scholarly journals Maggot debridement therapy for the treatment of diabetic foot ulcers: robbing the rich past to give to the sore

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Joseph Cutteridge ◽  
Katarzyna Bera
Keyword(s):  
Diabetic Foot ◽  
Chronic Wounds ◽  
Multiorgan Failure ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Necrotic Tissue ◽  
Foot Care ◽  
Surgical Interventions ◽  
Wound Debridement ◽  
Maggot Debridement Therapy

A diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus that results in significant morbidity and mortality. The lifetime risk of a patient with diabetes developing a DFU is 15-25%1. Furthermore, the incidence of DFUs is increasing in line with the growing burden of diabetes worldwide. The number of lower limb amputations secondary to diabetes has reached an all-time high in England, with 26,378 recorded from 2014-2017, an increase of 19.4% from 2010-20132. Maggot debridement therapy (MDT) involves the application of sterile larvae, usually of the species Lucilla sericata (common green bottle fly), which remove devitalised tissue to promote wound healing. This historical therapy re-emerged in the 1990s to combat the increasing incidence of recalcitrant wounds, such as DFUs. Since its reintroduction, there has been ongoing debate in the medical literature regarding the efficacy of MDT in the treatment of DFUs and other chronic wounds. We present the case of a 57-year-old male admitted with diabetic foot sepsis and multiorgan failure and discuss how MDT was used to complement initial surgical and antibiotic management. A 14-day course of MDT improved wound debridement and decreased necrotic tissue burden, after which no further surgical interventions were needed. This case provides further evidence that MDT is effective in the selective debridement of necrotic tissue and can aid the preservation of limb length in DFU patients, thereby highlighting the importance of MDT in multispecialist diabetic foot care.

scholarly journals Treatment of Non-Healing Diabetic Foot Wounds with Vaporous Hyperoxia Therapy in Conjunction with Standard Wound Care

2021 ◽  
Author(s):  
Dustin Kruse ◽  
Kenneth Morgan ◽  
Jeremy Christensen ◽  
Brian Derner ◽  
Brett Sachs
Keyword(s):  
Diabetic Foot ◽  
Oxygen Therapy ◽  
Chronic Wounds ◽  
Wound Care ◽  
Historical Analysis ◽  
Low Frequency ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Closure Rate ◽  
Wound Debridement

Vaporous Hyperoxia Therapy (VHTTM), a patented FDA-510 (k) cleared technology, is an adjunct therapy used in conjunction with standard wound care (SWC). VHT is said to improve the health of wounded tissue by administering a low-frequency, non-contact, non-thermal ionic anti-microbial hydrating mist alternating with concentrated topical oxygen therapy (TOT). VHT was used to treat 36 subjects with chronic diabetic foot ulcers (DFUs) that were previously treated unsuccessfully with SWC. The average age of DFU in the study was 11 months old and the average size was over 3 cm2. Wounds were either Wagner Grade 2 or 3 and most commonly on the plantar surface around the midfoot. Treatment consisted of twice weekly applications of VHT and wound debridement. Subjects were followed to wound closure, 20 weeks, or 40 treatments, whichever came first. The combination of SWC and VHT in the group that met and maintained compliance throughout the study period achieved an 83% DFU closure rate within a 20-week time period. The average time for DFU closure in this study was 9.4 weeks. Historical analysis of SWC shows a 30.9% healing rate of all wounds, not differentiating chronic wounds. Accordingly, SWC/VHT increases chronic diabetic foot ulcer healing rates by 2.85 times compared with SWC alone. The purpose of this study was two-fold: first, to observe the effect of VHT on healing rates and time to healing in previously nonhealing DFUs and second, to compare VHT with SWC, TOT and hyperbaric oxygen therapy (HBOT) and ultrasound therapies.

scholarly journals A Survey of Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer in Bangladesh

2014 ◽  
Vol 4 (1) ◽  
pp. 22-26 ◽  
Author(s):  
S Sharmisthas ◽  
P Wongchan ◽  
S Hathairat
Keyword(s):  
Diabetic Foot ◽  
Callus Formation ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Care Program ◽  
Foot Care ◽  
Multiple Choice Questions ◽  
Patients With Diabetes ◽  
Protective Sensation ◽  
Nurses Knowledge

Diabetic foot ulcer is a preventable complication of diabetes. Nurses must have knowledge related to this condition so that education can be given to patients. This study aims to examine the level of nurses’ knowledge regarding prevention and management of diabetic foot ulcer in Bangladesh. A survey involved 218 nurses working at a national, specialized, and well-established institute of diabetic care of Bangladesh. The Nurses’ Knowledge Regarding Prevention and Management of Diabetic Foot Ulcer Questionnaire (NKPMDFUQ) comprising of 40 questions with 20 true/false questions and 20 multiple choice questions was used. It was content validated and tested for internal consistency and stability yielding acceptable levels of reliability. The findings revealed that nurses had very low level of knowledge (M=52.60%, SD=7.86%). The content areas most nurses did not have knowledge were detecting loss of protective sensation of the feet, caring of callus formation, encouraging patients to have activity of daily living in order to self-manage, setting a goal for prevention of amputation, and giving advice to patients that causes of diabetes is the least important element in diabetic foot care program. The findings are beneficial for establishing training courses. Consequently, quality of care for patients with diabetes will be improved. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18549 Birdem Med J 2014; 4(1): 22-26

scholarly journals Diabetic Foot Ulcer: An Easy and Comprehensive Approach

2020 ◽  
Author(s):  
Imran Ali Shaikh ◽  
Naila Masood Sddiqui ◽  
Javeria Hameed Shaikh
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Microvascular Dysfunction ◽  
Complex Problem ◽  
Nerve Damage ◽  
Ulcer Formation ◽  
Foot Care ◽  
Foot Problems

Foot problems are commonly involved in diabetes, and the most common presentation of diabetes is an ulcer. Diabetic foot ulcer is a complex problem caused by reduced blood supply, nerve damage, or infection. But unfortunately in most of cases, these three factors have played a role for impairment of diabetic feet. Sometimes nerve damage or neuropathy is an initial insult, and multiple times ischemia is the leading factor for ulcer formation. After certain period, infection finally supervenes and makes a sterile ulcer to infected leads to loss of limb or foot. This becomes more complicated because of less pronounced ischemic symptoms in diabetic than non-diabetics. Furthermore, the healing of a neuroischemic ulcer is slowed down by microvascular dysfunction. Therefore, some ulcers can get better by revascularization, but pure ischemic ulcers rarely respond to revascularization. Many guidelines have largely ignored these specific demands related to ulcerated neuroischemic diabetic feet. Any diabetic foot ulcer should always be considered to have vascular impairment unless otherwise proven. This chapter highlights the best way to diagnose and treat these patients with diabetic foot ulcer. Most of the studies dealing with neuroischemic diabetic feet are not comparable in terms of patient populations, interventions, or outcomes. Therefore, there is an urgent need for a paradigm shift in diabetic foot care, that is, a new approach and classification of diabetics with foot ulcer in regard to clinical practice and research.

scholarly journals Prevention and treatment of diabetic foot ulcers

2017 ◽  
Vol 110 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Jonathan Zhang Ming Lim ◽  
Natasha Su Lynn Ng ◽  
Cecil Thomas
Keyword(s):  
Diabetic Foot ◽  
Healthcare Access ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Healthcare Provision ◽  
Foot Complications

The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

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 Pathogenesis and management of diabetic foot ulcers

2018 ◽  
Vol 5 (11) ◽  
pp. 4953 ◽  
Author(s):  
Yousif Alsanawi ◽  
Hassan Alismail ◽  
Mustafa AlabdRabalnabi ◽  
Hattan Alturki ◽  
Abdullah Alsuhaibani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Management Strategies ◽  
Blood Glucose Control ◽  
Disease Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Amputation ◽  
Wound Debridement ◽  
Significant Impairment

Diabetes mellitus is a major healthcare issue worldwide, and the trends keep rising. Diabetic foot ulcer is a morbidity associated with the disease process and causes significant impairment in quality of life due to its severe complications including infection, gangrene, and amputation. In this study, we aim to understand the pathogenesis of diabetic foot ulcer, its complications, and management strategies. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1970 to March 2017. The following search terms were used: diabetic foot ulcer, complications of diabetes mellitus, foot gangrene, surgical debridement of foot ulcer, osteomyelitis. Diabetic foot ulcer is a common morbidity in patients with diabetes mellitus, which can lead to lower limb amputation unless a prompt, rational, multidisciplinary approach to therapy is taken. Proper management can ensure successful and fast healing which includes patient education, blood glucose control, wound debridement, advanced dressing, offloading, and surgery.

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