Use of GBT013, a Collagen-Based Dressing, for the Healing of Diabetic Foot Ulcers

2018 ◽  
Vol 108 (5) ◽  
pp. 419-429
Author(s):  
Isabelle J. Dumont ◽  
Marc Lepeut ◽  
Coralie Segalen ◽  
Yannis Guillemin ◽  
Jean Noel Gouze
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Complete Healing ◽  
Ease Of Use ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Foot Care ◽  
University Of Texas

The number of people with diabetes is expected to reach 592 million in the year 2035. Diabetic foot lesions are responsible for more hospitalizations than any other complication of diabetes. The aims of this study were to examine for the first time a new biocompatible and biodegradable tridimensional collagen-based matrix, GBT013, in humans for diabetic foot ulcer wound healing and to evaluate its ease of use to better define a protocol for a future clinical trial. Seven adult patients with a diabetic foot ulcer of grade 1A to 3D (University of Texas Diabetic Wound Classification) were treated using GBT013, a new collagen-based advance dressing and were monitored in two specialized foot care units for a maximum of 9 weeks. Five of seven wounds achieved complete healing in 4 to 7 weeks. Nonhealed ulcers showed a significant reduction of the wound surface (>44%). GBT013 was well tolerated and displayed positive wound healing outcomes as a new treatment strategy of chronic foot ulcers in diabetic patients.

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

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.

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 Effectiveness of Topical Insulin Dressing in Healing of Diabetic Foot Ulcer among Diabetic Patients

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 158-161
Author(s):  
Meena P ◽  
Monisha V
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Sampling Technique ◽  
Diabetic Patients ◽  
Chronic Hyperglycemia ◽  
Post Test ◽  
Quasi Experimental ◽  
The Rich

Diabetes is previously known as the disease of the rich people, but now there is  no partiality between the rich and poor and it has become the third leading cause of  death. Diabetic Mellitus (DM) is a metabolic issue that is characteristics by  chronic hyperglycemia; it is a typical and conceivably persistent disease. The  aims of the present study to assess the effectiveness of insulin dressing of the diabetic foot ulcer among diabetic patients. A quasi-experimental research design with  purposive sampling technique was adopted to conduct a study among 30 diabetic foot ulcer patients. Demography data was collected and wound was measured and insulin dressing was done. After one week the wound was measured. Confidentiality was maintained throughout the procedure. The collected data were analyzed by using descriptive and inferential statistics. Among 30 samples pretest mean score of wound healing among patients with diabetic foot ulcer in the topical insulin dressing was 2.67±0.66 and the post test mean score was 1.43±0.57. The calculated paired ‘t’ test  value of t = 15.703 was found to be statistically highly significant at p<0.001 level.  The above finding clearly infers that topical insulin dressing to patients with diabetic foot ulcer had significant effect which resulted in the improvement in the level of  wound healing among patients with diabetic foot ulcer.

scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

Reducing Lower Extremity Amputations Due to Diabetes: The Application of Diabetic-Foot Protocol in Chiang Mai University Hospital

2008 ◽  
Vol 7 (2) ◽  
pp. 88-92 ◽  
Author(s):  
Kittipan Rerkasem ◽  
Natapong Kosachunhanun ◽  
Siam Tongprasert ◽  
Krit Khwanngern ◽  
Anuchart Matanasarawoot ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Standard Care ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
University Hospital ◽  
Diabetic Patients ◽  
Foot Care ◽  
Care Groups ◽  
Patients With Diabetes ◽  
Foot Disease

The aim of this study was to determine whether intensive treatment and education strategies for diabetic patients with ulcers help in preventing leg amputation. From August 2005 to March 2007, a diabetic-foot protocol using a multidisciplinary approach was applied at our hospital. All the subjects were educated regarding diabetic-foot disease and its complications and prevention. This report compares the amputation rate in patients receiving the protocol care from August 2005 to March 2007 with those who had standard care from August 2003 to July 2005. Seventy-three and 110 diabetic-foot ulcer patients received protocol and standard foot care, respectively. The incidence of major amputations in the protocol and standard care groups was 4.1% and 13.6%, respectively ( P = .03). Our protocol was associated with improved diabetic-foot care outcomes. It can be used by any hospital to improve outcomes for patients with diabetes.

Characteristics of microbial drug resistance and its correlates in chronic diabetic foot ulcer infections

2014 ◽  
Vol 63 (10) ◽  
pp. 1377-1385 ◽  
Author(s):  
Thokur S. Murali ◽  
Shettigar Kavitha ◽  
Jain Spoorthi ◽  
Deepika V. Bhat ◽  
Alevoor S. Bharath Prasad ◽  
...  
Keyword(s):  
Immune Response ◽  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Wound Healing Process ◽  
Diabetic Patients ◽  
Bacterial Strains ◽  
Microbial Drug Resistance

While virulence factors and the biofilm-forming capabilities of microbes are the key regulators of the wound healing process, the host immune response may also contribute in the events following wound closure or exacerbation of non-closure. We examined samples from diabetic and non-diabetic foot ulcers/wounds for microbial association and tested the microbes for their antibiotic susceptibility and ability to produce biofilms. A total of 1074 bacterial strains were obtained with staphylococci, Pseudomonas, Citrobacter and enterococci as major colonizers in diabetic samples. Though non-diabetic samples had a similar assemblage, the frequency of occurrence of different groups of bacteria was different. Gram-negative bacteria were found to be more prevalent in the diabetic wound environment while Gram-positive bacteria were predominant in non-diabetic ulcers. A higher frequency of monomicrobial infection was observed in samples from non-diabetic individuals when compared to samples from diabetic patients. The prevalence of different groups of bacteria varied when the samples were stratified according to age and sex of the individuals. Several multidrug-resistant strains were observed among the samples tested and most of these strains produced moderate to high levels of biofilms. The weakened immune response in diabetic individuals and synergism among pathogenic micro-organisms may be the critical factors that determine the delicate balance of the wound healing process.

scholarly journals Risk factor and Outcomes of Diabetic Foot Ulcer among Diabetes Mellitus Patients Admitted to Nekemte Referral Hospital, Western Ethiopia:Prospective cohort study

2019 ◽  
Author(s):  
Firomsa Bekele ◽  
Legese Chelkeba ◽  
Ginenus Fekadu ◽  
Kumera Bekele
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Risk Factor ◽  
Cohort Study ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Referral Hospital ◽  
Foot Ulcers ◽  
Diabetic Patients

Abstract Background:Foot problems are very common in people with diabetes affecting up to 15% of diabetic patients during their lifetime throughout the world. Foot ulcers significantly contribute to morbidity and mortality of patients with diabetes mellitus. The diabetic patients with foot ulcers require long-term hospitalization and carry the risk of limb amputation. Despite this, no study has been done on risk factor and outcomes of diabetic foot ulcer in NRH. Methods: A general prospective cohort study of diabetes mellitus patients who had diabetic foot ulcer was conducted among diabetes patients of Nekemte referral hospital (NRH) from March15 to June 15, 2018. The Wagner classification of diabetic foot ulcer was used to assess the severity of foot ulcers. Multivariate logistic regression was used to analyze the associations between dependent variable and independent variables. Results: Over the study period, 115 diabetes foot ulcer patients were admitted to the Nekemte referral hospital; of these patients, 35(30.43%) were under gone (minor and major amputations) and 80(69.57%) were healed. Grade of diabetic foot ulcerAOR=1.7; 95% CI: 1.604, 4.789,inappropriate antibioticsAOR = 2.526; 95% CI: 1.767, 8.314, Overweight AOR = 2.767; 95% CI: 1.827, 9.252, obesity AOR = 3.020; 95% CI: 2.556, 16.397,blood glucose controlAOR = 2.592; 95% CI: 1.937, 7.168, and neuropathy AOR = 1.565; 95% CI: 1.508, 4.822 were found to be a risk factor for amputation in multivariable logistic regression analysis. Conclusion: Blood glucose level, higher body mass index (BMI), inappropriate antibiotics given, neuropathy, and advanced grade of diabetic foot ulcer were independent predictors of amputation. Provision of special emphasis for patients having neuropathy and advanced grade of diabetic foot ulcer, decreasing excessive weight gain, managing hyperglycemia, and appropriate antibiotics prescription practice would decrease outcomes of diabetic foot ulcer. Key words:Diabetic Foot Ulcer, Risk Factors, Outcomes,Nekemte Referral hospital

scholarly journals Integrative Analysis of miRNA Expression Profiling of Diabetic Foot Ulcers Wound Treated With Zizhu Ointment

2021 ◽  
Author(s):  
Xiaoming Hu ◽  
Renyan Huang ◽  
Wenhui Li ◽  
Xiao Yang ◽  
Weijing Fan ◽  
...  
Keyword(s):  
Wound Healing ◽  
Chinese Medicine ◽  
Diabetic Foot ◽  
Expression Profiling ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Differentially Expressed Mirnas ◽  
Mirna Expression Profiling

Abstract Background: A major complication of diabetes is diabetic foot ulcers. Millions of patients suffer from the physiological and psychosocial effects of diabetic foot ulcers. However, the current treatment is not effective, and the patients’ prognosis has not been significantly improved.Results: Traditional Chinese medicine-Zizhu ointment exhibited its own characteristics and advantages in treating diabetic foot ulcer by promoting wound healing. The mechanism of Zizhu ointment promoting diabetic foot ulcer wound healing was explored by detecting its miRNA expression profiling. Eighty-three differentially expressed miRNAs were identified, 30 of which were upregulated and 53 were downregulated in diabetic cutaneous wounds treated with Zizhu ointment. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the differentially expressed miRNAs showed that they were involved in several pathways that could regulate the proliferation, differentiation, apoptosis, migration, and secretion of tissue repair cells, and were linked to inflammatory cells, the extracellular matrix, growth factors, and other relevant factors related to wound healing. Furthermore, miRNA-Target regulatory network and protein-protein interaction network were constructed. Twenty hub genes of networks were obtained.Conclusions: Our preliminary study provides a new alternative drug treatment for diabetic foot ulcers by traditional Chinese medicine, and will assist in better understanding its therapeutic targets.

scholarly journals Determinants of wound healing in patients hospitalized for diabetic foot ulcer: results from the MEDFUN study

2020 ◽  
Vol 54 (3) ◽  
pp. 207-216
Author(s):  
Ignatius U. Ezeani ◽  
Ejiofor T. Ugwu ◽  
Funmi O. Adeleye ◽  
Ibrahim D. Gezawa ◽  
Innocent O. Okpe ◽  
...  
Keyword(s):  
Wound Healing ◽  
Renal Impairment ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Adverse Outcomes ◽  
Diabetic Patients ◽  
Chi Square ◽  
Grade 3

AbstractObjective. The high amputation rates from diabetic foot ulcer (DFU) in Nigeria and prolonged hospitalization due to poor wound healing is a source of concern. Furthermore, factors that affect wound healing of DFUs have not yet been well studied in Nigeria, whereas knowing these factors could improve DFU outcomes. Therefore, the objective of this study was to determine the factors that are associated with the wound healing in patients hospitalized for DFU.Methods. The Multi-Center Evaluation of Diabetic Foot Ulcer in Nigeria (MEDFUN) was an observational study involving 336 diabetic patients hospitalized for DFU and managed by a multi-disciplinary team until discharge or death. Demographic, clinical, and biochemical characteristics were documented. Test statistics used were chi square, t-test, univariate, and multivariate logistic regression. The study endpoints were ulcer healing, LEA, duration of hospitalization, and mortality. Here we present data on wound healing.Results. The mean ± SD age was 55.9±12.5 years. Univariate predictors of wound healing were ulcer duration more than 1 month prior to hospitalization (p<0.001), peripheral arterial disease (PAD) (p<0.001), foot gangrene (p<0.001), Ulcer grade ≥3 (p=0.002), proteinuria (p=0.005), anemia (p=0.009), renal impairment (p=0.021), glycated hemoglobin ≥7% (0.012), and osteomyelitis (p<0.001). On multivariate regression, osteomyelitis was the strongest independent predictor of wound healing after adjusting for all other variables (OR 0.035; 95% CI 0.004–0.332). This was followed by PAD (OR 0.093; 95% CI 0.028–0.311), ulcer duration >1 month (OR 0.109; 95% CI 0.030–0.395), anemia (OR 0.179; 95% CI 0.056–0.571).Conclusion. Presence of osteomyelitis, duration of ulcer greater than 1 month, PAD, Wagner grade 3 or higher, proteinuria, presence of gangrene, anemia, renal impairment, and HbA1c ≥7% were the significant predictors of wound healing in patients hospitalized for DFU. Early identification and prompt attention to these factors in a diabetic foot wound might significantly improve healing and reduce adverse outcomes such as amputation and death.

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