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Management diabetic foot ulcer

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https://www.readbyqxmd.com/read/28532226/novel-biological-therapies-for-the-treatment-of-diabetic-foot-ulcers
#1
Jennifer Adeghate, Syed Nurulain, Kornélia Tekes, Erzsébet Fehér, Huba Kalász, Ernest Adeghate
The number of people with diabetes mellitus (DM) is estimated to exceed 640 million by the year 2040. Diabetic foot ulcer (DFU) is a debilitating illness that affects more than 2% of DM patients. DFU is caused by DM-induced neural and vascular lesions leading to a reduced sensation and microcirculation. The increase in the prevalence of DFU has prompted researchers to find new therapies for the management of DFU. Areas covered: This review presents the current status of novel biological therapies used in the treatment of DFU...
May 22, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28524000/the-effect-of-a-common-antibiotics-doxycycline-on-non-healing-chronic-wound
#2
Dixon H Xu, Ziwen Zhu, Yujiang Fang
Up to 25% of diabetic patients will develop a diabetic foot ulcer. Chronic wounds such as diabetic foot ulcers often fail to heal with conventional therapies. In recent years, it has been identified that chronic wounds are usually associated with elevated level of matrix metalloproteinases (MMPs). Doxycycline, a cheap tetracycline antibiotic, has been shown to inhibit MMPs both in vitro and in vivo independent of its antimicrobial property. In this review, we provide an overview of the roles of MMPs in the pathogenesis of chronic wounds and explore the potential application of doxycycline as a treatment option in managing chronic wounds such as diabetic foot ulcers...
May 18, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28513212/an-optical-fiber-based-smart-textile-smart-socks-to-manage-biomechanical-risk-factors-associated-with-diabetic-foot-amputation
#3
Bijan Najafi, Hooman Mohseni, Gurtej S Grewal, Talal K Talal, Robert A Menzies, David G Armstrong
OBJECTIVE: This study aimed to validate a smart-textile based on fiber-optics for simultaneous measurement of plantar temperature, pressure, and joint angles in patients with diabetic peripheral neuropathy (DPN). METHODS: After in-vitro validation in the laboratory, 33 eligible subjects with DPN were recruited (age: 58 ± 8 years, BMI: 31.5 ± 8 kg/m(2)) for assessing plantar pressure and temperature during habitual gait-speed in a clinical-setting. All participants were asked to walk at their habitual speed while wearing a pair of sensorized socks made from highly flexible fiber optics (SmartSox)...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28497218/to-evaluate-the-efficacy-of-an-acellular-flowable-matrix-in-comparison-with-a-wet-dressing-for-the-treatment-of-patients-with-diabetic-foot-ulcers-a-randomized-clinical-trial
#4
F Campitiello, M Mancone, A Della Corte, R Guerniero, S Canonico
The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra LifeScience Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in patients with diabetic foot ulcers. Sixty patients with diabetic foot ulcers (Grades 3 Wagner) were included in this randomized clinical trial. The study was conducted in the General Surgery Unit and Geriatric of the Second University of Naples, Italy, in the last 12 months. Forty-six cases of diabetic foot ulcers were equally and randomly divided into control and test groups...
May 11, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28485879/evidence-for-silver-in-wound-care-meta-analysis-of-clinical-studies-from-2000-2015
#5
Joachim Dissemond, Johannes Georg Böttrich, Horst Braunwarth, Jörg Hilt, Patricia Wilken, Karl-Christian Münter
BACKGROUND: Given that the scientific evidence for silver in wound care is generally considered insufficient, there is uncertainty among users regarding its clinical use. MATERIAL AND METHODS: A group of experts evaluated the clinical studies on silver in wound management published from 2000-2015. RESULTS: Overall, 851 articles were identified, 173 of which were included and categorized. There were 31 randomized controlled trials (RCTs) and eight cohort studies...
May 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28393586/evaluation-of-glycated-albumin-ga-and-ga-hba1c-ratio-for-diagnosis-of-diabetes-and-glycemic-control-a-comprehensive-review
#6
Sara Yazdanpanah, Mohammad Rabiee, Mohammadreza Tahriri, Mojgan Abdolrahim, Asadollah Rajab, Hossein E Jazayeri, Lobat Tayebi
Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose...
April 10, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28388680/association-between-diabetic-foot-ulcer-and-diabetic-retinopathy
#7
Duck Jin Hwang, Kyoung Min Lee, Moon Seok Park, Sung Hee Choi, Ji In Park, Joon Hee Cho, Kyu Hyung Park, Se Joon Woo
PURPOSE: We aimed to investigate the prevalence of diabetic retinopathy (DR) in patients with diabetic foot ulcer (DFU) and elucidate the association between DR and DFU severities and their shared risk factors. METHODS: A retrospective review was conducted on DFU patients who underwent ophthalmic and vascular examinations within 6 months; 100 type 2 diabetic patients with DFU were included. The medical records of 2496 type 2 diabetic patients without DFU served as control data...
2017: PloS One
https://www.readbyqxmd.com/read/28351488/investigating-the-effect-of-external-trauma-through-a-dynamic-system-modeling-approach-for-clustering-causality-in-diabetic-foot-ulcer-development
#8
Parisa Salimi, Mohsen Hamedi, Nima Jamshidi, Milad Vismeh
Diabetes and its associated complications are realized as one of the most challenging medical conditions threatening more than 29 million people only in the USA. The forecasts suggest a suffering of more than half a billion worldwide by 2030. Amid all diabetic complications, diabetic foot ulcer (DFU) has attracted much scientific investigations to lead to a better management of this disease. In this paper, a system thinking methodology is adopted to investigate the dynamic nature of the ulceration. The causal loop diagram as a tool is utilized to illustrate the well-researched relations and interrelations between causes of the DFU...
April 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28336046/charcot-arthropathy-versus-osteomyelitis-evaluation-and-management
#9
REVIEW
John Womack
Charcot arthropathy of the foot and ankle is a severe complication of peripheral neuropathy and is most commonly seen in the developed world in association with diabetes mellitus. Correct diagnosis and differentiation from osteomyelitis of the foot and ankle are critical to guide treatment. It can exist concomitantly with osteomyelitis, typically in the setting of an advanced midfoot ulcer. Simple plain radiographs and contrasted MRI studies often yield inconclusive or confusing data. Correct use of imaging studies and a clinical algorithm can be effective tools to help make accurate and early diagnoses and guide clinical interventions for these conditions...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28272013/when-traditional-offloading-is-not-an-option-could-an-external-fixator-be-a-solution-a-case-report
#10
Abdulaziz A Kimawi, Robert J Snyder, Mario A Cala, Cherison Cuffy
Offloading is a cornerstone in managing diabetic plantar foot ulcers; however, it often represents one of the most challenging aspects of treatment for clinician and patient alike. The authors present a case of a 61-year-old African American man with type 2 diabetes and a limb-threatening plantar foot ulcer that required aggressive wound and surgical management. Due to the heavy drainage and patient adherence issues, traditional offloading techniques such as total contact cast, DH Pressure Relief Walker (Össur, Foothill Ranch, CA), and wedge shoes, among others, were not viable options...
February 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28268140/comparison-of-metatarsal-head-resection-versus-conservative-care-in-treatment-of-neuropathic-diabetic-foot-ulcers
#11
Alireza Kalantar Motamedi, Mohammad Ansari
Complications from diabetic foot ulcers often lead to increased patient morbidity. Much debate still ensues concerning surgical versus conservative management of neuropathic diabetic foot ulcerations. The present study assessed and compared the efficacy of metatarsal head resection and medical approach in the treatment of neuropathic diabetic foot ulcers located at the plantar surface of metatarsal heads. In a retrospective cohort study, 24 consecutive neuropathic diabetic foot ulcers in the lower area of the metatarsal heads that had undergone metatarsal head resection were included as the operative group...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28257680/surgical-correction-of-the-achilles-tendon-for-diabetic-foot-ulcerations-and-charcot-neuroarthropathy
#12
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Achilles tendon pathologic conditions are implicated in contributing to the development of many diabetic foot complications including diabetic foot ulceration and Charcot neuroarthropathy. Surgical correction of the diabetic equinus deformity has been studied as an isolated or adjunctive treatment when dealing with difficult-to-close diabetic foot ulcerations or when surgically addressing the diabetic Charcot neuroarthropathy foot or ankle. This article reviews the most common indications, complications, and surgical procedures for equinus correction by either a tendo-Achilles lengthening or gastrocnemius recession for the management of diabetic foot conditions...
April 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28216809/healing-ulcers-and-preventing-their-recurrences-in-the-diabetic-foot
#13
S Raja Sabapathy, Madhu Periasamy
Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28182533/the-reality-of-routine-practice-a-pooled-data-analysis-on-chronic-wounds-treated-with-tlc-nosf-wound-dressings
#14
K C Münter, S Meaume, M Augustin, P Senet, J C Kérihuel
OBJECTIVE: A number of randomised controlled trials (RCT) have compared control groups with TLC-NOSF dressings (UrgoStart) on chronic wounds. Our aim was to determine whether the clinical trials' results translate into routine management of such wounds, by pooling the data from real-life observational studies. METHOD: Observational studies, conducted in France and Germany, evaluating current practices in patients suffering from non-selected chronic wounds treated with a TLC-NOSF dressing were identified...
February 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28120507/effect-of-systemic-insulin-treatment-on-diabetic-wound-healing
#15
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Gregory L Moneta, Amir F Azarbal
This study investigates if different diabetic treatment regimens affect diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a nonhealing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics, and outcome were collected. Nonhealing wound was defined as major or minor amputation or those who did not have complete healing until the last observation...
January 24, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28105902/cost-effectiveness-of-using-adjunctive-porcine-small-intestine-submucosa-tri-layer-matrix-compared-with-standard-care-in-managing-diabetic-foot-ulcers-in-the-us
#16
J F Guest, D Weidlich, H Singh, J La Fontaine, A Garrett, C J Abularrage, C R Waycaster
OBJECTIVE: To estimate the cost-effectiveness of using tri-layer porcine small intestine submucosa (SIS; Oasis Ultra) as an adjunct to standard care compared with standard care alone in managing diabetic foot ulcers (DFUs) in the US, from the perspective of Medicare. METHOD: A Markov model was constructed to simulate the management of diabetic neuropathic lower extremity ulcers over a period of one year in the US. The model was used to estimate the cost-effectiveness of initially using adjunctive SIS compared with standard care alone to treat a DFU in the US at 2016 prices...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28101794/diabetic-foot-infections-an-update-in-diagnosis-and-management
#17
REVIEW
Pinelopi Grigoropoulou, Ioanna Eleftheriadou, Edward B Jude, Nikolaos Tentolouris
Foot infections are a common problem in patients with diabetes and a risk factor for limb amputation. They occur as a result of skin ulceration, which facilitates penetration of pathogens to deeper tissues. The diagnosis of infection is clinical. Aerobic gram-positive cocci are the most common pathogens. Ulcers which are chronic, preceded by administration of antibiotics and hospitalization or complicated by severe infection are polymicrobial. Antibiotic therapy is initially empiric based on the severity of the infection...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28100957/conditions-for-success-in-introducing-telemedicine-in-diabetes-foot-care-a-qualitative-inquiry
#18
Beate-Christin Hope Kolltveit, Eva Gjengedal, Marit Graue, Marjolein M Iversen, Sally Thorne, Marit Kirkevold
BACKGROUND: The uptake of various telehealth technologies to deliver health care services at a distance is expanding; however more knowledge is needed to help understand vital components for success in using telehealth in different work settings. This study was part of a larger trial designed to investigate the effect of an interactive telemedicine platform. The platform consisted of a web based ulcer record linked to a mobile phone to provide care for people with diabetic foot ulcers in outpatient clinics in specialist hospital care in collaboration with primary health care...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#19
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28029181/new-horizons-in-the-understanding-of-the-causes-and-management-of-diabetic-foot-disease-report-from-the-2017-diabetes-uk-annual-professional-conference-symposium
#20
REVIEW
M Clokie, A L Greenway, K Harding, N J Jones, K Vedhara, F Game, K K Dhatariya
Diabetes-related foot disease remains a common problem. For wounds, classic teaching recommends the treatment of any infection, offloading the wound and ensuring a good blood supply, as well as ensuring that the other modifiable risk factors are addressed and optimized. There remain, however, several questions about these and other aspects of the care of diabetes-related foot disease. Some of these questions are addressed in the present report; in particular, the impact of newer technologies in the identification of any organisms present in a wound, as well as the use of novel approaches to treat infections...
March 2017: Diabetic Medicine: a Journal of the British Diabetic Association
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