is constantly rising overtime, therefore increasing the need for new alternatives to antibiotics and antifungals. Antimicrobial peptides (AMPs) are endogenous peptides that are naturally abundant in several organisms, such as bacteria, amphibians and mammals, particularly in the skin. These molecules have shown broad-spectrum antimicrobial activity and some of them even have wound-healing activity, establishing themselves as ideal candidates for treating multi-kingdom infected wounds. Furthermore, the role of AMPs with antifungal activity in wound management is poorly described and deserves further investigation in association with antibacterial agents, such as antibiotics and AMPs with antibacterial activity, or alternatively the application of broad-spectrum antimicrobial agents that target both aerobic and anaerobic bacteria, as well as fungi. Accordingly, the aim of this review is to unravel the molecular mechanisms by which AMPs achieve their dual antimicrobial and wound-healing properties, and to discuss how these are currently being applied as promising therapies against polymicrobial-infected chronic wounds such as DFUs.

scholarly journals Nutrition Supplementation and Education May Increase the Healing Rate in Diabetic Patients with Foot Ulcers (P19-005-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Raedeh Basiri ◽  
Maria Spicer ◽  
Bahram Arjmandi
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Diabetic Foot ◽  
Healing Rate ◽  
High Protein ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Wound Healing Rate

Abstract Objectives This study examined the effects of high protein dietary supplementation and nutrition education on the healing of diabetic foot ulcers. Methods Twenty-nine adults with diabetic foot ulcers were recruited from the Tallahassee Memorial Hospital Wound Care Clinic. Participants were randomly assigned to treatment (n = 15) or control (n = 14) group. The treatment group received two carbohydrate controlled high protein shakes to consume daily, and was educated regarding adequate intake of low-fat protein sources, fruits, vegetables, complex carbohydrates and minimizing simple carbohydrates. The control group did not receive any intervention. Daily supplementation provided a total of 500 kilocalories, 28 grams of high-quality protein, and approximately 50% of micronutrient requirements. Anthropometric measurements (weight, height, BMI) and wound planimetry were examined at baseline and every four weeks until the wound healed or up to 12 weeks. Results There was no significant difference between the groups at baseline for BMI (mean = 33.8 ± 7 kg/m2), age (mean = 53.34 ± 11.14 years), duration of diabetes (mean = 13 years), duration of wounds (mean 10.8 months) or wound area (mean = 450 mm2). Wound healing rate (decrease in the area of the wound/week) for the treatment group was three times faster than the control group (151.1 mm2/week vs. 45.2 mm2/week respectively). Conclusions Improved nutritional intake using nutritional supplementation and patient education has a strong positive effect on the wound healing rate of diabetic foot ulcers. Faster wound healing improves quality of life and functionality of patients with diabetic foot ulcers. Funding Sources Dissertation award.

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