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Diabetic ulcer foot

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https://www.readbyqxmd.com/read/27904691/implantation-of-placenta-derived-mesenchymal-stem-cells-accelerates-murine-dermal-wound-closure-through-immunomodulation
#1
Haifeng Wang, Lianyu Chen, Yang Liu, Bangzhen Luo, Nanzi Xie, Tao Tan, Lige Song, Pei Erli, Ming Luo
BACKGROUND: Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus. Although previous studies have established that inflammation, ischemia and neuropathy contribute to the development of DFU, it is still an unmet medical need due to lack knowledge of cellular and molecular mechanisms associated with DFU. In the present study, we tested our hypothesis that subcutaneous application of human placental mesenchymal stem cells (PMSCs) can accelerate diabetic dermal wound healing by modulating immunoresponse...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27902390/virulence-determinants-in-clinical-staphylococcus-aureus-from-monomicrobial-and-polymicrobial-infections-of-diabetic-foot-ulcers
#2
Kavitha Shettigar, Spoorthi Jain, Deepika V Bhat, Raviraj Acharya, Lingadakai Ramachandra, Kapaettu Satyamoorthy, T S Murali
Antibiotic resistance in Staphylococcus aureus is a major public health concern and Methicillin Resistant S. aureus has emerged as an important pathogen. We characterized S. aureus isolates from monomicrobial and polymicrobial wound infections from 200 diabetic individuals with foot ulcers to understand their underlying diversity and pathogenicity. Staphylococcal Cassette Chromosome mec typing was performed and genes coding for production of biofilm, Panton-Valentine Leukocidin, Toxic Shock Syndrome Toxin, Leukotoxins DE and M were screened...
October 19, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27896528/low-level-laser-therapy-as-an-adjunct-to-conventional-therapy-in-the-treatment-of-diabetic-foot-ulcers
#3
R K Mathur, Khageswar Sahu, Siddharth Saraf, Pooja Patheja, Fareed Khan, P K Gupta
Foot ulcers are serious complications of diabetes mellitus (DM) and are known to be resistant to conventional treatment. This study was conducted to evaluate the efficacy of low-level laser therapy (LLLT) for the treatment of diabetic foot ulcers in a tertiary care centre (Department of Surgery, Mahatma Gandhi Memorial Medical College and Maharaja Yashwantrao Hospital, A.B. Road, Indore). A total of 30 patients with type 2 DM having Meggitt-Wagner grade I foot ulcers of more than 6 weeks duration with negative culture were studied...
November 29, 2016: Lasers in Medical Science
https://www.readbyqxmd.com/read/27894749/the-microbiology-of-diabetic-foot-infections-in-patients-recently-treated-with-antibiotic-therapy-a-prospective-study-from-india
#4
Ashu Rastogi, Suja Sukumar, Abhishek Hajela, Soham Mukherjee, Pinaki Dutta, Sanjay Kumar Bhadada, Anil Bhansali
AIM: Clinicians often treat clinically infected diabetic foot ulcers without information from cultures of the wound. The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously treated patients with a clinically infected DFU. RESEARCH DESIGN AND METHODS: 293 consecutive patients with clinically infected DFU on prior antimicrobial treatment within the immediate past few days for a duration greater than one week were evaluated for microbial etiology, antibiotic sensitivity and final outcomes...
November 9, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27893380/area-determination-of-diabetic-foot-ulcer-images-using-a-cascaded-two-stage-svm-based-classification
#5
Lei Wang, Peder Pedersen, Emmanuel Agu, Diane Strong, Bengisu Tulu
It is standard practice for clinicians and nurses to primarily assess patients' wounds via visual examination. This subjective method can be inaccurate in wound assessment and also represents a significant clinical workload. Hence, computer-based systems, especially implemented on mobile devices, can provide automatic, quantitative wound assessment and can thus be valuable for accurately monitoring wound healing status. Out of all wound assessment parameters, the measurement of the wound area is the most suitable for automated analysis...
November 23, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27888790/complication-assessment-and-prevention-strategies-using-midfoot-fusion-bolt-for-medial-column-stabilization-in-charcot-s-osteoarthropathy
#6
Alexander T Mehlhorn, Markus Walther, Niklas Iblher, Norbert P Südkamp, Hagen Schmal
In Charcot's osteoarthropathy stabilization of the medial column of the foot was introduced in order to establish a stable foot and reduce the risk for amputation. This study was performed to analyze postoperative complications, define risk factors for those and develop strategies for prevention. Since bolt dislocation takes place frequently, it was aimed to predict an appropriate time point for bolt removal under the condition that osseous healing has occurred. Fourteen consecutive patients with neuroosteoarthropathy of the foot and arch collapse were treated with open reduction and stabilization using midfoot fusion bolt and lateral lag screws...
November 4, 2016: Foot
https://www.readbyqxmd.com/read/27887858/predictive-value-of-neutrophil-to-lymphocyte-ratio-in-diabetic-wound-healing
#7
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Robert B McLafferty, Nabil J Alkayed, Gregory L Moneta, Amir F Azarbal
OBJECTIVE: The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds. METHODS: The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27883358/negative-pressure-wound-therapy-inhibit-inflammation-by-up-regulating-atf-3-and-down-regulating-nuclear-factor-%C3%AE%C2%BAb-in-diabetic-patients-with-foot-ulcerations
#8
T Wang, R He, J Zhao, J C Mei, M Z Shao, Y Pan, J Zhang, H S Wu, M Yu, W C Yan, L M Liu, F Liu, W P Jia
BACKGROUND: Negative pressure wound therapy (NPWT) was one of the most important treatments of diabetic foot, but the underlying mechanisms still remain elusive. This study aimed to evaluate the inflammatory signals involved in the effects of NPWT on diabetic foot ulcers. METHODS: We enrolled 22 patients with diabetic foot ulceration, eleven treated with NPWT and others treated with traditional debridement. All the patients were treated and observed for 1 week...
November 24, 2016: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/27882360/static-and-dynamic-predictors-of-foot-progression-angle-in-individuals-with-and-without-diabetes-mellitus-and-peripheral-neuropathy
#9
Ericka N Merriwether, Mary K Hastings, Michael J Mueller, Kathryn L Bohnert, Michael J Strube, Darrah R Snozek, David R Sinacore
INTRODUCTION: Foot progression angle (FPA) is a predictor of elevated regional plantar stresses and loads, which are indicators of dermal injury risk in individuals with diabetes mellitus and peripheral neuropathy (DMPN). FPA accounts for 15-45% of the variance in plantar stresses and loads in adults with DMPN. However, the biomechanical factors underlying an "out-toeing" gait pattern in this clinical population have not been examined. The primary purpose of this study was to identify static and dynamic predictors of foot progression angle magnitude in adults with and without DMPN...
2016: Annals of Gerontology and Geriatric Research
https://www.readbyqxmd.com/read/27871769/-effect-of-mechanical-vibration-on-transcutaneous-oxygen-levels-in-the-feet-of-type-2-diabetes-mellitus-patients
#10
Gerardo Rodríguez Reyes, Lidia Núñez Carrera, Aldo Alessi Montero, Adriana Solís Vivanco, Ivett Quiñones Uriostegui, Alberto Isaac Pérez Sanpablo
BACKGROUND AND OBJECTIVE: Foot conditions in patients with diabetes mellitus (DM) are major causes of morbidity and disability. Whole body vibration may promote blood circulation in the lower limbs, hence facilitating perfusion and promoting the supply of nutrients and oxygen to comprised tissues. Transcutaneous oxygen levels (TcPO2)>40mmHg in cases of diabetic foot syndrome are associated with a good prognosis in the resolution of ulcers. The objective of this study was to determine whether whole body vibration favors some parameters of interest related to complications associated with the diabetic foot syndrome...
November 18, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#11
REVIEW
Daniel J Short, Thomas Zgonis
Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#12
REVIEW
Claire M Capobianco, Thomas Zgonis
Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865313/surgical-equinus-correction-for-the-diabetic-charcot-foot-what-the-evidence-reveals
#13
REVIEW
Claire M Capobianco
Triceps surae contracture, or equinus, is a known deforming force in the foot and ankle. Biomechanical studies have shown that ankle equinus significantly alters gait and plantar pressures, and in the diabetic neuropathic patient population, this can propagate plantar ulceration and/or Charcot neuroarthropathy (CN). Surgical correction of equinus is globally and frequently used to aid in plantar wound healing in the neuropathic diabetic patient, with and without CN. Treatment guidelines for equinus correction in this medically complex population are undefined and lack evidence from high-quality published peer-reviewed studies...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865312/an-overview-of-internal-and-external-fixation-methods-for-the-diabetic-charcot-foot-and-ankle
#14
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Diabetic Charcot neuroarthropathy (DCN) of the foot and ankle is a challenging disease with regard to clinical presentation, pathogenesis, and prognosis. Its surgical management is equally difficult to interpret based on the wide array of options available. In the presence of an ulceration or concomitant osteomyelitis, internal fixation by means of screws, plates, or intramedullary nailing needs to be avoided when feasible. External fixation becomes a great surgical tool when managing DCN with concomitant osteomyelitis...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27863489/the-effect-of-cumulative-glycemic-burden-on-the-incidence-of-diabetic-foot-disease
#15
Robert G Dekker, Charles Qin, Bryant S Ho, Anish R Kadakia
BACKGROUND: Glycemic control is a known modifiable risk factor for diabetic foot disease. Prior attempts to define its relationship with diabetic foot ulcer and Charcot arthropathy fail to account for variability in control and duration of diabetic disease. We developed a novel metric to reflect aggregate disease exposure in a diabetic, termed cumulative glycemic burden. We hypothesized that it would be positively associated with both diabetic foot ulcer and radiographically diagnosed Charcot arthropathy...
November 18, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27861361/a-quantitative-real-time-assessment-of-buerger-exercise-on-dorsal-foot-peripheral-skin-circulation-in-patients-with-diabetes-foot
#16
Chang-Cheng Chang, Men-Yen Chen, Jen-Hsiang Shen, Yen Bin Lin, Wen-Wei Hsu, Bor-Shyh Lin
Buerger exercise can improve the peripheral circulation of lower extremities. However, the evidence and a quantitative assessment of skin perfusion immediately after this exercise in patients with diabetes feet are still rare.We recruited 30 patients with unilateral or bilateral diabetic ulcerated feet in Chang Gung Memorial Hospital, Chia-Yi Branch, from October 2012 to December 2013. Real-time dorsal foot skin perfusion pressures (SPPs) before and after Buerger exercise were measured and analyzed. In addition, the severity of ischemia and the presence of ulcers before exercise were also stratified...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27849290/the-prevention-of-diabetic-foot-ulceration-how-biomechanical-research-informs-clinical-practice
#17
Frank E DiLiberto, Judith F Baumhauer, Deborah A Nawoczenski
Background: Implementation of interprofessional clinical guidelines for the prevention of neuropathic diabetic foot ulceration has demonstrated positive effects regarding ulceration and amputation rates. Current foot care recommendations are primarily based on research regarding the prevention of ulcer recurrence and focused on reducing the magnitude of plantar stress (pressure overload). Yet, foot ulceration remains to be a prevalent and debilitating consequence of Diabetes Mellitus...
November 16, 2016: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/27846299/hyperglycemia-induces-skin-barrier-dysfunctions-with-impairment-of-epidermal-integrity-in-non-wounded-skin-of-type-1-diabetic-mice
#18
Junko Okano, Hideto Kojima, Miwako Katagi, Takahiko Nakagawa, Yuki Nakae, Tomoya Terashima, Takeshi Kurakane, Mamoru Kubota, Hiroshi Maegawa, Jun Udagawa
Diabetes causes skin complications, including xerosis and foot ulcers. Ulcers complicated by infections exacerbate skin conditions, and in severe cases, limb/toe amputations are required to prevent the development of sepsis. Here, we hypothesize that hyperglycemia induces skin barrier dysfunction with alterations of epidermal integrity. The effects of hyperglycemia on the epidermis were examined in streptozotocin-induced diabetic mice with/without insulin therapy. The results showed that dye leakages were prominent, and transepidermal water loss after tape stripping was exacerbated in diabetic mice...
2016: PloS One
https://www.readbyqxmd.com/read/27846028/evaluation-of-the-efficacy-of-highly-hydrophilic-polyurethane-foam-dressing-in-treating-a-diabetic-foot-ulcer
#19
Jae-A Jung, Ki-Hyun Yoo, Seung-Kyu Han, Eun-Sang Dhong, Woo-Kyung Kim
OBJECTIVE: To demonstrate the efficacy of a highly hydrophilic polyurethane foam dressing in the treatment of diabetic ulcers. BACKGROUND: Diabetic foot ulcers often pose a difficult treatment problem. Polyurethane foam dressings have been used worldwide to accelerate wound healing, but only a few clinical studies demonstrate the effect of foam dressing on the healing of diabetic ulcers. METHODS: Medical records of 1342 patients with diabetic ulcers who were admitted and treated at the authors' institution were reviewed...
December 2016: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/27843849/a-study-of-risk-factors-and-foot-care-behavior-among-diabetics
#20
Mackson Nongmaithem, Arjinder Pal Singh Bawa, Abhilash Kumar Pithwa, Simran Kaur Bhatia, Gurjit Singh, Somnath Gooptu
BACKGROUND: Diabetic foot results in considerable morbidity and mortality in developing countries and the prevalence of diabetes is expected to increase further in the next decades in these countries. Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation...
April 2016: Journal of Family Medicine and Primary Care
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