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use of antibiotics in diabetic foot ulcers

Ashu Rastogi, Anish Bhattacharya, Mahesh Prakash, Sarika Sharma, Bhagwant R Mittal, Niranjan Khandelwal, Anil Bhansali
OBJECTIVE: Diabetic foot osteomyelitis (DFO) is difficult to diagnose in the presence of Charcot's neuroarthropathy (CN) and bone biopsy is not always possible. We aimed to assess the efficacy of PET/computed tomography using F-fluoride (F-fluoride PET/CT) and fluorine-18-fluorodeoxyglucose-labeled autologous leukocytes (F-FDG-LL PET/CT) in comparison with contrast-enhanced MRI (CEMRI) for the detection of DFO. PATIENTS AND METHODS: Thirty-two patients with chronic CN and foot ulcer suspected of having DFO were prospectively evaluated...
October 4, 2016: Nuclear Medicine Communications
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
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
Bianca L Price, Andrew M Lovering, Frank L Bowling, Curtis B Dobson
Diabetes has major implications for public health, with diabetic foot ulcers (DFUs) being responsible for significant morbidity and mortality. A key factor in the development of non-healing ulcers is infection, which often leads to the development of biofilm, gangrene and amputation. A novel approach to treating DFUs is the local release of antibiotics from calcium sulfate beads. We have developed a novel model system to study and compare the release and efficacy of antibiotics released locally, using collagen as a substrate for biofilm growth, and incorporating serum to mimic the biochemical complexity of the wound environment...
September 12, 2016: Antimicrobial Agents and Chemotherapy
S Subbu Lakshmi, G Chelladurai, B Suresh
The pus samples from diabetic foot ulcer patients and urine samples from urinary tract infected patients were collected and inoculated in nutrient agar plates. The colonies showing different morphologies were streaked on selective agar plates. The antibacterial assay of selected commercial antibiotics was tested against the foot ulcer and urinary tract isolates. The result revealed that most of the organisms were found to be resistant against the antibiotics. Screening of antibacterial activity of selected plants, methanol extracts of plants were prepared and tested against foot ulcer pathogens...
September 2016: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
Michael Loesche, Sue E Gardner, Lindsay Kalan, Joseph Horwinski, Qi Zheng, Brendan P Hodkinson, Amanda S Tyldsley, Carrie L Franciscus, Stephen L Hillis, Samir Mehta, David J Margolis, Elizabeth A Grice
Microbial burden of chronic wounds is believed to play an important role in impaired healing and development of infection-related complications. However, clinical cultures have little predictive value of wound outcomes, and culture-independent studies have been limited by cross-sectional design and small cohort size. We systematically evaluated the temporal dynamics of the microbiota colonizing diabetic foot ulcers (DFU), a common and costly complication of diabetes, and its association with healing and clinical complications...
August 23, 2016: Journal of Investigative Dermatology
K Rahim, M Qasim, H Rahman, T A Khan, I Ahmad, N Khan, A Ullah, A Basit, S Saleha
OBJECTIVE: Chronic wound infections impose major medical and economic costs on health-care systems, cause significant morbidity, mortality and prolonged hospitalisation. The presence of biofilm producing bacteria in these wounds is considered as an important virulence factor that leads to chronic implications including ulceration. The undertaken study aimed to isolate and identify the biofilm aerobic bacterial pathogens from patients with chronic wound infections, and determine their antibiotics resistance profiles Method: During this study, swab specimens were collected from patients with chronic wounds at teaching hospitals of Peshawar, Pakistan between May 2013 and June 2014...
August 2016: Journal of Wound Care
Raquel Santos, Diana Gomes, Hermes Macedo, Diogo Barros, Catarina Tibério, Ana Salomé Veiga, Luís Tavares, Miguel Castanho, Manuela Oliveira
Diabetic patients frequently develop diabetic foot ulcer (DFU), particularly vulnerable to Staphylococcus aureus opportunistic infections. It is urgent to find new treatments for bacterial infections. The antimicrobial peptide (AMP) nisin is a potential candidate, mainly due to its broad spectrum of action against pathogens. Considering that AMP can be degraded or inactivated before reaching their target at therapeutic concentrations, it is mandatory to establish effective AMP delivery systems, being the natural polysaccharide guar gum one of the most promising...
August 5, 2016: Journal of Medical Microbiology
Fengning Chuan, Min Zhang, Yang Yao, Wenqing Tian, Xiaoqun He, Bo Zhou
The aim of this study was to describe the characteristics of diabetic foot ulcer (DFU) patients with anemia and assess the relationship between anemia and DFU outcome. A retrospective cohort study was conducted on patients with DFU who attended our hospital from May 2007 to September 2014. All of the variables in the DFU patients with and without anemia were compared. In this study, 353 subjects were included, anemia was present in 236 patients (66.9%). These patients were significantly male, more likely to be a smoker, had a lower level of serum albumin and worse kidney function, more likely to use at least 2 types of antibiotics and had a worse perfusion of the lower limb, a larger and deeper ulcer and a more severe infection...
September 2016: International Journal of Lower Extremity Wounds
Angela Walker
The purpose of this small evaluation on five patients presenting to community podiatry services in Birmingham with foot ulceration was to explore common problems associated with diabetes and other high-risk conditions and illustrate the clinical effectiveness and experience of using a chitosan absorbent gelling fibre dressing (KytoCel®, Aspen Medical). Each of these case studies bought their individual complex issues and complications that affected the healing process. General wound care involved debridement, if required, dressings, pressure redistribution addressing footwear needs, systemic antibiotics where required, and shared care with the multidisciplinary team (MDT) in secondary care where appropriate...
June 23, 2016: British Journal of Nursing: BJN
Marie-Céline Zanella, Benjamin Kressmann, Lydia Wuarin, Benoit Coulin, Sophie Maître, Domizio Suva, Benjamin A Lipsky, Ilker Uçkay
In diabetic patients, foot ulcer is a common problem which prevalence during life is about 25%. Infection occurs as a complication in almost 50% of cases, is associated with significant morbidity and a reduced quality of life and is sometimes the trigger leading to amputation. Ulcers and infections occur among patients with predisposing factors such as peripheral neuropathy and arterial insufficiency, and require a multi-disciplinary care system. The knowledge of the microbiology of diabetic foot infection is necessary for a wise use of empirical and targeted antibiotic therapy...
April 13, 2016: Revue Médicale Suisse
T V Prakash, Dr Ajay Chaudhary, Shyam Purushothaman, Smitha K V, Varada Arvind K
UNLABELLED: BACKGROUND : In India, the high cost of medical treatments and limited resources can deter patients from receiving available care, leading to the development of chronic wounds. We evaluated the use of epidermal grafting in patients with complex, long-term chronic wounds. METHODS: Eighteen patients with complex wounds were treated with epidermal micrografts between September 2014 and March 2015 at a state-run, community health center in Mahe, Puducherry, India...
2016: Curēus
Windy E Cole
Diabetes often causes ulcers on the feet of diabetic patients. A 56-year-old, insulin-dependent, diabetic woman presented to the wound care center with a Wagner grade 3 ulcer of the right heel. She reported a 3-week history of ulceration with moderate drainage and odor and had a history of ulceration and osteomyelitis in the contralateral limb. Rigorous wound care, including hospitalization; surgical incision and drainage; intravenous antibiotic drug therapy; vacuum-assisted therapy; and a new room temperature, sterile, human acellular dermal matrix graft were used to heal the wound, save her limb, and restore her activities of daily living...
March 2016: Journal of the American Podiatric Medical Association
Karen Smith, Andrew Collier, Eleanor M Townsend, Lindsay E O'Donnell, Abhijit M Bal, John Butcher, William G Mackay, Gordon Ramage, Craig Williams
BACKGROUND: The aim of this study was to characterise the microbiome of new and recurrent diabetic foot ulcers using 16S amplicon sequencing (16S AS), allowing the identification of a wider range of bacterial species that may be important in the development of chronicity in these debilitating wounds. Twenty patients not receiving antibiotics for the past three months were selected, with swabs taken from each individual for culture and 16S AS. DNA was isolated using a combination of bead beating and kit extraction...
2016: BMC Microbiology
Jen-Hsiang Shen, Chin-Jui Liu, Shun-Chun Lo, Yu-Tsung Chen, Chang-Cheng Chang
BACKGROUND: Patients with diabetes mellitus are susceptible to foot ulcerations associated with the complex triad of peripheral sensory neuropathy, vasculopathy, and trauma. Local infection of a diabetic foot ulcer (DFU) acts a significant deterrent to healing because the response to aggressive debridement antimicrobial therapy is limited when peripheral circulation is poor. CASE REPORT: We share an experience of using silver-impregnated hydrofiber wound dressing as an alternative to amputation in an 85-year-old female patient with an infected, ischemic DFU...
March 2016: Journal of Wound, Ostomy, and Continence Nursing
Nikunj Vaidhya, Arpit Panchal, M M Anchalia
Diabetic foot wounds present a great challenge to surgeons. They are difficult to heal and are a significant risk factor for non-traumatic foot amputation besides being a huge financial burden. NPWT systems commercially available (VAC™ system, KCI Inc., USA) are costly precluding widespread use. To determine whether negative-pressure wound therapy (NPWT) would afford quicker wound recovery as compared to saline-moistened gauze in the treatment of diabetic foot wounds. Sixty patients were randomized into either the experimental NPWT group or conventional dressing group (control)...
December 2015: Indian Journal of Surgery
Antony H Bateman, Sara Bradford, Thomas W Hester, Igor Kubelka, Jennifer Tremlett, Victoria Morris, Elizabeth Pendry, Venu Kavarthapu, Michael E Edmonds
In this article, we describe emergency and elective pathways within our orthopedic multidisciplinary inpatient care of patients with diabetic foot problems. We performed a retrospective cohort review of 19 complex patients requiring orthopedic surgical treatment of infected ulceration or Charcot feet or deformity at our institution. A total of 30 admissions (19 emergency, 11 elective) were included. The pathways were coordinated by a multidisciplinary team and comprised initial assessment and investigation and a series of key events, which consisted of emergency and elective surgery together with the introduction, and change of intravenous antibiotics when indicated...
December 2015: International Journal of Lower Extremity Wounds
Veera Venkata Satyanarayana Reddy Karri, Gowthamarajan Kuppusamy, Siddhartha Venkata Talluri, Karthik Yamjala, Sai Sandeep Mannemala, Rajkumar Malayandi
BACKGROUND: Diabetic foot ulcers are one of the major causes of mortality in diabetic patients. Very few drugs and therapies have regulatory approval for this indication and several agents from diverse pharmacological classes are currently in various phases of clinical trials for the management of diabetic foot ulcers. SCOPE: The purpose of this review is to provide concise information of the drugs and therapies which are approved and present in clinical trials...
2016: Current Medical Research and Opinion
O I Butranova, T N Razdrogina
BACKGROUND: Type 2 diabetes mellitus is a chronic pathology characterized by high prevalence, high morbidity and mortality. According to the data of the Ministry of Health of Volgograd region the number of patients with type 2 diabetes was 68,227 people on 01.01.2014. Medical and social significance of type 2 diabetes mellitus is determined by its complications. Skin and soft tissue infections (SSTIs) in patients with type 2 diabetes are among the main factors of hospitalization and mortality [1]...
2015: International Journal of Risk & Safety in Medicine
Moustafa Y El-Naggar, Yousry M Gohar, Magdy A Sorour, Marian G Waheeb
This study proposes an alternative approach for the use of chitosan silver-based dressing for the control of foot infection with multidrug-resistant bacteria. Sixty-five bacterial isolates were isolated from 40 diabetic patients. Staphylococcus aureus (37%) and Pseudomonas aeruginosa (18.5%) were the predominant isolates in the ulcer samples. Ten antibiotics were in vitro tested against diabetic foot clinical bacterial isolates. The most resistant S. aureus and P. aeruginosa isolates were then selected for further study...
February 2016: Journal of Microbiology and Biotechnology
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