scholarly journals A REVIEW ON DETERMINING FACTORS FOR WOUND HEALING IN DIABETIC FOOT ULCERS

2021 ◽  
Vol 3 (1) ◽  
pp. 260-268

Diabetic Foot Ulcers (DFU) are significant complications of diabetes mellitus. DFU will often heal in a shorter period if factors that inhibit wound healing are identified and managed. This review was to identify determining factors that are associated with wound healing in DFU patients. Glycaemic control, adequate nutrition, presence of infection, the use of modern dressing approach, provide sufficient offloading and avoid unhealthy lifestyle like smoking are the highlighted determining factors discussed in this review and found to have an association towards a timely manner of wound healing in diabetic foot ulcers.

2019 ◽  
Vol 26 (09) ◽  
pp. 1487-1490
Author(s):  
Shafaatullah ◽  
Sadaf Iqbal ◽  
Bushra Zulfiqar ◽  
Shayan Zufishan

Introduction: Diabetes mellitus is one of the most common metabolic disorders affecting a large part of our population. Apart from its effect on all organ systems, these metabolic derangements affect other processes in the body as well. Diabetic wounds are difficult to treat with conventional treatments. Delayed wound healing has led to increased morbidity and mortality in the population. Increased blood glucose leads to ineffective angiogenesis and less collagen deposition. In various studies long acting insulin zinc suspension has been shown to augment wound healing without any harmful effects. Objectives: To find out the advantages of topical insulin in the management of diabetic foot ulcers. Study Design: Observational study. Setting: Plastic Surgery and General Surgery Department, Baqai Medical University Karachi. Period: January 2014 to December 2016. Material and Methods: Patients visiting the Surgical OPD with diabetes mellitus and concomitantly having foot ulcers were included in the study. Diabetics having blood glucose levels of 110-130 gm/dl and ulcers measuring more than one cm on the dorsum of the foot were included in the study. All patients having foot ulcers were treated by daily topical spray of 1cc saline mixed with 5 units of insulin. This treatment was continued for 12 weeks or till the time ulcer was completely healed (whichever was earlier) and ulcer size was measured weekly. Ulcer size and depth before and after treatment was measured. Results: We had a total of 65 participants, among them there were 52 males and 13 females presenting with diabetic foot ulcer. Around 87.6% (n=57) patients had type 2 diabetes mellitus whereas 12.3% (n=8) patients had type 1 diabetes mellitus. Upon examination of the patient the location, size and depth of the ulcer was measured as well. These parameters were measured before and after treatment by topical insulin spray. Right foot ulcers were present in 64.6% of the patients and 35.38% patients had left foot ulcers. The mean size and depth of ulcer was 5.1 + 1.1 cm2 and 8.7 + 0.12 mm respectively. After treatment the mean size and depth of ulcer was found to be 1 + 0.04cm2 and 1.4 + 0.12mm respectively. Conclusion: There was significant improvement after treatment of diabetic foot ulcers with topical insulin spray. The wound size and depth were considerably decreased. This treatment had more promising results than conventional treatment methods for diabetic foot ulcers.


2021 ◽  
Vol 7 (3) ◽  
pp. 167
Author(s):  
Efa Refiani ◽  
Rita Maliza ◽  
Husna Fitri ◽  
Putri Lestari

Diabetic Foot Pain and Ulcers is one of the complications diseases caused by Diabetes Mellitus (DM). Based on data from the Ministry of Health in 2014, diabetic foot ulcers in Indonesia 54%. Diabetic foot ulcer disease can cause infection and tissue death. Treatment of diabetic foot ulcers has been treated with ointments or gels containing antimicrobials, biomaterials, and active compounds, accelerating the wound healing process. The active compounds from medicinal plants that play a role in the treatment of diabetic foot ulcers have been widely reported. The purpose of writing this article is to look at the therapeutic effects of active compounds that play a role in wound healing. In this systematic review, we searched the PubMed, Science Direct, and Google Scholar databases to identify primer articles that were published from 2010 to 2020. Ten studies were selected and published between 2015-2020. Furthermore, the plant species used for the treatment of diabetic foot ulcers contain active phenolic, gallic acid, flavonoids, gallic acid, flavonoids, and tannins compounds that play a role in the acceleration of the healing process of diabetic foot ulcers. Keywords: Diabetes mellitus, diabetic foot ulcers, the active compound, medicinal plants


2020 ◽  
Vol 3 (1) ◽  
pp. 265-271
Author(s):  
Dewi Astuti Pasaribu ◽  
Septian Mixrova Sebayang

Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus (DM) that can be slow to heal, result in repeated hospitalizations, require intense and costly treatment, and reduce the quality of life. The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. Quasi-experimental study using before and after changes to wound healing in between February until May 2019.Thirty patients from an inpatient rooms with ulcers who met study criteria agreed to participate. Subjects were recruited by the researchers in the hospital where they received treatment. Data were collected using investigator-developed forms: patient information form and the diabetic foot exercises log. Patients in the intervention group received standard wound care and performed daily foot exercises for 3 week. Diabetic wound healing of the patients in the intervention were examined and measured at the 3rd weeks. To analyze and compare the data, frequency distribution, mean (standard deviation), and the paired samples t test were used. The mean of diabetic wound healing were 3.50, 2.90, and 2.40 in the study intervention group in 1st, 2nd, and 3rd weeks, respectively. Significant differences were found between diabetic wound healing in pre-test and post-test group (p=0.041). An important finding in this study was the DFU area decreased more in those who exercised more. Findings suggest foot exercises should be included in the treatment plan when managing patients with diabetic foot ulcers.     Abstrak Luka kaki diabetic adalah suatu komplikasi yang serius pada diabetes mellitus dimana dapat memperlambat penyembuhan, hospitalisasi berulang, membutuhkan pengobatan yang mahal dan menurunkan kualitas hidup. Tujuan penelitian ini adalah untuk mengetahui efek senam kaki terhadap penyembuhan luka pada pasien diabetes mellitus tipe 2. Jenis penelitian Quasi eksperimen digunakan untuk melihat perubahan sebelum dan sesudah penyembuhan luka dari Februari sampai Mei 2019. Tiga puluh pasien dari ruang inap dengan luka menjadi kriteria inklusi sebagai responden. Responden direkrut oleh peneliti di rumah sakit dimana pasien sedang menjalani perawatan. Pengumpulan data menggunakan kuesioner data demografi dan lembar observasi penyembuhan luka. Pasien akan diberikan latihan selama 3 minggu. Penyembuhan luka diabetic pada pasien akan dikaji dan diukur sampai minggu ke tiga. Untuk menganalisis dan membandingkan data, distribusi frekuensi, mean (standar deviasi), dan paired t test dilakukan. Mean penyembuhan luka diabetik diantaranya 3.50, 2.90 dan 2.40 pada kelompok intervensi pada minggu pertama, kedua, dan ketiga secara berurutan. Perbedaan signifikan penyembuhan luka diabetic antara kelompok pre-test dan post-test (p=0.041). Suatu temuan penting bahwa area luka kaki diabetic semakin menurun pada orang yang melakukan senam. Temuan ini juga senam kaki sebaiknya dimasukkan dalam rencana perawatan ketika merawat pasien dengan luka kaki diabetik.


Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.


Author(s):  
Ioanna A. Anastasiou ◽  
Ioanna Eleftheriadou ◽  
Anastasios Tentolouris ◽  
Georgia Samakidou ◽  
Nikolaos Papanas ◽  
...  

Diabetic foot ulcers are one of the most dreadful complications of diabetes mellitus and efforts to accelerate diabetic wound healing are of paramount importance to prevent ulcer infections and subsequent lower-limb amputations. There are several treatment approaches for the management of diabetic foot ulcers and honey seems to be a safe and cost-effective therapeutic approach on top of standard of care. The aim of this review was to summarize the therapeutic properties of honey and the data regarding its possible favorable effects on diabetic wound healing. A literature search of articles from 1986 until April 2021 was performed using MEDLINE, EMBASE, and the Cochrane Library to assess for studies examining the therapeutic wound healing properties of honey, it's in vitro effect, and the efficacy and/or mechanism of action of several types of honey used for the treatment of diabetic animal wounds. Honey has antioxidant, anti-inflammatory, and antibacterial properties and in vitro studies of keratinocytes and fibroblasts, as well as studies in diabetic animal models show that treatment with honey is associated with increased re-epithelialization and collagen production, higher wound contraction, and faster wound healing. The use of honey could be a promising approach for the management of diabetic foot ulcers.


2021 ◽  
Vol 10 (2) ◽  
pp. 371
Author(s):  
Kor H. Hutting ◽  
Wouter B. aan de Stegge ◽  
Jaap J. van Netten ◽  
Wouter A. ten Cate ◽  
Luuk Smeets ◽  
...  

Diabetic foot ulcers, complicated by osteomyelitis, can be treated by surgical resection, dead space filling with gentamicin-loaded calcium sulphate-hydroxyapatite (CaS-HA) biocomposite, and closure of soft tissues and skin. To assess the feasibility of this treatment regimen, we conducted a multicenter retrospective cohort study of patients after failed conventional treatments. From 13 hospitals we included 64 patients with forefoot (n = 41 (64%)), midfoot (n = 14 (22%)), or hindfoot (n = 9 (14%)) ulcers complicated by osteomyelitis. Median follow-up was 43 (interquartile range, 20–61) weeks. We observed wound healing in 54 patients (84%) and treatment success (wound healing without ulcer recurrence) in 42 patients (66%). Treatment failures (no wound healing or ulcer recurrence) led to minor amputations in four patients (6%) and major amputations in seven patients (11%). Factors associated with treatment failures in univariable Cox regression analysis were gentamicin-resistant osteomyelitis (hazard ratio (HR), 3.847; 95%-confidence interval (CI), 1.065–13.899), hindfoot ulcers (HR, 3.624; 95%-CI, 1.187–11.060) and surgical procedures with gentamicin-loaded CaS-HA biocomposite that involved minor amputations (HR, 3.965; 95%-CI, 1.608–9.777). In this study of patients with diabetic foot ulcers, complicated by osteomyelitis, surgical treatment with gentamicin-loaded CaS-HA biocomposite was feasible and successful in 66% of patients. A prospective trial of this treatment regimen, based on a uniform treatment protocol, is required.


2013 ◽  
Vol 20 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Teodora Chiţă ◽  
Delia Muntean ◽  
Luminiţa Badiţoiu ◽  
Bogdan Timar ◽  
Roxana Moldovan ◽  
...  

Abstract Background and aims: Infected foot ulcer is one of the most feared complications of diabetes mellitus. Staphylococcus aureus is the most frequently isolated pathogen in diabetic foot infections. The aim of this study was to evaluate the prevalence of S. aureus strains involved in producing foot infections in diabetic patients and the antibiotic resistance pattern of these strains. Material and methods: The study included 33 S. aureus strains isolated from 55 diabetic foot ulcers. The subjects were selected from the 2465 patients with diabetes mellitus hospitalized in the Timişoara Diabetes Clinic, between 2011 and 2013. Germs’ identification relied on cultural and biochemical characteristics. Final identification and antimicrobial testing were performed using the Vitek 2 (Bio Merieux France) automatic analyzer. Results: All the 55 samples collected from diabetic foot ulcers were positive. We isolated 64 bacterial strains (some samples were positive for 2 microorganisms). The most frequently isolated germ was S. aureus, in 33 samples (51.56%). All these S. aureus strains showed resistance to benzylpenicillin, while only 33.33% were methicillin-resistant (MRSA). Conclusions: The most frequently isolated germ in the wound secretions from diabetic foot ulcers was S. aureus. The highest percentage of antimicrobial resistance was recorded to benzylpenicillin and erythromycin.


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