Diabetic wound infection: A review on microbial population and infection control

A diabetic foot ulcer is one of the major complications of diabetes and it leads to lower extremity amputation in patients. This review explores the current research on microbial populations on diabetic wounds, and also treatment alternatives to combat the infection on chronic diabetic wounds. The microbial communities exist in diabetic wound infection are diverse. Microbes rarely survived in single species of planktonic cells. They usually exist in a complex polymicrobial biofilm population which consists of different types of microorganisms. Furthermore, the development of bacterial biofilm on the wound that usually consists of multidrug-resistant pathogens also delayed the wound healing. To overcome this problem, many types of modern wound dressing were developed including hydrocolloid, hydrogel, alginate and collagen wound dressing. Besides, modern biotechnological advancements such as cell therapy, bioengineered skin, dermal scaffolds, tissue-engineered artificial skin and growth factors were also employed to promote the recovery of the wound. In conclusion, diabetes mellitus is a major health care challenge worldwide. Diabetic patients are at risk for developing foot ulcer which ultimately leads to amputation; hence a safe and effective alternative treatment is required to improve diabetic patients’ quality life.

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A COMPARATIVE STUDY OF PLATELET RICH PLASMA DRESSING VS NORMAL SALINE DRESSING IN THE MANAGEMENT OF DIABETIC FOOT ULCER

10.36106/ijsr/7515167 ◽

2021 ◽

pp. 19-22

Author(s):

Vijay kumar Siddalingappa ◽

Mohan kumar Kariyappa ◽

Subhashish Das

Keyword(s):

Diabetic Foot ◽

Platelet Rich Plasma ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Control Group ◽

Diabetic Patients ◽

Study Group ◽

Diabetic Ulcer ◽

Plantar Aspect ◽

Diabetic Wounds

90 patients with diabetic foot ulcer admitted in Department of General Surgery R. L. JALAPPA HOSPITAL, TAMAKA, KOLAR, in between the study period of December 2017 to June 2019. The study is estimated to include diabetic foot ulcer patients satisfying inclusion criteria who are admitted in surgical wards of RLJH and RC. A complete detailed history, as per standard proforma will be obtained and documented. All patients will undergo clinical examination with relevant investigations after obtaining an informed consent. Patients are divided into 2 groups using even-odd method to include similar type of cases in both groups, where even group is study group and odd group is control group. RESULTS: Predisposition of diabetic foot ulcer was common among males than in females, More number of diabetic patients presented with diabetic foot ulcer arising from trauma than those occurring spontaneously. The spontaneous onset ulcers healed better with PRP than those arising due to traumatic onset. The ulcers on dorsal aspect heal faster than on plantar aspect, PRP dressing improved the rate of healing in lower Wagner grade ulcer than in higher grade ulcer, Patients who were on insulin alone showed better healing than those on OHA. Over all PRP dressing group showed higher rate of ulcer size reduction than those on saline dressing. CONCLUSION: The diabetic ulcer in the study group treated with PRP dressing contracted in wound size more than in the control group. This indicates that PRP dressing is an effective method to facilitate wound contraction in diabetic patients with foot ulcer. PRP dressing is found to be more effective, cost efcient and safe promoter of ulcer wound healing and can be used as an adjunct to saline dressings for enhanced healing of diabetic wounds.

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Mobile Health untuk Mencegah Luka Diabetes: A Systematic Review

Jurnal Penelitian Kesehatan SUARA FORIKES (Journal of Health Research Forikes Voice) ◽

10.33846/sf12301 ◽

2021 ◽

Vol 12 (3) ◽

pp. 225

Author(s):

Risyda Zakiyah Hanim ◽

Tuti Herawati

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Mobile Health ◽

Diabetic Foot ◽

Positive Impact ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Wound ◽

Diabetic Wounds ◽

Prevention Of Diabetes

Ulcus diabeticum is the most common complication that results in death. Diabetic foot currently reach 40 to 60 million people in patients diagnosed with diabetes mellitus. This article was a mobile-health systematic review in preventing diabetic foot injuries. The search sources were Scopus, Science Direct, PubMed, ProQuest, Ebscohost and Sage published from 2015 to 2020 with the search keywords of "diabetes mellitus", "ulcus diabetic", "foot ulcer", "diabetic wound", "prevention", "mhealth", "telehealth ", " telemedicine", and "telenursing". The results show that there were four components in preventing diabetes wounds, namely monitoring foot temperature, foot images, directed guidance and virtual consultation. Mhealth has a positive impact on the prevention of diabetes mellitus wounds so that mHealth can be applied to prevent the incidence of diabetic wounds. Keywords: m-health; prevention; diabetic wounds ABSTRAK Ulkus diabeticum merupakan komplikasi yang paling banyak mengakibatkan kematian. Kaki diabetik saat ini mencapai 40 hingga 60 juta jiwa pada pasien yang terdiagnosa diabetes mellitus. Artikel ini merupakan systematic review mobile-health dalam mencegah luka kaki diabetik. Sumber pencarian adalah Scopus, Science Direct, PubMed, ProQuest, Ebscohost dan Sage yang diterbitkan dari 2015 hingga 2020 dengan kata kunci pencarian "diabetes mellitus", "ulcus diabetic", "foot ulcer", "diabetic wound" "prevention", "mhealth", "telehealth", "telemedicine", dan "telenursing". Hasil menunjukkan terdapat empat komponen dalam pencegahan luka diabetes yakni monitoring suhu kaki, gambar kaki, panduan terarah dan konsultasi virtual. mhealth berdampak positif pada pencegahan luka diabetes mellitus sehingga mHealth dapat memungkinkan untuk diterapkan untuk mencegah kejadian luka diabetes. Kata kunci: mhealth; pencegahan; luka diabetes

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A comparative study to assess the effectiveness of Topical Insulin Dressing vs Normal Saline Dressing on wound healing of Diabetic Foot Ulcer

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.3755 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 134-138

Author(s):

Ruban David ◽

Nandhini Rajkumar

Keyword(s):

Wound Healing ◽

Normal Saline ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

T Test ◽

Diabetic Patients ◽

Background Variable ◽

Diabetic Wound ◽

Paired T Test

Diabetic foot ulcer (diabetic foot ulcer) is an injury entering through the profound vascular and collagenous (dermis) layers of the skin in diabetic patients. Helpless information by walking care and helpless foot care rehearses were distinguish as significant danger factors for foot issues in diabetes. The principle target of the investigation was to survey the effectiveness of topical insulin dressing versus saline dressing and analyze the degree of diabetic injury healing. Quasi-experimental with comparative research design was embraced for the investigation. Convenience sampling technique was utilized to choose 60 examples. Structured interview was used to collect background variable and Wagner diabetic wound assessment scale for assessing diabetic wound. The diabetic wound was dressed with topical insulin dressing and normal saline dressing for 6 days. The calculated paired 't' test value of t = 15.703 was found to be statistically highly significant at p<0.001 level whereas the calculated paired 't' test value of t = 3.247 was found to be statistically highly significant at p<0.01 level. There was significant that the topical insulin dressing is the more effective and improving the level of wound healing than normal saline dressing.

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

Journal of Clinical Medicine ◽

10.3390/jcm10071495 ◽

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.

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Updates in Diabetic Wound Healing, Inflammation, and Scarring

Seminars in Plastic Surgery ◽

10.1055/s-0041-1731460 ◽

2021 ◽

Author(s):

Nina Dasari ◽

Austin Jiang ◽

Anna Skochdopole ◽

Jayer Chung ◽

Edward Reece ◽

...

Keyword(s):

Wound Healing ◽

Disease Process ◽

Wound Dehiscence ◽

Diabetic Patients ◽

Wound Infections ◽

Diabetic Wound ◽

Complex Process ◽

Diabetic Wound Healing ◽

Almost All ◽

Diabetic Wounds

AbstractDiabetic patients can sustain wounds either as a sequelae of their disease process or postoperatively. Wound healing is a complex process that proceeds through phases of inflammation, proliferation, and remodeling. Diabetes results in several pathological changes that impair almost all of these healing processes. Diabetic wounds are often characterized by excessive inflammation and reduced angiogenesis. Due to these changes, diabetic patients are at a higher risk for postoperative wound healing complications. There is significant evidence in the literature that diabetic patients are at a higher risk for increased wound infections, wound dehiscence, and pathological scarring. Factors such as nutritional status and glycemic control also significantly influence diabetic wound outcomes. There are a variety of treatments available for addressing diabetic wounds.

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Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

Journal of Diabetes Research ◽

10.1155/2017/2879249 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 22

Author(s):

Tesfamichael G. Mariam ◽

Abebaw Alemayehu ◽

Eleni Tesfaye ◽

Worku Mequannt ◽

Kiber Temesgen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Cross Sectional Study ◽

Care Practice ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

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DIABETIC FOOT INFECTIONS;

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.01.2718 ◽

2008 ◽

Vol 15 (01) ◽

pp. 153-161

Author(s):

MUHAMMAD SAEED AKHTAR ◽

MAQSOOD AHMAD ◽

MUHAMMAD BADAR BASHIR ◽

Muhammad Irfan ◽

Zahid Yasin Hashmie

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Diabetic Patients ◽

Surgical Department ◽

Diabetic Foot Infections ◽

Group A ◽

Hospital Stays ◽

Male Patients ◽

Group B

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

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Osteomyelitis, diabetic foot ulcers and the role of the community nurse

British Journal of Community Nursing ◽

10.12968/bjcn.2021.26.sup6.s6 ◽

2021 ◽

Vol 26 (Sup6) ◽

pp. S6-S9

Author(s):

Melanie Lumbers

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Holistic Approach ◽

Diabetic Patients ◽

Positive Outcomes ◽

Community Nurse ◽

Complex Needs ◽

Health And Wellbeing

Community nurses face numerous challenges in both diagnosing and effectively treating their patients. The diabetic patient has complex needs requiring a holistic approach. With a reported increase in diabetic patients, and a possible decline in some routine screening following Covid-19 pandemic, complications in diabetic patients are likely to rise. It is estimated that 25% of diabetic patients will develop a diabetic foot ulcer (DFU), with a reported 43% of DFU already infected at first presentation to a health professional. NICE categorise the level of infection in DFU based on standardised assessments such as SINBAD. A high categorised DFU has the possibility of osteomyelitis. It is imperative that osteomyelitis is treated immediately to achieve positive outcomes, benefitting the patients' health and wellbeing in addition to reducing the financial implications to the NHS.

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Antihyperglycemic and diabetic wound healing activity of smallanthus sonchifolius leaves extract

MATEC Web of Conferences ◽

10.1051/matecconf/201819707001 ◽

2018 ◽

Vol 197 ◽

pp. 07001

Author(s):

Rina Herowati ◽

Alip D.S. Saputri ◽

Tri Wijayanti ◽

Gunawan P. Widodo

Keyword(s):

Wound Healing ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Topical Administration ◽

Serum Glucose ◽

Diabetic Wound ◽

Smallanthus Sonchifolius ◽

Biopsy Punch ◽

Diabetic Wound Healing ◽

Wound Healing Activity

Diabetic patient tend to suffer from lower extremity complication that contribute to the occurence of diabetic foot ulcer. Smallanthus sonchifolius or yacon leaves extract has been used as an alternative medicine for diabetes and also showed antibacterial activity. This research aims to obtain the antihyperglycemic and diabetic wound healing activity of yacon leaves extract. Diabetic condition of rat was induced by streptozotocin (45 mg/kg bw) and nicotinamide (110 mg/kg bw). Rats were then allowed to develop diabetes for 21 days. A biopsy punch then was used to create a wound. Yacon leaves extract were administered by oral and topical for 14 day. The serum glucose level and diameter of the wound were measured every week, and histopatology study of the skin was conducted at the end of the study. Oral administration of yacon leaves extract (150 mg/kg bw) together with topical administration showed antihyperglycemic as well as diabetic wound healing activities comparable to the reference drugs (glibenclamide oral and nebacetin cream).

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Organo-Selenium-Containing Polyester Bandage Inhibits Bacterial Biofilm Growth on the Bandage and in the Wound

Biomedicines ◽

10.3390/biomedicines8030062 ◽

2020 ◽

Vol 8 (3) ◽

pp. 62

Author(s):

Phat Tran ◽

Tyler Enos ◽

Keaton Luth ◽

Abdul Hamood ◽

Coby Ray ◽

...

Keyword(s):

Wound Infection ◽

Wound Dressing ◽

Laser Scanning ◽

Bacterial Biofilm ◽

Laser Scanning Microscopy ◽

Confocal Laser ◽

Bacterial Strains ◽

Biofilm Growth ◽

Biofilm Model

The dressing material of a wound plays a key role since bacteria can live in the bandage and keep re-infecting the wound, thus a bandage is needed that blocks biofilm in the bandage. Using an in vivo wound biofilm model, we examined the effectiveness of an organo-selenium (OS)-coated polyester dressing to inhibit the growth of bacteria in a wound. Staphylococcus aureus (as well as MRSA, Methicillin resistant Staph aureus), Stenotrophomonas maltophilia, Enterococcus faecalis, Staphylococcus epidermidis, and Pseudomonas aeruginosa were chosen for the wound infection study. All the bacteria were enumerated in the wound dressing and in the wound tissue under the dressing. Using colony-forming unit (CFU) assays, over 7 logs of inhibition (100%) was found for all the bacterial strains on the material of the OS-coated wound dressing and in the tissue under that dressing. Confocal laser scanning microscopy along with IVIS spectrum in vivo imaging confirmed the CFU results. Thus, the dressing acts as a reservoir for a biofilm, which causes wound infection. The same results were obtained after soaking the dressing in PBS at 37 °C for three months before use. These results suggest that an OS coating on polyester dressing is both effective and durable in blocking wound infection.

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