EFFECTIVITY OF INDONESIAN HONEY ON DIABETIC FOOT ULCERS HEALING PROCESS: OBSERVATIONAL CASE STUDY

Background: Diabetic foot ulcers were common diabetes complication that progressively growth globally. The effectivity of Manuka honey in wound healing process was huge published currently. Modern dressing and Manuka honey may not affordable and cost effective since these dressings were not produced originally in Indonesia. In addition, the published study of Indonesian honey is still lack. Therefore, we conducted this study to investigate the effectivity of Indonesian honey in diabetic foot ulcers healing process. Method: This study design was observational case study. This study was conducted among type 2 diabetes with diabetic foot ulcers in Griya Afiat Homecare and ETN Center in Makassar City, Indonesia from March to June 2014. The Bates Wound Assessment Tool (BWAT) were used to collect the score of diabetic foot ulcer healing process regarding wound size, depth, edges, undermining, necrotic tissue type, necrotic amount, granulation, epithelization, exudate type and amount, surrounding skin color, edema and induration. Descriptive, Independent t-test, Analysis of Variance (ANOVA) and Wilcoxon signed rank test were conducted appropriately. Results: In total, 10 type 2 diabetes patients with diabetic foot ulcers were participated. The factors associated with wound healing process were diabetes treatment (t= 2.44, p= 0.041) and primary dressing (t= -2.76, p= 0.025). The effect of honey primary dressing was in reducing wound size (p= 0.043), improving necrotic tissue type (p= 0.041), reducing necrotic tissue amount (p= 0.042), increasing granulation (p= 0.038) and epithelization (p= 0.042). In the counterpart, the effect of modern dressing was in improving necrotic tissue type (p= 0.046) and increasing granulation (p= 0.042). Conclusion: Indonesian honey is beneficial on diabetic foot ulcers healing process. Recommendation: Therefore, findings suggest that honey should be considered as the alternative, cost effective and beneficial wound dressing on the diabetic foot ulcers.

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Maggot debridement therapy to treat hard-to-heal diabetic foot ulcers: a single-centre study

Journal of Wound Care ◽

10.12968/jowc.2021.30.sup12.s30 ◽

2021 ◽

Vol 30 (Sup12) ◽

pp. S30-S36

Author(s):

Harikrishna KR Nair ◽

Nazni Wasi Ahmad ◽

AA Ismail ◽

Ali A Alabed ◽

Benjamin Oh Zheming ◽

...

Keyword(s):

Diabetic Foot ◽

Case Series ◽

Cost Effective ◽

Lucilia Cuprina ◽

Study Endpoint ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Necrotic Tissue ◽

Maggot Debridement Therapy ◽

Diabetic Wounds

Objective: Maggot debridement therapy (MDT) has seen a resurgence in recent years in the treatment of hard-to-heal wounds, as a result of rising antibiotic resistance. The sterilised larvae of Lucilia cuprina have been used in MDT in Malaysia since 2003, with encouraging results for the treatment of hard-to-heal diabetic wounds. We report a case series of 30 patients selected from our clinic by convenient sampling with diabetic lower limb ulcers treated with MDT. The average age of patients receiving MDT was >50 years. Of the 30 patients in the study, nine were female and 21 were male. All patients had underlying diabetes, two patients had leg ulcers and 28 patients had diabetic foot ulcers. Sterilised Lucilia cuprina larvae were applied via a standard method of 10 maggots per square centimetre and dressed with sterile gauze. The study endpoint was defined as ≤5% coverage with slough or necrotic tissue following three successive applications of MDT. In this study, maximum debridement of wounds was achieved in 96.6% (29 patients) of our patients, with ≤5% coverage with slough or necrotic tissue, in addition to a reduction in wound-related pain, as assessed by a visual analogue scale. No adverse events were reported. The findings of this study support the use of MDT as a safe, efficacious, and cost-effective method of managing diabetic wounds.

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

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620930120 ◽

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.

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Osteopontin levels in plasma, muscles, and bone in patient with non-healing diabetic foot ulcers: A new player in wound healing process?

Journal of Diabetes and its Complications ◽

10.1016/j.jdiacomp.2018.05.009 ◽

2018 ◽

Vol 32 (8) ◽

pp. 795-798 ◽

Cited By ~ 2

Author(s):

Z. Feldbrin ◽

E. Omelchenko ◽

A. Lipkin ◽

M. Shargorodsky

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Healing Process ◽

Foot Ulcers ◽

Wound Healing Process ◽

Diabetic Foot Ulcers

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Nanobiocatalysts: Cu/TiO2-SiO2 Nanoparticles as Tissue-Regeneration Treatment for Diabetic Foot Ulcers: In Vivo Studies

Current Biotechnology ◽

10.2174/2211550109999201026085353 ◽

2020 ◽

Vol 9 (3) ◽

pp. 230-239

Author(s):

Tessy López-Goerne ◽

Francisco J. Padilla-Godínez ◽

Luis Pérez-Dávalos ◽

Paola Ramírez-Olivares ◽

Daniela Arellano

Keyword(s):

Wound Healing ◽

Tissue Regeneration ◽

Diabetic Foot ◽

Conservative Therapy ◽

Healing Process ◽

In Vivo Studies ◽

Successful Outcome ◽

Foot Ulcers ◽

Wound Healing Process ◽

Diabetic Foot Ulcers

Background: Diabetic foot ulcers (DFUs) exhibit 80% of prevalence in Mexico. Efficient tissue regeneration therapies are the key factors to avoid amputations. Objective: In this study, the healing properties of a Cu/TiO2-SiO2 nanobiocatalyst applied in DFUs were analyzed. Furthermore, the morphology and crystalline structures were characterized. Methods: The nanobiocatalyst was synthesized by a sol-gel patented method proposed by López et al. The compound was characterized by scanning and transmission electron microscopies and Xray diffraction. The nanoparticles were embedded in a polymeric gel matrix (nanogel), which was utilized as a conservative therapy for chronic non-healing DFU in 8 patients with several comorbidities and chronic complications of diabetes. Wound debridement was performed prior to the nanogel administration. The nanogel was applied over the ulcers on alternate days for different periods of time, depending on the case. Results: Significant improvement in terms of enhanced epithelialization was observed in the wound healing process after a few applications. Infection spread was limited, and tissue regeneration was enhanced, with significant healing of the ulcers observed in each case. Furthermore, the successful outcome allowed to avoid the amputations that were proposed to some of the patients. Conclusion: The study proved the efficiency of the nanobiocatalyst as a safe, conservative therapy for chronic non-healing DFUs. Further investigation must be carried out to fully elucidate the wound-healing mechanisms of the nanoparticles.

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Targeting MMP-9 in Diabetic Foot Ulcers

Pharmaceuticals ◽

10.3390/ph12020079 ◽

2019 ◽

Vol 12 (2) ◽

pp. 79 ◽

Cited By ~ 7

Author(s):

Jeffrey I. Jones ◽

Trung T. Nguyen ◽

Zhihong Peng ◽

Mayland Chang

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Healing Process ◽

Foot Ulcers ◽

Wound Healing Process ◽

Diabetic Foot Ulcers ◽

Novel Approach ◽

Medical Need ◽

Diabetic Wound Healing ◽

Diabetic Wounds

Diabetic foot ulcers (DFUs) are significant complications of diabetes and an unmet medical need. Matrix metalloproteinases (MMPs) play important roles in the pathology of wounds and in the wound healing process. However, because of the challenge in distinguishing active MMPs from the two catalytically inactive forms of MMPs and the clinical failure of broad-spectrum MMP inhibitors in cancer, MMPs have not been a target for treatment of DFUs until recently. This review covers the discovery of active MMP-9 as the biochemical culprit in the recalcitrance of diabetic wounds to healing and targeting this proteinase as a novel approach for the treatment of DFUs. Active MMP-8 and MMP-9 were observed in mouse and human diabetic wounds using a batimastat affinity resin and proteomics. MMP-9 was shown to play a detrimental role in diabetic wound healing, whereas MMP-8 was beneficial. A new class of selective MMP-9 inhibitors shows clinical promise for the treatment of DFUs.

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Treatment of diabetic foot ulcers with Therapeutic Magnetic Resonance (TMR®) improves the quality of granulation tissue

European Journal of Histochemistry ◽

10.4081/ejh.2017.2800 ◽

2017 ◽

Vol 61 (3) ◽

Cited By ~ 6

Author(s):

Letizia Ferroni ◽

Chiara Gardin ◽

Andrea De Pieri ◽

Maria Sambataro ◽

Elena Seganfreddo ◽

...

Keyword(s):

Magnetic Resonance ◽

Diabetic Foot ◽

Day Treatment ◽

Healing Process ◽

Adverse Outcomes ◽

Foot Ulcers ◽

Wound Healing Process ◽

Diabetic Foot Ulcers ◽

Molecular Features ◽

Extracellular Matrix Components

Diabetic foot ulcers (DFUs) often result in severely adverse outcomes, such as serious infections, hospitalization, and lower extremity amputations. In last few years, to improve the outcome of DFUs, clinicians and researchers put their attention on the application of low intensity pulsating electro-magnetic fields through Therapeutic Magnetic Resonance (TMR®). In our study, patients with DFUs have been divided into two groups: The Sham Group treated with non-functioning TMR® device, and the Active Group treated with a functioning device. Biopsies were recovered from ulcers before and after a 15-day treatment with both kind of TMR® device. To recognize signs of inflammation or healing process, the harvested biopsies were subjected to histological and molecular analyses. The histological analysis showed a change in cell population after treatment with TMR®: an increase of fibroblasts and endothelial cells with a reduction of inflammatory cells. After TMR® application, the gene expression profile analysis revealed an improvement in extracellular matrix components such as matrix metalloproteinases, collagens and integrins, a reduction in pro-inflammatory interleukins, and an increase in growth factors expression. In conclusion, our research has identified histological and molecular features of reduced inflammation and increased cell proliferation during the wound healing process in response to TMR® application.

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Treatment of diabetic foot ulcers

Journal of Korean Medical Association ◽

10.5124/jkma.2021.64.8.529 ◽

2021 ◽

Vol 64 (8) ◽

pp. 529-536

Author(s):

Jiyong Ahn

Keyword(s):

Wound Healing ◽

Cost Effectiveness ◽

Soft Tissue ◽

Diabetic Foot ◽

Healing Process ◽

Foot Ulcers ◽

Wound Healing Process ◽

Diabetic Foot Ulcers ◽

High Quality ◽

Dressing Materials

Background: Diabetic foot ulcers (DFUs), a risk factor for infection, remain a difficult clinical complication. Infected DFUs may be associated with lower extremity amputation. To achieve wound healing and avoid amputation, an assortment of dressing materials and negative pressure wound therapy (NPWT) have been used on soft tissue injuries resulting from infected DFUs. A great deal of interest about the use of dressing materials and NPWT in the treatment of DFUs has arisen. However, there have only been a few high-quality studies regarding this topic.Current Concepts: Ideal dressing materials should satisfy certain conditions to alleviate symptoms of DFU infection and enhance the wound healing process. A single dressing material cannot fulfill all of these requirements. Based on clinical trials, different dressing materials must be chosen according to the status of the individual wound environment, including the amount of exudate, degree of pain, severity of the infection, and cost-effectiveness. However, there has been no clear evidence that advanced wound dressing materials are superior to basic dressing materials in wound healing. Recently, NPWT has been used to cover the soft tissue defects of infected DFU with granulation tissue. NPWT may contribute to changing growth factor expression, micro- and macro-deformation, vascular flow, amount of exudate, and the bacterial environment in DFU, despite the unclear mechanism of its role in wound repair.Discussion and Conclusion: Further research to obtain high-quality evidence regarding the benefits of using dressing materials and NPWT is needed. The optimal protocol for DFU and cost-effectiveness should be included in these future studies.

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Attack of the NETs! NETosis primes IL-1β-mediated inflammation in diabetic foot ulcers

Clinical Science ◽

10.1042/cs20200240 ◽

2020 ◽

Vol 134 (12) ◽

pp. 1399-1401

Author(s):

Man K.S. Lee ◽

Gopalkrishna Sreejit ◽

Prabhakara R. Nagareddy ◽

Andrew J. Murphy

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

Healing Process ◽

Foot Ulcers ◽

Wound Healing Process ◽

Inflammasome Activation ◽

Diabetic Foot Ulcers ◽

Nlrp3 Inflammasome Activation ◽

Improve Wound Healing ◽

Insight Into

Abstract In volume 133 issue 4 of Clinical Science, Liu et al. showed that neutrophils release extracellular traps (NETs) in the setting of diabetes which acts as a stimulus for NLRP3 inflammasome activation in macrophages to promote IL1β-dependent exacerbation of inflammation. They also provide evidence to show that degrading NETs improves the wound healing process. These findings provide an insight into how NETs communicate with other cells in the vicinity (e.g. macrophages) to exacerbate the inflammatory response. Most importantly, they provide novel avenues to improve wound healing process such as diabetic foot ulcers (DFUs) by targeting NETs.

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