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diabetic foot ulceration

Elizabeth F McElroy
Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is an automated system used to deliver, dwell, and remove topical solutions from the wound bed. Recently, a reticulated open cell foam dressing with through holes (ROCF-CC) was developed, which assists with wound cleansing by removing thick exudate and infectious materials. We present our experience using NPWTi-d with ROCF-CC on complex wounds when complete surgical debridement was inappropriate because of medical instability, recurrent non-viable tissue, or palliative treatment plan...
February 19, 2019: International Wound Journal
Ning Wang, Bo-Hua Yang, Gang Wang, Yu Gao, Xin Cao, Xiao-Fu Zhang, Cheng-Cheng Yan, Xiao-Tong Lian, Bo-Hong Liu, Shang Ju
OBJECTIVE: To clarify and quantify risk factors among local characteristics of the foot for major amputation in diabetic foot patients. METHODS: Articles published before January 2018 on PubMed and Embase were conducted observational studies about risk factors for major amputation in patients with diabetic foot were retrieved and systematically reviewed by using Stata 12.0 statistical software. RESULTS: A total of 4668 major amputees and 65 831 controls were reported in 18 observational studies...
February 19, 2019: Journal of Cellular Biochemistry
Shazli Azmi, Maryam Ferdousi, Alise Kalteniece, Hamad Al-Muhannadi, Abdulrahman Al-Mohamedi, Nebras H Hadid, Salah Mahmoud, Harun A Bhat, Hoda Y A Gad, Adnan Khan, Georgios Ponirakis, Ioannis N Petropoulos, Uazman Alam, Rayaz A Malik
The diagnosis and management of diabetic neuropathy can be a major challenge. Late diagnosis contributes to significant morbidity in the form of painful diabetic neuropathy, foot ulceration, amputation, and increased mortality. Both hyperglycaemia and cardiovascular risk factors are implicated in the development of somatic and autonomic neuropathy and an improvement in these risk factors can reduce their rate of development and progression. There are currently no US Food and Drug Administration (FDA)-approved disease-modifying treatments for either somatic or autonomic neuropathy, as a consequence of multiple failed phase III clinical trials...
2019: Therapeutic Advances in Endocrinology and Metabolism
Juanzi Zhang, Wenxian Hu, Qixian Diao, Zhaowei Wang, Jin Miao, Xiao Chen, Zhijun Xue
The present study aimed to explore the therapeutic effect and underlying mechanism of epidermal growth factor (EGF) on the wound healing of diabetic foot ulcers (DFU). A total of 48 rabbits with DFU were randomly divided into 2 groups, comprising the treatment and control groups. Full-thickness skin (10×10 mm) was excised from the thigh of each rabbit. The wounds in the treatment group were treated with 100 mg/l EGF once a day for 1 month. The control group received no treatment. At 20 days following treatment, new granulation tissues that formed beyond the edge of the wound were collected for subsequent analysis...
March 2019: Experimental and Therapeutic Medicine
Alexander W W Langford-Smith, Ahmad Hasan, Ria Weston, Nicola Edwards, Alan M Jones, Andrew J M Boulton, Frank L Bowling, S Tawqeer Rashid, Fiona L Wilkinson, M Yvonne Alexander
Endothelial colony forming progenitor cell (ECFC) function is compromised in diabetes, leading to poor vascular endothelial repair, which contributes to impaired diabetic foot ulcer healing. We have generated novel glycomimetic drugs with protective effects against endothelial dysfunction. We investigated the effect of glycomimetic C3 on the functional capacity of diabetic ECFCs. ECFCs were isolated from healthy controls and patients with diabetes with neuroischaemic (NI) or neuropathic (NP) foot ulcers. Functionally, diabetic ECFCs demonstrated delayed colony formation (p < 0...
February 19, 2019: Scientific Reports
Ju-Yi Li, Zhong-Jing Wang, Ai-Ping Deng, Yu-Ming Li
Objectives: Chronic foot ulceration is a severe complication of diabetes, driving morbidity and mortality. The aim of our study was to identify novel biomarkers of impaired wound healing in diabetic foot ulcers. Methods: 109 patients with neuropathic diabetic foot ulcers and 30 burn victims otherwise healthy participated. Antibody-coated glass slide arrays were used to determine the levels of 80 human cytokines in pooled plasma or pooled wound exudate of diabetic foot ulcers with rapidly healing (RH, n = 12) and matched nonhealing (NH, n = 12) patients...
2019: Journal of Diabetes Research
Tao Li, Yu Ma, Min Wang, Tao Wang, Jing Wei, Rui Ren, Min He, Guixue Wang, Johnson Boey, David G Armstrong, Wuquan Deng, Bing Chen
Aim: This study was designed to examine the potential mechanism underlying these roles of platelet-rich plasma in treating diabetic foot ulcers (DFUs). Methods: Staphylococcus aureus and HaCaT were co-cultured under high glucose conditions to serve as an in vitro model for infected cells in DFUs. Platelet-rich gel (PRG) or extract liquid of platelet-rich gel (EPG) were used to interfere with the model to observe the growth of HaCaT cells and S. aureus , and the effect of miR-21 changes in HaCaT cells on PDCD4, NF-κB activity and related inflammatory factors...
2019: Infection and Drug Resistance
Pei-Yueng Lee, Pui-Wah Kong, Yong-Hao Pua
BACKGROUND: Previous reliability studies on peak plantar pressure measurements in patients with previous diabetic foot ulceration (DFU) did not stratify their analyses according to whether the foot had a previous ulcer. RESEARCH QUESTION: Does test-retest reliability of peak foot pressure measurements from the various foot regions differ between the ulcerated and non-ulcerated feet? METHODS: Data from 23 participants with peripheral neuropathy and healed plantar DFU were analysed in this test-retest reliability comparison study...
February 4, 2019: Gait & Posture
Jesús Martín-Vaquero, Ascensión Hernández Encinas, Araceli Queiruga-Dios, Juan José Bullón, Alfonso Martínez-Nova, Jose Torreblanca González, Cristina Bullón-Carbajo
One of the diseases that could affect diabetic patients is the diabetic foot problem. Unnoticed minor injuries and subsequent infection can lead to ischemic ulceration, and may end in a foot amputation. Preliminary studies have shown that there is a positive relationship between increased skin temperature and the pre⁻ulceration phase. Hence, we have carried out a review on wearables, medical devices, and sensors used specifically for collecting vital data. In particular, we are interested in the measure of the foot⁻temperature...
February 14, 2019: Sensors
José Luis Lázaro-Martínez, Yolanda García-Álvarez, Francisco Javier Álvaro-Afonso, Esther García-Morales, I Sanz-Corbalán, Raúl Juan Molines-Barroso
OBJECTIVE: To describe the outcomes of a new product based on negatively charged polystyrene microspheres (NCM) technology, in non-responding diabetic foot ulcers (DFU). METHODS: A clinical case series of patients with a hard-to-heal DFU treated with NCM were recruited between March and June 2017 in a specialised diabetic foot unit. DFUs were treated daily with NCM over four weeks, although the health professional could decide to continue NCM treatment in some patients...
February 2, 2019: Journal of Wound Care
Safak Ozer Balin, Ayse Sagmak Tartar, Kader Uğur, Faruk Kilinç, Selda Telo, Ali Bal, Mehmet Balin, Ayhan Akbulut
This study was undertaken to evaluate the diagnostic and prognostic values of pentraxin-3 (PTX-3) in patients with infected diabetic foot ulcers (IDFU) as well as to assess the association between PTX-3 levels and IDFU severity. This study included 60 IDFU patients (Group 1), 45 diabetic patients without DFU (Group 2), and 45 healthy controls. Patients with IDFU were divided into mild, moderate, and severe subgroups based on classification of clinical severity. Patients who underwent amputation were also documented...
February 15, 2019: International Wound Journal
Musarrat Riaz, Zahid Miyan, Nazish Waris, Syed I H Zaidi, Bilal Tahir, Asher Fawwad, Abdul Basit
To compare the outcomes of diabetic foot ulcers (DFU) in terms of healing and lower extremity amputation (LEA) rate before and after training of multidisciplinary foot care team (MDFCT). Subjects were categorised into two groups; Group-A cases seen between 1997 and 2006 (before upgrading of training and services of MDFCT) and Group-B cases seen between 2007 and 2016 (after upgrading of training and services of MDFCT). Baseline demographic characteristics, biochemical results, and outcomes of DFU in terms of healing or amputation were analysed by using statistical package social science (SPSS) version 20...
February 15, 2019: International Wound Journal
Michael L Anthony, Kimberly S Cravey, Said A Atway
Only a small percentage of the general diabetic population develops Charcot neuroarthropathy. Charcot arthropathy greatly increases the risk of foot complications. At our academic institution, there appeared to be an increased incidence of Charcot arthropathy in transplant patients. We hypothesized that Charcot neuroarthropathy incidence is higher in the diabetic patients who had received kidney or kidney-pancreas transplants. The charts of 1000 patients were reviewed from January 2000 to January 2011. Four hundred and eighty-seven patients were included in the study...
February 11, 2019: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Anıl Murat Öztürk, Meltem Taşbakan, Dilek Yeşim Metin, Can Yener, Serhat Uysal, Ilgın Yıldırım Şımşır, İlgen Ertam, Hüsnü Pullukçu, Bilgin Arda, Şevki Çetinkalp
Background/aim: Clinicians often neglect fungal infections and do not routinely investigate deep tissue from the wound for fungal culture and sensitivity due to insufficient information in the literature. In this study, we aimed to evaluate fungal etiology of invasive fungal diabetic foot which is rarely reported in the literature. Materials and methods: The patients who were unresponsive to antibiotic therapy and those with positive fungal in bone or deep tissue culture were enrolled in the study...
February 11, 2019: Turkish Journal of Medical Sciences
Francisco Javier Álvaro-Afonso, José Luis Lázaro-Martínez, Nikolaos Papanas
Diabetic foot ulcers (DFUs) have a complex pathophysiology and require an expert multidisciplinary treatment. There are several, both systemic and local, risk factors for DFUs. A recent meta-analysis of 18 studies has now provided robust evidence on the detrimental effect of smoking on healing of DFUs. Indeed, healing rates were consistently lower among smokers than among nonsmokers. Based on this new evidence, it is reasonable to consider the utility of smoking cessation programs. Incorporation of the latter into the holistic therapeutic strategy for DFUs may be anticipated to improve healing rates, but this remains to be shown...
December 2018: International Journal of Lower Extremity Wounds
Kimie Takehara, Makoto Oe, Yumiko Ohashi, Yuichiro Tsunemi, Takashi Kadowaki, Hiromi Sanada
PURPOSE: The primary aim of this study was to compare patient reported versus clinician-observed nonulcerative foot conditions in patients attending a diabetic foot clinic and deemed at risk for diabetic foot ulcers. DESIGN: Retrospective review of medical records. SUBJECTS AND SETTING: The medical records of 126 patients with diabetes mellitus and deemed at risk for developing diabetic foot ulcers were reviewed. All patients received care from a diabetic foot outpatient clinic in a university-based hospital in Tokyo, Japan, between November 2008 and October 2009...
February 8, 2019: Journal of Wound, Ostomy, and Continence Nursing
Andrew J Hale, Emily Vicks, Mary T LaSalvia, John M Giurini, Adolf W Karchmer
Diabetic foot infections are a common cause of morbidity and mortality in the United States, and successful treatment often requires an aggressive and prolonged approach. Recent work has elucidated the importance of appropriate therapy for a given severity of diabetic foot infection, and highlighted the ongoing risk such patients have for subsequent invasive life-threatening infection should diabetic foot ulcers fail to heal. The authors describe the case of a man with diabetes who had prolonged, delayed healing of a diabetic foot ulcer...
November 2018: Journal of the American Podiatric Medical Association
Francisco Javier Álvaro-Afonso, Jose Luis Lázaro-Martínez, Yolanda García-Álvarez, Nikolaos Papanas
No abstract text is available yet for this article.
December 2018: Annals of Translational Medicine
Yolanda García-Álvarez, José Luis Lázaro-Martínez, Raúl Juan Molines-Barroso
No abstract text is available yet for this article.
December 2018: Annals of Translational Medicine
Linda Wennberg, Sarah Widgren, Rimma Axelsson, Kurt Gerok-Andersson, Börje Åkerlund
AIM: To investigate at a national level the multidisciplinary team (MDT) care of patients with diabetes mellitus and foot complications. METHODS: A questionnaire was sent to all 75 Swedish hospitals with emergency departments, which were grouped according to size. RESULTS: The response rate was 92 %, 58/69 of the hospitals have a foot team. Most teams have access to an internal medicine specialist/diabetologist, podiatrist and orthotist. Fewer teams reported access to an orthopaedic surgeon and infectious diseases specialist and only half to a vascular surgeon...
February 7, 2019: Diabetes Research and Clinical Practice
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