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Prevention diabetic foot ulcer

Dong-Lin Xia, Yan-Pei Chen, Yu-Fei Wang, Xiao-Dong Li, Ning Bao, Hong He, Hai-Ying Gu
OBJECTIVES: Diabetic patients are at increased risk of severe skin infections. Covering the wound as early as possible can prevent infection and shorten the course of treatment. In this study, the authors fabricated a waterproof and breathable composite liquid dressing (CLD) that formed a barrier to bacteria and shortened healing time of diabetic rat skin ulcers. METHODS: The CLD was prepared in a formulation that, on evaporation of the liquid carrier, acts as a waterproof, breathable coating on injured skin...
November 2016: Advances in Skin & Wound Care
Sui-Whi Jane, Ming-Shyan Lin, Wen-Nan Chiu, Randal D Beaton, Mei-Yen Chen
OBJECTIVES: To explore the prevalence, discomfort, and self-relief behaviours of painful diabetic neuropathy (PDN) among rural community residents with type 2 diabetes. DESIGN: A community-based, cross-sectional study. SETTING: This study was part of a longitudinal cohort study of a nurse-led health promotion programme for preventing foot ulceration in Chiayi County, Taiwan. PARTICIPANTS: Six hundred and twenty-eight community adults with type 2 diabetes participated in this study...
October 3, 2016: BMJ Open
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
E López-Gavito, P Parra-Téllez, J Vázquez-Escamilla
Diabetes mellitus is a major chronic degenerative disease, which currently is taking on alarming proportions in the population of our country. Neuropathic arthropathy is one of the most interesting degenerative joint disorders and increasingly common within the orthopedic pathology. It is defined as a progressive degenerative arthropathy, chronic and affecting one or more peripheral joints, and develops as a result of the lack of sensory perception normal in the innervation of joints. As a result the joints of the feet are subjected to trauma and repetitive injury causing a neurotraumatic effect with progressive damage to the joints of the hindfoot, midfoot and forefoot...
January 2016: Acta Ortopédica Mexicana
Ibrahim S Al-Busaidi, Nadia N Abdulhadi, Kirsten J Coppell
Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002-2013, 47...
August 2016: Sultan Qaboos University Medical Journal
Pengzi Zhang, Jing Lu, Yali Jing, Sunyinyan Tang, Dalong Zhu, Yan Bi
Diabetic foot is a severe public health issue, yet rare studies investigated its global epidemiology. Here we performed a systematic review and meta-analysis through searching PubMed, EMBASE, ISI Web of science and Cochrane database. We found that that global diabetic foot ulcer prevalence was 6.3% (95%CI: 5.4%-7.3%), which was higher in males (4.5%, 95%CI: 3.7%-5.2%) than in females (3.5%, 95%CI: 2.8%-4.2%), and higher in type 2 diabetic patients (6.4%, 95%CI: 4.6%-8.1%) than in type 1 diabetics (5.5%, 95%CI: 3...
September 1, 2016: Annals of Medicine
Geisa Maria Campos de Macedo, Samanta Nunes, Tania Barreto
Skin disorders, usually neglected and frequently underdiagnosed among diabetic patients, are common complications and encounter a broad spectrum of disorders in both type 1 and type 2 diabetes mellitus (DM)-e.g. cutaneous infection, dry skin, pruritus. Skin disorders are highly associated with increased risk of important outcomes, such as skin lesions, ulcerations and diabetic foot, which can lead to major complications and revolve around multifactorial factors besides hyperglycemia and advanced glycation end products...
2016: Diabetology & Metabolic Syndrome
Alessandra M Mantovani, Cristina E P T Fregonesi, Mariana R Palma, Fernanda E Ribeiro, Rômulo A Fernandes, Diego G D Christofaro
: Individuals with diabetes develop lower extremity amputation for several reasons. Investigations into pathways to the development of complications are important both for treatment and prevention. AIM: To evaluate the relationship between amputation and risk factors in people with diabetes mellitus. MATERIALS AND METHOD: All participants included in this study (n=165) were recruited from the Diabetic Foot Program, developed in a Brazilian University, over seven years (2007-2014) and all information for this study was extracted from their clinical records...
August 23, 2016: Diabetes & Metabolic Syndrome
Joseph A Molnar, Lucian G Vlad, Tuna Gumus
There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished...
September 2016: Plastic and Reconstructive Surgery
Sicco A Bus
BACKGROUND: An increased plantar pressure is a causative factor in the development of plantar foot ulcers in people with diabetes mellitus, and ulcers are a precursor of lower extremity amputation. METHODS: In this article, the evidence is reviewed that relieving areas of increased plantar pressure (ie, offloading) can heal plantar foot ulcers and prevent their recurrence. RESULTS: Noninfected, nonischemic neuropathic plantar forefoot ulcers should heal in 6 to 8 weeks with adequate offloading...
September 2016: Plastic and Reconstructive Surgery
Olivia B Hughes, Adele Rakosi, Flor Macquhae, Ingrid Herskovitz, Joshua D Fox, Robert S Kirsner
BACKGROUND: Wound healing is a dynamic process whereby cells, growth factors (GFs), and the extracellular matrix (ECM) interact to restore the architecture of damaged tissue. Chronic wounds can be difficult to treat due to the increased presence of inflammatory cells that degrade the ECM, GF, and cells necessary for wound healing to occur. Cellular and acellular matrix products can be used in the management of a variety of chronic wounds including venous, diabetic, and pressure ulcers and other conditions such as burns, epidermolysis bullosa, pyoderma gangrenosum, and surgical wounds...
September 2016: Plastic and Reconstructive Surgery
Gustav Jarl, Lars-Olov Lundqvist
INTRODUCTION: Therapeutic shoes are prescribed to prevent diabetic foot ulcers, but adherence to wearing the shoes is often poor. AIM: The aim of this study was to review the literature on factors that are associated with adherence to wearing therapeutic shoes and construct a model of adherence to aid future research and development in the field. METHODS: We conducted a systematic search in PubMed, CINAHL, and PsycINFO for quantitative studies on factors associated with adherence to wearing therapeutic shoes among people with diabetes...
2016: Patient Preference and Adherence
Cynthia A Luu, Ethan Larson, Timothy M Rankin, Jennifer L Pappalardo, Marvin J Slepian, David G Armstrong
We report on the use of free fat grafting as a means of redistributing normal and shear stress after healing of plantar diabetic foot wounds. Although fat augmentation (lipofilling) has been described previously as an approach to supplement defects and prevent atrophy, including use as an adjunct to wound healing and to mitigate pain in the foot, we are unaware of any reports in the medical literature that have described its use in the high-risk diabetic foot in remission. An active 37-year-old man with type 2 diabetes and neuropathy presented with gangrene of his fifth ray, which was amputated...
July 2016: Plastic and Reconstructive Surgery. Global Open
Lisa Heuch, Judith Streak Gomersall
BACKGROUND: The incidence of foot ulceration related to diabetes is increasing. Many foot care professionals recommend offloading measures as part of management strategies for modulating excess pressure to prevent development of diabetic foot ulcers (DFUs). These measures may include padding, insoles/orthotic devices and footwear. There is a lack of evidence-based guidance on the effectiveness of the different offloading options for preventing primary ulceration in those with diabetes...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
Yusuke Mineoka, Michiyo Ishii, Akiko Tsuji, Yoriko Komatsu, Yuko Katayama, Mitsuko Yamauchi, Aki Yamashita, Yoshitaka Hashimoto, Naoto Nakamura, Yasukazu Katsumi, Motohide Isono, Michiaki Fukui
BACKGROUND: Foot ulceration is a serious problem for patients with type 2 diabetes and early detection of risks for this condition is important for preventing complications. We conducted a cross-sectional study in patients with type 2 diabetes to determine the relationship between limited joint mobility (LJM) of hand and diabetic foot risk classified using the criteria of the International Working Group on the Diabetic Foot (IWGDF). METHODS: Relationships of LJM of hand and the foot risk with the IWGDF category, hemoglobin A1c, age, body mass index, blood pressure, estimated glomerular filtration (eGFR), diabetic complications including diabetic peripheral neuropathy (DPN), and peripheral arterial disease (PAD) were evaluated in 528 consecutive patients with type 2 diabetes...
August 16, 2016: Journal of Diabetes
Marwa Ahmed, Sherif A Reffat, Amany Hassan, Fikry Eskander
BACKGROUND: Diabetic foot ulcer is considered as a major health problem that predisposes to limb amputation. Among the different methods to achieve ulcer healing, platelet-rich plasma (PRP) gel is gaining popularity. It is thought to stimulate wound closure by providing essential growth factors for healing. This study aims to evaluate the value of autologous PRP gel in the treatment of diabetic ulcers. METHODS: The study included 56 patients of both sex from 18 to 80 years, with clean chronic diabetic foot ulcers divided into 2 equal groups...
August 12, 2016: Annals of Vascular Surgery
Reinout van Crevel, Steven van de Vijver, David A J Moore
Tropical countries are experiencing a substantial rise in type 2 diabetes, which is often undiagnosed or poorly controlled. Since diabetes is a risk factor for many infectious diseases, this increase probably adds to the large infectious disease burden in tropical countries. We reviewed the literature to investigate the interface between diabetes and infections in tropical countries, including the WHO-defined neglected tropical diseases. Although solid data are sparse, patients with diabetes living in tropical countries most likely face increased risks of common and health-care-associated infections, as well as infected foot ulcers, which often lead to amputation...
August 4, 2016: Lancet Diabetes & Endocrinology
R Mahieu, M N O Coenen, T van Bemmel, H J van der Zaag-Loonen, W J Theuvenet
AIMS: Present-day screening of the diabetic foot involves the Semmes Weinstein Monofilament Test for evaluating loss of sensibility, while testing for intrinsic muscle weakness is not implied. Just as with the early detection of sensibility loss, early detection of intrinsic muscle weakness might have important implications for the prevention of both ulceration and deformity in patients with diabetes. The purpose of this study is to investigate the prevalence of patients with diabetes presenting intrinsic muscle weakness of the hallux, but with a normal sensibility of the sole of the foot...
September 2016: Diabetes Research and Clinical Practice
Sarah Malacarne, Bernhard Chappuis, Marc Egli, Isabelle Hagon-Traub, Katrin Schimke, Claude Schönenweid, Bettina Peter-Riesch
Diabetic foot complications are a public health challenge and preventive measures although simple are often not enforced, as evidenced by the lack of decrease in the rate of ulcers and amputation in Switzerland. This article proposes a risk score to grade individual risk of the diabetic patient and an individualized prevention measures as this risk. We discuss the importance of collaboration of various specialists. Two areas are important, first the early involvement of specialists in revascularization because the diabetic population with feet at risk of ulcération risk nowadays primarily has neuro-ichemic ulcerations and also the close collaboration with podiatrists and orthopedic shoemakers who are full partners of the multidisciplinary team...
June 1, 2016: Revue Médicale Suisse
Mehtap Evran, Murat Sert, Tamer Tetiker, Gamze Akkuş, Ömer Sunkar Biçer
Spontaneous calcaneal fractures in diabetic patients without obvious trauma may occur, sometimes accompanying diabetic foot ulcers. In the current study we report four cases who were hospitalized for diabetic foot ulcer with concomitant calcaneal fractures. There were four diabetic patients (one type 1 and three type 2) who registered with diabetic foot ulcers with coexisting calcaneal fractures, all of which were classified as Type A according to Essex Lopresti Calcaneal Fracture Classification. Two of the patients with renal failure were in a routine dialysis program, as well as vascular compromise and osteomyelitis in all of the patients...
July 16, 2016: World Journal of Clinical Cases
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