Experience of using atraumatic ointment bandages based on peruvian balsam in the complex treatment of patients with chronic wound defects of the lower limbs

2020 ◽  
pp. 43-57
Author(s):  
Anna Tabuika
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Local Treatment ◽  
Lower Limbs ◽  
Complex Treatment ◽  
Average Area ◽  
Arterial Insufficiency ◽  
Significant Activation

The article reflects the results of a retrospective non-comparative study, the objects of which were 34 outpatient comorbid patients (15 of which are over 60 years old) with chronic wounds of the lower limbs developed against the background of varicosity, post-thrombotic disease, chronic arterial insufficiency of the lower limbs, diabetes mellitus or their combination. Their local treatment was carried out using atraumatic ointment dressing «Branolind N» containing Peruvian balsam. There were 23 women (67.6 %) and 11 men (32.4 %). In microbiological study prior to the beginning of treatment in 31 patients the growth of a pathogen of wound infection was revealed; in 19 patients — Staphylococcus aureus in monoculture and in various associations, in 6 patients — Pseudomonas aeruginosa in monoculture, in other cases — other pathogens. In 3 patients the pathogen was not detected. The average wound size was 34 cm2 . The phase of the wound process was additionally confirmed by cytological studies. After treatment the average area of the wound defect decreased by 10 cm2 and made 24 cm2 on average. Full healing of the wound defect occurred in 11 patients, the others had granulation and active marginal epithelization. There was also a decrease in bacterial semination of wounds, a change in composition of infection agents to less aggressive monoflora, and cytologically — a decrease in signs of inflammation against the background of significant activation of reparative processes.

scholarly journals Study of the influence of vacuum therapy on the wound process in patients with diabetic foot syndrome

2019 ◽  
Vol 74 (4) ◽  
pp. 283-288
Author(s):  
Petr A. Gerasimchuk ◽  
Alexander V. Shidlovskyi ◽  
Dmitriy B. Fira ◽  
Andrey V. Pavlyshyn
Keyword(s):  
Diabetes Mellitus ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Chronic Wound ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Vacuum Therapy ◽  
Social Significance ◽  
Number Of Patients ◽  
Bed Days

Background: According to the International Diabetes Federation (IDF), the number of patients on diabetes mellitus is now more than 415 million people on Earth, until 2030 it will increase to 439 million, and by 2035 ― will reach 592 million. Throughout life, 4.625% of patients with diabetes mellitus develops a diabetic foot syndrome with the formation of wounds, whose treatment, can not yet be considered satisfactory, since in 1525% of patients are the direct cause of high amputations of the lower limbs. This requires finding new effective methods for treating wound defects in patients with diabetic foot syndrome, one of which can be vacuum wound therapy. Aims: To study the effectiveness of vacuum therapy in the treatment of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenetic form of the lesion. Materials and methods: The effect of vacuum therapy on the course of acute and chronic wound process in 231 patients with neuropathic and ischemic form of diabetic foot syndrome was studied during 20142017. Evaluation of the dynamics of the wound process was carried out on the basis of clinical, planimetric, microbiological, morphological methods, as well as microcirculation indices in the area round the wound. Results: Vacuum therapy of acute and chronic wounds in patients with different pathogenetic forms of diabetic foot syndrome, allows to stabilize the course of wound process, stimulate regenerative processes in the wound, improve local microcirculation (p0.05). This, in turn, allows a shorter time to prepare a wound for closure by one of the methods of plastic surgery or create favorable conditions for its independent epithelization. In patients with ischemic lesions (chronic arterial insufficiency of the third degree), the carrying out of vacuum therapy by standard method leads to an intensification of the pain syndrome. This causes the need to apply an initial negative pressure in the system in the range of 7080 mm Hg, which makes it possible to stop pain during the day. At 23 days of the postoperative period, negative pressure is established at standard values. Conclusions: Vacuum therapy of wounds in patients with diabetic foot syndrome is an effective method of treatment that allows the doctor to reduces the duration of treatment of patients in hospital with a neuropathic form of diabetic foot syndrome on average (4.31.7) bed-days, and patients with ischemic form ― on average (4.11.9) bed-days, which has both medical and social significance.

scholarly journals Use of negative pressure in the treatment of anaerobic non-clostridial perineal infection

2021 ◽  
Vol 8 (3) ◽  
pp. 44-47
Author(s):  
B. A. Salazar Mun'oz
Keyword(s):  
Diabetes Mellitus ◽  
Negative Pressure ◽  
Clinical Case ◽  
Negative Pressure Wound Therapy ◽  
Local Treatment ◽  
Complex Treatment ◽  
Wound Therapy

The article presents a clinical case of a successful complex treatment anaerobic non-clostridial perineal infection in a 54-year-old patient with long-term diabetes mellitus. Particular attention is paid to the possibilities of local treatment using negative pressure wound therapy in the management of this patients category.

scholarly journals Clinical, pathomorphological and immunohistochemical evaluation of tissue repair in diabetic foot ulcers

2019 ◽  
Vol 21 (6) ◽  
pp. 490-496 ◽  
Author(s):  
Alla Y. Tokmakova ◽  
Ekaterina L. Zaitseva ◽  
Iya A. Voronkova ◽  
Marina V. Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Tissue Repair ◽  
Chronic Wounds ◽  
Soft Tissues ◽  
Local Treatment ◽  
Surgical Debridement ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Before And After

Background: It is known that wound healing is Impaired in diabetes mellitus. Possible reasons are widely being searched. However, despite all the available data, reliable markers of reparative processes in diabetes mellitus are needed to be found. Aim: To study morphological and some immunohistochemical markers of tissue repair in patients with diabetic foot ulcers after local treatment. Materials and methods: 70 patients with diabetic foot ulcers before and after surgical debridement were included. Histological (light microscopy) and immunohistochemical (CD68, MMP-9, TIMP-1) characteristics of tissue repair processes in soft tissues of the lower extremities in patients with diabetes mellitus were analyzed. Histological and immunohistochemical examination of soft tissues were performed in 63 patients before and after surgical debridement and 10 days after local treatment. Results: After the surgical debridement a significant reduction in the area of wounds was registered by 23.4% (p 0.05), wound depth by 29.4% (p 0.05). Based on the results of the morphological study, the presence of mature granulation tissue in the wounds was confirmed. Immunohistochemical study of wound biopsies demonstrated a significant decrease in proteolytic activity in the wound as a decrease in MMP-9 expression (p 0.05). Statistically significant changes in the number of macrophages against the initial data were not found, as well as increased expression of TIMP-1 was observed (p 0.05 and 0.05, respectively). Conclusion: According to the data, there was a significant decrease in the area and depth of wounds during local treatment. The intensity of tissue repair was confirmed by the results of histological and immunohistochemical studies. However, the absence of a statistically significant change in the amount of macrophages on the background of treatment suggests that this repair link is disrupted in diabetes mellitus, which is the reason for the "chronic" wounds and requires further studies.

scholarly journals Risk factors for a delayed course of reparative processes after destructive intervention on the integumentary tissues of the foot

2021 ◽  
Author(s):  
А.А. Кубанов ◽  
Е.К. Мураховская ◽  
Р.Н. Комаров ◽  
А.Н. Дзюндзя ◽  
И.А. Винокуров
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Clinical Observation ◽  
Lower Extremities ◽  
Arterial Disease ◽  
Lower Limbs ◽  
Delayed Healing ◽  
Healing Wounds ◽  
Arterial Insufficiency

В статье обобщены сведения о заболеваниях и состояниях, оказывающих влияние на процессы нормального заживления после деструктивных вмешательств на покровных тканях стопы, представлены современные данные литературы, посвященные этим вопросам. Неадекватная оценка состояния пациента перед проведением планового деструктивного вмешательства на нижних конечностях может привести к формированию длительно незаживающего раневого дефекта и нарушению функции конечности. Проведение деструктивного вмешательства требует настороженности в отношении ряда заболеваний и состояний, влияющих на процессы нормального заживления, таких как сахарный диабет, метаболический синдром, иммунодефицит. Особое внимание в статье уделено оценке состоятельности кровотока нижних конечностей в связи с тем, что хроническая артериальная недостаточность является одной из наиболее значимых причин замедленного течения репаративных процессов в области стоп. Представлено собственное клиническое наблюдение, иллюстрирующее отсутствие нормальной регенерации в условиях гипергликемии и хронической артериальной недостаточности нижних конечностей. The article summarizes information about diseases and conditions that affect the processes of normal healing after destructive interventions on the integumentary tissues of the foot, presents modern literature data on these issues. An inadequate assessment of the patient's condition before a planned destructive intervention on the lower extremities can lead to a long-term non-healing wounds and dysfunction of the extremity. A destructive intervention requires attention to a number of diseases and conditions that affect normal healing processes, such as diabetes mellitus, metabolic syndrome, and immunodeficiency. Particular attention is paid to the assessment of the consistency of the blood flow of the lower extremities because chronic arterial insufficiency is one of the most significant reasons for the slow reparative processes in the foot area. The authors present their own clinical observation that illustrates the absence of normal regeneration in conditions of hyperglycemia and chronic arterial disease of the lower limbs. Keywords: destruction, destructive interventions, atherosclerosis, wound healing, regeneration, chronic arterial insufficiency, lower limbs, delayed healing.

scholarly journals Vacuum therapy for chronic wounds

2012 ◽  
Vol 15 (3) ◽  
pp. 45-49 ◽  
Author(s):  
Ekaterina Leonidovna Zaytseva ◽  
Alla Yur'evna Tokmakova
Keyword(s):  
Diabetes Mellitus ◽  
Topical Treatment ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Vacuum Therapy ◽  
Current Review ◽  
Different Types ◽  
Patients With Diabetes

Chronic wound in patients with diabetes mellitus (DM) is one of the most urgent problems of modern diabetology and surgery. Numberof patients suffering from different types of chronic wounds follows increase in DM incidence. Vacuum therapy is a novel perspectivemethod of topical treatment for non-healing chronic wounds of various etiology. Current review addresses experimental and clinicalevidence for this method.

scholarly journals TERAPIA HIPERBÁRICA, EFECTIVIDAD EN EL TRATAMIENTO DE PIE DIABÉTICO

2020 ◽  
Vol 5 (3) ◽  
pp. 27
Author(s):  
Viviana Margarita Espinel Jara ◽  
Fernando Rodrigo Noboa Proaño ◽  
María Ximena Tapia Paguay ◽  
María Paola Chalá Minda ◽  
Rocío Elizabeth Castillo Andrade ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Streptococcus Pyogenes ◽  
Lower Limbs ◽  
Type Ii ◽  
Clearance Time ◽  
Enterococcus Spp ◽  
High Incidence ◽  
Hyperbaric Therapy

Introducción: La Diabetes Mellitus Tipo 2 (DM2), enfermedad de alta incidencia. Un 15% de diabéticos presentan úlceras y lesiones en miembros inferiores cuyos tratamientos son dolorosos, largos y caros. Objetivo: determinar la efectividad de la terapia hiperbárica en el tratamiento del pie diabético. Métodos: Estudio no experimental, descriptivo, observacional y longitudinal, incluyó 160 pacientes, se aplican terapias de 30´ a 45´ minutos, cada 10 días durante 2 meses o más, evaluadas en fichas de seguimiento. Resultados: Pacientes con más de 6 años de diagnóstico de DM2, mayores de 40 años; 60% femenino; lesiones 70% tipo II y IV según Clasificación Meggitt-Wagner. Bacterias encontradas 40% Enterococcus spp., 25%, Staphylococcus aureus, 20%, Estreptococos pyogenes y 15% Corynebacterium spp. 85% de lesiones sin infección luego de 3 sesiones, en un 95% la epitelización y cicatrización inicia luego de 6 sesiones. Conclusiones: Altas concentraciones tisulares de oxígeno reducen el tiempo de eliminación de infecciones. Tratamiento más económico. Disminuyen procedimientos quirúrgicos de amputación.   Abstract Introduction:Type 2 Diabetes Mellitus (DM2), a high incidence disease. 15% of diabetics have ulcers and lesions in the lower limbs whose treatments are painful, long and expensive. Objective: to determine the effectiveness of hyperbaric therapy in the treatment of diabetic foot. Methods:  Non--experimental, descriptive, observational and longitudinal study; included 160 patients, therapies were treated from 30´ to 45´ minutes, every 10 days for 2 months or more, evaluated in follow-up cards. Results: Patients with more than 6 years of DM2 diagnosis, older than 40 years; 60% female; 70% type II and IV injuries according to the Meggitt-Wagner classification. Bacteria found 40% Enterococcus spp., 25%, Staphylococcus aureus, 20%, Streptococcus pyogenes and 15% Corynebacterium spp. 85% of lesions without infection after 3 sessions, in 95% epithelialization and healing started after 6 sessions. Conclusions: High tissue oxygen complications reduce infection clearance time. Cheaper treatment. Decrease surgical amputation procedures

scholarly journals Graphene Oxide affects Staphylococcus aureus and Pseudomonas aeruginosa dual species biofilm in Lubbock Chronic Wound Biofilm model

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mara Di Giulio ◽  
Silvia Di Lodovico ◽  
Antonella Fontana ◽  
Tonino Traini ◽  
Emanuela Di Campli ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Graphene Oxide ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Antimicrobial Treatment ◽  
Microbial Colonization ◽  
Wound Management ◽  
Promising Tool ◽  
Complex Procedure

Abstract Chronic wound management becomes a complex procedure because of the persistence of forming biofilm pathogens that do not respond to antimicrobial treatment. The aim of this paper is to detect the Graphene Oxide-GO effect on Staphylococcus aureus and Pseudomonas aeruginosa dual species wound biofilm in Lubbock Chronic Wound Biofilm-LCWB model. LCWB is a recognized model that mimics the spatial microbial colonization into chronic wounds and reproduces the wound and its clot. Staphylococcus aureus PECHA 10 and P. aeruginosa PECHA 4, are the pathogens used in the study. The GO effect on both in forming and mature biofilms, is detected by the evaluation of the CFU/mg reduction, the cell viability and ultrastructural analysis of the treated LCWBs. Graphene Oxide, at 50 mg/l, shows a significant antibiofilm effect in forming and mature LCWBs. In particular, during the biofilm formation, GO reduces the S. aureus and P. aeruginosa growth of 55.05% ± 4.73 and 44.18% ± 3.91 compared to the control. In mature biofilm, GO affects S. aureus and P. aeruginosa by reducing their growth of 70.24% ± 4.47 and 63.68% ± 17.56, respectively. Images taken by SEM show that GO display a disaggregated microbial effect also disrupting the fibrin network of the wound-like biofilm framework. In conclusion, GO used against microorganisms grown in LCWB, displays a significant inhibitory action resulting in a promising tool for potential application in wound management.

scholarly journals Prevalence of infected chronic wound isolates and their Minimum inhibitory concentrations against third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda

2021 ◽  
Author(s):  
Wangoye Khalim ◽  
Mwesigye James ◽  
Tungotyo Martin ◽  
Twinomujuni Silvano Samba
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Referral Hospital ◽  
Third Generation ◽  
Regional Referral Hospital ◽  
Surgical Ward ◽  
Broth Microdilution Method ◽  
Third Generation Cephalosporins ◽  
Klebsiella Spp

Abstract Background: Globally, the burden of infected chronic wounds is likely to increase due to the rising levels of bacterial resistance to antibiotics and non-communicable diseases such as Diabetes mellitus and cancer. Furthermore, the burden of antibiotic resistant strains in infected chronic wounds is likely to increase especially in resource constrained areas like Mbarara regional referral Hospital where the selection of antibiotic therapy does not usually depend on known antibiotic susceptibilities. Therefore the objectives of this study were; (I) to determine the prevalence of infected chronic wounds isolates from patients admitted in the surgical ward of MRRH, Uganda and (II) to determine the MIC of infected chronic wound isolates against the third generation cephalosporins.Method(s): This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Wound swabs were aseptically collected, registered in the laboratory register and depending on the nature of samples; each specimen was inoculated on chocolate, blood, mannitol salt sugar, xylose lysine decarboxylated agar, and MacConkey Agar and incubated at 350C-370C in the incubator. Broth microdilution method was used to test for MIC.The collected data was entered into Microsoft Excel and exported to STATA version 15.0 for statistical analysis. Chi square/Fishers’s Exact test and analysis of variance (ANOVA) tests were used to analyse data for objective 1 and 2 respectively.Results: The most prevalent pathogens isolated were staphylococcus aureus (40.6%,) and Klebsiella spp (29%,) while the least prevalent pathogens were Providencia spp(1.4%, n=1/69) and Enterobacter agglomerans(2.9%, n=2/29). Generally, staphylococcus aureus exhibited the lowest MIC against cefoperazone+sulbactum 2g (Sulcef®) and ceftriaxone 1g (Epicephin®) (4.33±8.41µ/ml and 15.77±23.32µ/ml respectively). However, the differences in mean MIC observed across various groups were not statistically significant (P >0.05).Conclusion: The most prevalent pathogens isolated from patients with infected chronic wounds at the surgical ward of MRRH were Staphylococcus aureus, Klebsiella spp and proteus spp and the most effective third generation cephalosporins were cefoprazone+sulbactam 2g and ceftriaxone 1g (Epicephin®) while the most ineffective antibiotics were cefpodoxime 200mg and cefixime 400mg.

Fluorescent Imaging and Precise Suppression of Bacterial Infection in Chronic Wounds by Porphyrin-Based Metal-Organic Framework Nanorod

2021 ◽  
Author(s):  
zhen zou ◽  
Lihua Zhang ◽  
Minzhi Ouyang ◽  
Yufei Zhang ◽  
Huanxiang Wang ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Antibacterial Agents ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Metal Organic Framework ◽  
Critical Role ◽  
Fluorescent Imaging ◽  
Wound Management ◽  
Metal Organic ◽  
Chronic Wound Management

Nano-antibacterial agents play a critical role in chronic wound management. However, an intelligent nanosystem that can provide both visual warning of infection and precise sterilization remains a hurdle. Herein, a...

scholarly journals Staphylococcal Sepsis with Multiple Abscesses, Urinary Tract Infection, and Bilateral Renal Vein Thrombosis in a Patient with Uncontrolled Diabetes Mellitus

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Malik A. A. Khan ◽  
Jonathan Michael Hunter ◽  
Christopher Tan ◽  
Mostafa Seleem ◽  
Peter J. O. Stride
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Renal Vein ◽  
Medical Condition ◽  
Vascular Complications ◽  
Renal Vein Thrombosis ◽  
Intravenous Antibiotic ◽  
Incision And Drainage ◽  
Vein Thrombosis ◽  
Uncontrolled Diabetes

We report a case of staphylococcal sepsis with vascular complications including peripheral emboli and renal vein thrombosis. Bilateral renal vein thrombosis has not been reported as a complication ofStaphylococcus aureus(SA) axillary abscess. Uncontrolled diabetes was the only detected predisposing medical condition. The patient was treated successfully with incision and drainage of soft-tissue abscesses and intravenous antibiotic for six weeks and with anticoagulation for renal vein thrombosis.

Sign in / Sign up

Export Citation Format

Share Document