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Management diabetic foot ulcer

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https://www.readbyqxmd.com/read/29779008/intervention-planning-for-the-reduce-maintenance-intervention-a-digital-intervention-to-reduce-reulceration-risk-among-patients-with-a-history-of-diabetic-foot-ulcers
#1
Kate Greenwell, Katy Sivyer, Kavita Vedhara, Lucy Yardley, Frances Game, Trudie Chalder, Gayle Richards, Nikki Drake, Katie Gray, John Weinman, Katherine Bradbury
OBJECTIVES: To develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk. METHODS: Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I of intervention planning, evidence was collated from a scoping review of the literature and qualitative interviews with patients who have had DFUs (n=20)...
May 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/29772673/reducing-amputations-in-people-with-diabetes-rapid-evaluation-of-a-new-care-pathway
#2
Sandra MacRury, Kate Stephen, Fiona Main, Jane Gorman, Sandra Jones, David Macfarlane
People with diabetes are at increased risk of foot ulcers, which, if left untreated, can lead to infection, gangrene, and subsequent amputation. Management by a multidisciplinary diabetes foot team has been shown to reduce amputation rates; however, accessing specialist treatment is made particularly difficult when living in remote and rural locations, such as many individuals cared for within NHS Highland. The RAPID project was made up of two phases: firstly, to evaluate the technical feasibility of a new integrated care pathway using innovative technology, and secondly, to establish process enhancement of the pathway to justify a larger-scale study...
May 16, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29757846/increasing-diabetic-patient-engagement-and-self-reported-medication-adherence-using-a-web-based-multimedia-program
#3
Kerri Elsabrout
BACKGROUND AND PURPOSE: Evidence-based, multimedia applications to supplement clinical care can improve patient engagement and clinical outcomes. Patients with diabetes with potentially devastating complication of foot ulcers present a substantial opportunity to improve engagement. This project examines how providing an online, multimedia self-management program affects patient engagement and self-reported medication adherence scores within 4-6 weeks compared with preprogram scores. METHODS: Participants included 14 adult, diabetic outpatients receiving care at a Wound Care Center in suburban New York...
May 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29738299/perception-of-diabetic-foot-ulcers-among-general-practitioners-in-four-european-countries-knowledge-skills-and-urgency
#4
José Luis Garcia-Klepzig, Juan Pedro Sánchez-Ríos, Chris Manu, Raju Ahluwalia, Claas Lüdemann, Marco Meloni, Elisabetta Lacopi, Víctor Rodriguez-Saenz De Buruaga, Benjamin Bouillet, Julien Vouillarmet, Jose Luis Lazaro Martinez, Kristien Van Acker
OBJECTIVE: Diabetic foot ulcers (DFU) have the potential to deteriorate rapidly, in the absence of prompt assessment and treatment. The aim of this study was to analyse the awareness and perception of DFU among general practitioners (GPs) from four European countries, and to find possible differences between these countries in terms of management. METHOD: A two-part, quantitative, online questionnaire was distributed to GPs across four countries in Europe-the UK, France, Germany and Spain...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29725580/salient-features-and-outcomes-of-charcot-foot-an-often-overlooked-diabetic-complication-a-17-year-experience-at-a-diabetic-center-in-bangkok
#5
Yotsapon Thewjitcharoen, Jeeraphan Sripatpong, Wyn Parksook, Sirinate Krittiyawong, Sriurai Porramatikul, Taweesak Srikummoon, Somkiet Mahaudomporn, Soontaree Nakasatien, Thep Himathongkam
Background: Charcot foot is a rare but a serious diabetic condition. Recognition of this often overlooked condition to provide timely and proper management is important for a better prognosis. Limited data on Charcot foot was available in Asians. Aims: The aim of this study is to describe salient features and outcomes of Charcot foot in Thai patients. Method: We presented our experience of 40 cases of Charcot foot patients who were treated from 2000 to 2016 at Theptarin Hospital, Bangkok, Thailand...
March 2018: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29718812/safety-and-efficacy-of-an-autologous-blood-clot-product-in-the-management-of-texas-1a-or-2a-neuropathic-diabetic-foot-ulcers-a-prospective-multicenter-open-label-pilot-study
#6
Robert J Snyder, Maria A Kasper, Keyur Patel, Marissa J Carter, Igal Kushnir, Alon Kushnir, Thomas E Serena
OBJECTIVE: This pilot study evaluates safety in terms of the occurrence of adverse events (AEs) as well as the efficacy in terms of complete wound healing rates of a blood clot product when applied to chronic neuropathic diabetic foot ulcers (DFUs). MATERIALS AND METHODS: Participants were chosen from patients with DFUs visiting the wound care clinic. Up to 10 mL of blood drawn from each participant was injected into the product's clotting tray. Within 12 minutes, the blood clot product was formed, applied to the single DFU of each participant, and covered with primary and secondary dressings...
April 20, 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29694293/development-of-a-pharmacoeconomic-model-to-demonstrate-the-effect-of-clinical-pharmacist-involvement-in-diabetes-management
#7
Heather Ourth, Jordan Nelson, Patrick Spoutz, Anthony P Morreale
BACKGROUND: A data collection tool was developed and nationally deployed to clinical pharmacists (CPs) working in advanced practice provider roles within the Department of Veterans Affairs to document interventions and associated clinical outcomes. Intervention and short-term clinical outcome data derived from the tool were used to populate a validated clinical outcomes modeling program to predict long-term clinical and economic effects. OBJECTIVE: To predict the long-term effect of CP-provided pharmacotherapy management on outcomes and costs for patients with type 2 diabetes...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29683538/effectiveness-of-viable-cryopreserved-placental-membranes-for-management-of-diabetic-foot-ulcers-in-a-real-world-setting
#8
Katherine M Raspovic, Dane K Wukich, Daniel Q Naiman, Lawrence A Lavery, Robert S Kirsner, Paul J Kim, John S Steinberg, Christopher E Attinger, Alla Danilkovitch
In a multicenter randomized controlled trial (RCT), the use of viable cryopreserved placental membrane (vCPM) for chronic diabetic foot ulcers (DFUs) resulted in a higher proportion of wound closure in comparison to good wound care: 62% vs. 21% (p < 0.01). However, patients in RCTs are not representative of daily physician practice. Healthcare databases serve as a valuable tool to evaluate therapy effectiveness and to supplement evidence from RCTs. The objective of this study was to evaluate the effectiveness of vCPM for DFU management using Net Health's WoundExpert® electronic health records (EHR)...
April 23, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29682995/efficacy-and-safety-of-the-combination-of-isosorbide-dinitrate-spray-and-chitosan-gel-for-the-treatment-of-diabetic-foot-ulcers-a-double-blind-randomized-clinical-trial
#9
Sylvia Elena Totsuka Sutto, Yunuen Itzet Rodríguez Roldan, Ernesto German Cardona Muñoz, Teresa Arcelia Garcia Cobian, Sara Pascoe Gonzalez, Abril Martínez Rizo, Miriam Mendez Del Villar, Leonel García Benavides
AIM: To evaluate whether a combination of isosorbide dinitrate spray and chitosan gel (10%) topically applied can have additive benefits for management of diabetic foot ulcers. METHODS: In a randomized, placebo-controlled, double-blinded clinical trial, 68 patients were divided into four groups: Group 1: treated with chitosan gel; Group 2: isosorbide dinitrate spray; Group 3: combination of isosorbide dinitrate spray and chitosan gel; Group 4: placebo. RESULTS: Histological analyses showed a significant regeneration in all groups ( p < 0...
April 1, 2018: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/29611155/managing-the-diabetic-foot-ulcer-how-best-practices-fit-the-real-2018-united-states
#10
Nicole Ilonzo, Munir Patel, John C Lantis
Diabetes Mellitus is a serious systemic illness that has an epidemic-like increasing prevalence in the United States, as well as the rest of the world. With the increasing number of people with diabetes comes the higher incidence of diabetes-related complications. One of these known complications, diabetic foot ulcers (DFU), has an estimated lifetime incidence of 15% in diabetics. Having a DFU increases the risk of infection, amputation, and even death, which is why prompt treatment and surveillance of such ulcers is imperative...
March 29, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29590230/duration-of-type-2-diabetes-is-a-predictor-of-elevated-plantar-foot-pressure
#11
Brooke Falzon, Cynthia Formosa, Liberato Camilleri, Alfred Gatt
AIMS: Elevated plantar pressure is considered a significant risk factor for ulceration in diabetes mellitus. The aim of this study was to determine whether duration of diabetes could affect plantar pressure in patients with no known significant comorbidity or foot pathology. METHODS: Participants with type 2 diabetes, but without known confounding factors that could alter peak pressure, were matched for age, weight, and gender and categorized into 3 groups of diabetes duration: group 1 (1-5 yr), group 2 (6-10 yr), and group 3 (11-15 yr)...
2018: Review of Diabetic Studies: RDS
https://www.readbyqxmd.com/read/29584602/effect-of-a-new-purified-collagen-matrix-with-polyhexamethylene-biguanide-on-recalcitrant-wounds-of-various-etiologies-a-case-series
#12
Dimitrios Lintzeris, Karen Vernon, Heather Percise, Andy Strickland, Kari Yarrow, Amber White, Mary Gurganus, Susan Sherrod, Kathleen Vergin, Laura Johnson
INTRODUCTION: The management of chronic, nonhealing wounds in patients with multiple comorbidities continues to be a challenge for health care practitioners. Chronic wounds typically do not progress through the normal phases of wound healing and generally remain stagnant during the inflammatory phase, resulting in an increase in proteolytic enzymes with degradation of the extracellular matrix. Bacterial biofilm has been documented to be one of the main factors delaying wound healing, resulting in the prolongation of the inflammatory phase...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29584601/application-of-viable-cryopreserved-human-placental-membrane-grafts-in-the-treatment-of-wounds-of-diverse-etiologies-a-case-series
#13
Derek S Anselmo, James B McGuire, Ebony Love, Tracey Vlahovic
There is evidence in the literature that viable cryopreserved human placental membrane (vCHPM) grafts are effective in treating diabetic foot ulcers and venous leg ulcers. OBJECTIVE: This case series presents 3 cases of chronic ulcerations - 1 arterial ulcer (AU), 1 pressure ulcer (PU), and 1 recurrence of a pyoderma gangrenosum ulcer (PGU) - that had failed previous courses of standard wound care and were subsequently treated with vCHPM to determine if the treatment is an effective modality for treating wounds of these etiologies...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29581804/anxiety-and-depression-among-adult-patients-with-diabetic-foot-prevalence-and-associated-factors
#14
Ali Ahmad, Mousa Abujbara, Hashem Jaddou, Nidal A Younes, Kamel Ajlouni
Background: Diabetic foot is a frequent complication of diabetes mellitus with subsequent disturbances in the daily life of the patients. The co-existence of depression and anxiety among diabetic foot patients is a common phenomenon and the role of each of them in perpetuating the other is highlighted in the literature. Our study aimed to determine the prevalence rates of anxiety and depression, and to examine the associated risk factors among diabetic foot patients. Methods: This is a cross-sectional study...
May 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29566422/clinical-prospective-study-on-the-use-of-subcutaneous-carboxytherapy-in-the-treatment-of-diabetic-foot-ulcer
#15
Lynda Khiat, Gustavo H Leibaschoff
Diabetic footfoot ulcer (DFU) is a serious complication of diabetes mellitus, and possibly the major morbidity of the diabetic foot. It is the most common foot injury in diabetic patients and can lead to lower-extremity amputation. Management of DFU requires a systematic knowledge of the major risk factors for amputation, frequent routine evaluation, scrupulous preventive maintenance, and correction of peripheral arterial insufficiency. Carboxytherapy refers to the subcutaneous injection of CO2 to improve the microcirculation and promote wound-healing by stimulating the microcirculation...
March 22, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29564953/fifty-patient-study-evaluating-the-efficacy-of-modified-collagen-with-glycerin-in-periwound-skin-management
#16
Harikrishna K R Nair
The management of chronic nonhealing ulcers pose a great challenge because they are associated with morbidity and increased costs. This report presents the observations of standard management along with application of modified collagen with glycerin (MCG) in the periwound area for management of nonhealing wounds. This observational report included 50 patients (33 male, 17 female) aged 24 to 94 years having nonhealing wounds. All wounds were treated using standard treatment protocols (TIME concept), whereas the periwound severity was assessed using the Harikrishna Periwound Skin Classification (HPSC)...
March 1, 2018: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29559450/current-challenges-and-opportunities-in-the-prevention-and-management-of-diabetic-foot-ulcers
#17
William J Jeffcoate, Loretta Vileikyte, Edward J Boyko, David G Armstrong, Andrew J M Boulton
Diabetic foot ulcers remain a major health care problem. They are common, result in considerable suffering, frequently recur, and are associated with high mortality, as well as considerable health care costs. While national and international guidance exists, the evidence base for much of routine clinical care is thin. It follows that many aspects of the structure and delivery of care are susceptible to the beliefs and opinion of individuals. It is probable that this contributes to the geographic variation in outcome that has been documented in a number of countries...
April 2018: Diabetes Care
https://www.readbyqxmd.com/read/29547034/effects-of-ph-on-the-antibiotic-resistance-of-bacteria-recovered-from-diabetic-foot-ulcer-fluid-an-in-vitro-study
#18
Carla D McArdle, Katie M Lagan, David A McDowell
BACKGROUND: This study investigated the resistance of bacteria isolated from diabetic foot ulcers (DFUs) to antibiotics frequently used in the management of the diabetic foot infections, at a range of pH values (pH 6.5, 7.5, and 8.5) known to exist in DFU wound fluid. This study aimed to determine whether changes (or atypical stasis) in wound fluid pH modulate the antibiotic resistance of DFU isolates, with potential implications in relation to the suppression/eradication of bacterial infections in DFUs...
January 2018: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29521922/the-effect-of-foot-exercises-on-wound-healing-in-type-2-diabetic-patients-with-a-foot-ulcer-a-randomized-control-study
#19
Şahizer Eraydin, Gülçin Avşar
PURPOSE: The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. DESIGN: Prospective, randomized controlled study. SUBJECT AND SETTINGS: Sixty-five patients from an outpatient clinic with grade 1 or 2 ulcers (Wagner classification) who met study criteria agreed to participate; 60 patients completed the study and were included in the final analysis. Subjects were followed up between February 2014 and June 2015...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29509115/delayed-referral-of-patients-with-diabetic-foot-ulcers-across-europe-patterns-between-primary-care-and-specialised-units
#20
Chris Manu, Elisabetta Lacopi, Benjamin Bouillet, Julien Vouillarmet, Raju Ahluwalia, Claas Lüdemann, José Luis Garcia-Klepzig, Marco Meloni, Víctor Rodriguez-Saenz De Buruaga, Juan Pedro Sánchez-Ríos, Mike Edmonds, Jan Apelqvist, José Luis Lázaro-Martínez, Kristien Van Acker
OBJECTIVE: Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units. METHOD: A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU...
March 2, 2018: Journal of Wound Care
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