scholarly journals Fungal Infection: A Hidden Enemy in Diabetic Foot Ulcers

2015 ◽  
Vol 2 (2) ◽  
pp. 74-76
Author(s):  
Saravanan Sanniyasi ◽  
Jagan Balu ◽  
Cunnigaiper Dhanasekharan Narayanan
Keyword(s):  
Antibiotic Therapy ◽  
Fungal Infection ◽  
Antifungal Therapy ◽  
Diabetic Foot ◽  
Fungal Infections ◽  
Asia Pacific ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcers ◽  
Fungal Stain

ABSTRACT Diabetic foot ulcers are on the rise and increasingly associated with amputations. Fungal infections have recently been implicated in the nonhealing nature of these wounds. One hundred five patients treated as in-patients with nonhealing diabetic ulcers in a tertiary care hospital were included in this prospective study. Wound swabs and deep tissue biopsies were taken from these ulcers for fungal stain and culture and bacterial culture. Once the fungal stain or the culture study is positive, oral Fluconazole was started. Nineteen patients grew fungus in the ulcer, commonest species being Candida tropicalis (10.5%). The most common bacterial organism isolated with fungal infection is Pseudomonas followed by Enterococcus. Patients on prolonged antibiotic therapy showed statistically significant increase in fungal infection. Patients who underwent amputation within 15 days of admission were higher in fungal culture positive group, due to progression of ulcer in spite of antibiotic therapy. There is a definite correlation between incidence of amputation and fungal infection in whom antifungal therapy was not started, though not statistically significant. Fourteen patients, who did not undergo amputation, had faster wound healing and lesser progression of disease, with none of them requiring amputation after initiating antifungal therapy. Our study reveals that there is a definite relation between fungal infections and nonhealing nature of diabetic ulcers. Further randomized trials are necessary to substantiate this finding. How to cite this article Sanniyasi S, Balu J, Narayanan CD. Fungal Infection: A Hidden Enemy in Diabetic Foot Ulcers. J Foot Ankle Surg (Asia-Pacific) 2015;2(2):74-76.

scholarly journals Effect of Health Education on Improving the Knowledge among Diabetes Mellitus Patients in the Prevention of Diabetic Ulcer in Regional Hospital of Tidore Island

2021 ◽  
Vol 4 (4) ◽  
pp. 379-384
Author(s):  
Haeril Amir ◽  
Nur Wahyuni Munir
Keyword(s):  
Diabetes Mellitus ◽  
Health Education ◽  
Diabetic Foot ◽  
Regional Hospital ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Diabetic Ulcers

International  Diabetes  Federation  (IDF) reported that the number of diabetes mellitus patients worldwide increases every year. Diabetes mellitus is a chronic disease due to damage to the pancreas in producing enough insulin and characterized by impaired metabolism of fats, increased blood sugar, carbohydrates and protein both absolutely and relatively. Diabetic foot ulcers (DFU) are among the most common complications in diabetic patients and are associated with high mortality, morbidity, and health costs.   This study was to determine the effect of health education on knowledge improvement about diabetic ulcers in the regional hospital of Tidore Islands.  This research is a quasi-experimental type with a pretest-posttest without a control group design. The research sample consisted of 30 respondents who met the inclusion criteria. Data were analyzed using a paired test and processed with statistic version 21. Based on the research results, there was an improved knowledge in pre and post-health education counseling, where the average score before health education counseling was 11.6. After health counseling, the average value was 15.0. The results showed the effect of knowledge in the prevention of diabetic ulcers with a p-value =0,000.  Health education is an effort to improve patient's ability to prevent diabetic foot ulcers that have been proven in several scientific studies. Health education methods provide additional information so that patients who previously wondered about their disease can directly ask health workers. Health education affects the knowledge improvement of Diabetes Mellitus patients in the Regional hospital of Tidore Islands  

Fungal infection in diabetic foot ulcers

2005 ◽  
Vol 22 (8) ◽  
pp. 1124-1125 ◽  
Author(s):  
E. Mlinaric Missoni ◽  
M. Vukelic ◽  
D. de Soy ◽  
M. Belicza ◽  
V. Vazic Babic ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

scholarly journals Clinical study of coexistence of fungal infections in diabetic foot ulcers and its management

2017 ◽  
Vol 4 (12) ◽  
pp. 3943
Author(s):  
Mohammed Raza ◽  
Basavarajendra S. Anurshetru
Keyword(s):  
Diabetic Foot ◽  
Fungal Infections ◽  
Significant Risk ◽  
Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Foot Care ◽  
Culture Methods ◽  
Fungal Isolation ◽  
Diabetic Ulcer

Background: Presently 62 million Indians are diabetics and these numbers are on the rise. Amongst chronic complications of uncontrolled diabetes, foot ulcer is one. Diabetes is the leading cause of non-traumatic lower extremity amputation in developing countries with risk being 15 to 46 times higher. Infections are predominantly polymicrobial, predominantly Aerobic Gram-Positive cocci with higher incidence of anaerobic species and fungal infections. Treatment of fungal infections in diabetic foot ulcers might reduce the disability, morbidity and mortality in diabetic patients.Methods: A total of 100 diabetic foot ulcer patients admitted or who visited to JSS Hospital over a period of 2 years, meeting the inclusion/exclusion criteria of the study, formed the study population. Detailed history, clinical evaluation & necessary investigations were done. Fungal isolation from the ulcer done by 10% KOH study, Gram stain, SDA culture and slide culture methods. Positive patients were treated with antifungal agents. Outcome of the disease studied based on ulcer progression, wound healing and tissue amputations.Results: Polymicrobial flora in diabetic foot ulcers was seen (137 organisms in 100 subjects), predominantly Enterobacteriaceae and Pseudomonas. Prevalence of fungal infections in present study was 19%, of which Candida species was the commonest.Conclusions: Present study signifies the need of mycological evaluation of nonhealing diabetic ulcer, with poor progression despite antibacterial therapy & foot care, introduction of antifungal treatment for proved fungal infections in diabetic foot ulcers, considering fungal infection as significant risk factor.

scholarly journals Use of Cellular and Tissue-based Product in the Treatment of Diabetic Foot Ulcers

2016 ◽  
Vol 3 (2) ◽  
pp. 92-96
Author(s):  
Thomas E Serena ◽  
Raphael A Yaakov ◽  
Eliot N Mostow
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Relevant Literature ◽  
Cost Of Care ◽  
Asia Pacific ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Economic Evaluations ◽  
Diabetic Foot Ulcers

ABSTRACT Introduction The prevalence of diabetes has been rising sharply and the rise in chronic wounds parallels this trend. Lower extremity ulcers present a serious complication for people with diabetes. While debridement of necrotic tissue and off-loading plays an important role in wound healing, many patients with diabetic foot ulcers (DFUs) fail to heal with standard of care (SOC) alone. Unresolved ulcers can lead to complications, such as osteomyelitis and amputation. There continues to be a need for the evaluation of novel wound therapies that can accelerate wound healing and lower the cost of care associated with DFUs. This paper presents recent evidence for the use of cellular and/or tissue-based products (CTPs) and offers an approach for selecting an appropriate CTP. Materials and methods A systematic literature search was conducted using PubMed, Embase, Medline, Cochrane library, and NHS Economic Evaluation Database. Full-length articles in English were assessed for relevance to select studies on effectiveness and economic evaluations. Additionally, Google Scholar was used to gather relevant literature on commonly used CTPs, including Apligraf®, EpiFix®, and Dermagraft®. Findings Results from randomized controlled trials (RCTs) provided evidence for the superior efficacy of CTPs over SOC alone in treatment of chronic DFUs. In recent studies evaluating commonly used CTPs, significantly higher number of DFUs achieved complete closure with EpiFix® when compared to either Apligraf® or Dermagraft®. While cost-effectiveness studies continue to be limited, current literature suggests that CTPs can decrease the long-term costs associated with the care of DFUs by increasing the healing rate, reducing recovery time, and lowering the risk of infection and complications. Cellular and/or tissue-based products (CTPs) may result in higher average number of ulcer-free months and lower average number of amputations or resections compared to SOC alone. How to cite this article Serena TE, Yaakov RA, Mostow EN. Use of Cellular and Tissue-based Product in the Treatment of Diabetic Foot Ulcers. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):92-96.

scholarly journals A Comparative Study between the Use of Negative Pressure Wound Therapy and Silver-Releasing Foam Dressings in the Management of Diabetic Ulcers

2021 ◽  
Author(s):  
George Taliat ◽  
Clement D’Souza
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Treatment Modalities ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Therapy ◽  
Diabetic Ulcers ◽  
Surgical Department

Abstract Introduction Diabetic foot ulcers are one among the most commonly encountered complication of diabetes mellitus tackled by the surgical department worldwide. Negative pressure wound therapy (NPWT) and silver-releasing foam dressings are effective modalities for the treatment of ulcers. This study compares the two treatment modalities. Methods Sixty adult patients admitted with diabetic foot ulcers undergoing NPWT (vacuum-assisted closure [VAC]) or silver-releasing foam dressing (Biatain Ag) treatment were included in the study. Patients undergoing either of the treatment modalities were observed and followed up on a weekly basis prospectively. Wounds were routinely examined for the size of ulcer in area (cm2) and time taken for wound healing. Patients were also assessed qualitatively by means of a questionnaire to find out patient satisfaction and compliance. Results Time taken for wound healing among Biatain Ag group was found to be 24±9.483 days compared with only 19.73±7.575 days in the VAC group. Decrease in size ulcer measured in area was found to be 38.79% in Biatain Ag group, whereas in the VAC group it was found to be 26.56%. Patients were satisfied with both modalities of treatment; however, patient compliance was better for the Biatain Ag Group due to decrease in restriction of mobility and decrease in cost. Conclusion Overall, both modalities of treatment were found to be comparable and can be used with similar efficacy. It can be concluded that silver-releasing foam dressing can act as a beneficial alternative to NPWT in the treatment of diabetic ulcers.

Photodynamic Topical Antimicrobial Therapy for Infected Diabetic Foot Ulcers in Patients With Diabetes: A Case Series

2020 ◽  
pp. 153473462092988
Author(s):  
Enrico Brocco ◽  
Vincenzo Curci ◽  
Roberto Da Ros ◽  
Cesare Miranda ◽  
Giovanni Boschetti ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Fungal Infections ◽  
Case Series ◽  
Healing Time ◽  
Host Cells ◽  
Therapeutic Interventions ◽  
Sufficient Evidence ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Microbial Agents

Diabetic foot ulcers (DFUs) are common, complex, costly complications, associated with frequent recurrences and increased morbidity and mortality. DFUs can be prevented and their healing can be mostly influenced by appropriately and aggressively managing any infection, but the role of antiseptic therapies in reducing healing time lacks sufficient evidence. Several therapeutic interventions have been developed based on the principles of photomedicine to overcome the issue of poor drug circulation in infected areas, with the aim of killing microbial agents while leaving the surrounding host cells unharmed. Such techniques use absorption of photons by specific chromophores. Among these, RLP068 is a tetracationic Zn(II) phthalocyanine derivative activated by exposure to red light, used as a topical treatment for superficial bacterial and fungal infections. The photoactivation of RLP068 results in the production of singlet oxygen and other reactive oxygen species, able to affect a range of cellular targets, including cell membrane and/or wall, cytoplasm, and cellular components, resulting in a rapid, broad range, bactericidal and fungicidal effect. The phase IIa study showed that photoactivated RPL068 is capable of inducing a dose-dependent reduction in total and pathogen microbial load in infected diabetic foot ulcers. In this article, a case series of 22 DFU treated with photoactivated RLP068 at 5 different centers in Italy is presented. Considering microbial agents reduction, ulcer healing facilitation, healing rate (9 DFUs out of 22), and amputation rate (only 1 case over 22), the decrease in the cost of DFU seems to be a point in favor of RLP068 and its cost-effectiveness.

Clinical performance evaluation of a newly developed sock for people with diabetes

2021 ◽  
pp. 095441192110020
Author(s):  
Berna Cüreklibatır Encan ◽  
Arzu Marmaralı ◽  
Dilek Bayraktar ◽  
Şevki Çetinkalp ◽  
Ilgın Yıldırım Şimşir
Keyword(s):  
Diabetic Foot ◽  
Plantar Pressure ◽  
Clinical Performance ◽  
Fungal Infections ◽  
Callus Formation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Metatarsal Bones ◽  
Patients With Diabetes ◽  
Diabetic Wounds

Diabetes mellitus (DM) is a chronic disease that has become a global health problem. As the population of people with diabetes is growing worldwide, the prevalence of complications associated with DM, such as diabetic foot, also increases. Neuropathy and high plantar pressure are the two most frequent causes of foot ulceration. Since diabetic wounds tend to heal slowly, it is crucial to prevent diabetic foot ulcers before they occur. In this study, the efficacy of a sock developed for diabetes in the previous research of the authors was investigated in a clinical study with the participation of patients with diabetes over a 6-month period. At the end of the study, it was observed that none of the participants had experienced any new ulcers, bacterial or fungal infections, or callus formation during this research. Moreover, a slight decrease in pressure was observed for the first, second, and third metatarsal bones when the socks were worn on day 1. On the other hand, pressure reduction was identified for the fourth and fifth metatarsal bones in all following measurements. However, analyses revealed that duration of usage did not have a statistically significant effect on overall plantar pressure. It was also found that pressure on the fourth and fifth metatarsal bones significantly decreased. Assessment of wearing comfort revealed the satisfaction of the patients, as well. Based on the promising outcomes of this clinical evaluation, these socks developed for people with diabetes can be strongly expected to help avoid diabetic foot ulcers.

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