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wound healing in diabetic foot

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https://www.readbyqxmd.com/read/29785265/a-randomized-controlled-trial-of-the-safety-and-efficacy-of-a-topical-gentamicin-collagen-sponge-in-diabetic-patients-with-a-mild-foot-ulcer-infection
#1
Ilker Uçkay, Benjamin Kressmann, Sébastien Di Tommaso, Marina Portela, Heba Alwan, Hubert Vuagnat, Sophie Maître, Christophe Paoli, Benjamin A Lipsky
Objectives: The initial phase of infection of a foot ulcer in a person with diabetes is often categorized as mild. Clinicians usually treat these infections with antimicrobial therapy, often applied topically. Some experts, however, believe that mild diabetic foot ulcer infections will usually heal with local wound care alone, without antimicrobial therapy or dressings. Methods: To evaluate the potential benefit of treatment with a topical antibiotic, we performed a single-center, investigator-blinded pilot study, randomizing (1:1) adult patients with a mild diabetic foot ulcer infection to treatment with a gentamicin-collagen sponge with local care versus local care alone...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29782416/acellular-flowable-matrix-in-the-treatment-of-tunneled-or-cavity-ulcers-in-diabetic-feet-a-preliminary-report
#2
Ferdinando Campitiello, Manfredi Mancone, Angela Della Corte, Raffaella Guerniero, Silvestro Canonico
OBJECTIVE: The authors aimed to explore the feasibility and safety of an advanced, acellular, flowable wound matrix (FWM) in patients with diabetes-related cavity or tunnel lesions involving deep structures. METHODS: Patients with diabetic foot ulcers were hospitalized at the General and Geriatric Surgery Unit of the University of Campania in Naples, Italy, between March 2015 and December 2015. Twenty-three patients with tunneled or cavity ulcers were treated. The lesions were filled with the FWM...
June 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29767913/development-of-coverage-and-its-evaluation-in-the-treatment-of-chronic-wounds
#3
Marcia Diana Umebayashi Zanoti, Helena Megumi Sonobe, Sidney José Lima Ribeiro, Ana Maria Minarelli Gaspar
OBJECTIVES: To describe the development of the bacterial cellulose coating with anti-inflammatory Ibuprofen (BC/Ibu) and to evaluate the cicatrization process with its use in patients with chronic wounds of venous and diabetic etiology. METHODS: Longitudinal descriptive study. The cellulose membrane, cultivated with bacteria Gluconacetobacter xylinus and with incorporation of Ibuprofen, was used in the treatment of patients with chronic wounds in public health services in a Brazilian municipality...
October 2017: Investigación y Educación en Enfermería
https://www.readbyqxmd.com/read/29758297/effect-of-negative-pressure-wound-therapy-on-molecular-markers-in-diabetic-foot-ulcers
#4
Rehab A Karam, Noha A Rezk, Tamer M Abdel Rahman, Mohamed Al Saeed
Diabetic foot ulcers are one of the most common complications of diabetes with high morbidity and mortality. Negative pressure wound therapy (NPWT) is one of the treatment modalities that facilitates the wound healing process; however, its molecular mechanism remains unclear. The aim of this study was to investigate the mechanism of action of NPWT in the treatment of diabetic foot ulcers via measuring the tissue expression of genes related to the wound healing process. The study included 40 patients with diabetic foot ulceration, 20 of them received NPWT and the other 20 were a control group treated with advanced moist therapy...
May 11, 2018: Gene
https://www.readbyqxmd.com/read/29746280/the-impact-of-microbial-communities-on-wound-healing-a-review
#5
Zhenzhen Xu, Henry C Hsia
Chronic, nonhealing wounds place an enormous burden on both the health care system and patients, with no definitive treatments available. There has been increasing evidence that the microbial composition of wounds may play an important role in wound healing. Culture-independent methods for bacterial detection and analysis have revealed the wound microbiome to be much more diverse and complex than culture alone. Such methods primarily rely on targeted amplification and sequencing of various hypervariable regions of the bacterial 16S rRNA for phylogenetic analysis...
April 30, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29738296/microcurrent-as-an-adjunct-therapy-to-accelerate-chronic-wound-healing-and-reduce-patient-pain
#6
Harikrishna K R Nair
OBJECTIVE: The primary aim is to assess the efficacy of microcurrent, a form of electrical stimulation, as an adjunct therapy in accelerating healing in chronic wounds by reducing wound size and pain level. The secondary aim is to assess the qualitative changes in these parameters: inflammatory symptoms, vasodilation, sleep quality, gait and frequency of bowel movement. METHOD: Eligible patients with chronic wounds were enrolled between March and June 2016, from the Wound Care Unit, Hospital Kuala Lumpur in this consecutive case series...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29738294/clinical-application-of-a-3d-printed-scaffold-in-chronic-wound-treatment-a-case-series
#7
Haining Sun, Huayao Lv, Fanghui Qiu, Duolun Sun, Yue Gao, Ning Chen, YongKe Zheng, Kunxue Deng, Yaya Yang, Haitao Zhang, Tao Xu, Dongni Ren
OBJECTIVE: This case series evaluates the safety and effectiveness of 3D-printed scaffold in chronic wounds. The scaffold is a composite of natural and synthetic materials, and can be prepared in the form of powder or membrane. METHOD: We recruited patients with pressure ulcera (PU) and/or a diabetic foot ulcers (DFU). We used two methods: 3D-printed scaffolds alone, or 3D-printing powder mixed with platelet-rich fibrinogen (PRF). Clinicians and patients were asked to rate the scaffold's ease of application and comfort during use...
May 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29725945/low-level-laser-irradiation-modifies-the-effect-of-hyperglycemia-on-adhesion-molecule-levels
#8
Krzysztof Góralczyk, Justyna Szymańska, Łukasz Gryko, Jacek Fisz, Danuta Rość
Endothelium plays a key role in maintaining vascular homeostasis by secreting active factors involved in many biological processes such as hemostasis, angiogenesis, and inflammation. Hyperglycemia in diabetic patients causes dysfunction of endothelial cells. Soluble fractions of adhesion molecules like sE-selectin and vascular cell adhesion molecule (sVCAM) are considered as markers of endothelial damage. The low-level laser therapy (LLLT) effectively supports the conventional treatment of vascular complications in diabetes, for example hard-to-heal wounds in patients with diabetic foot syndrome...
May 3, 2018: Lasers in Medical Science
https://www.readbyqxmd.com/read/29718816/a-post-marketing-surveillance-study-of-chronic-wounds-treated-with-a-native-collagen-calcium-alginate-dressing
#9
Matthew Sabo, Lam Le, Raphael A Yaakov, Marissa Carter, Thomas E Serena
Chronic wounds (ie, wounds that fail to progress through a normal, orderly, timely sequence of repair) continue to pose significant clinical and economic burdens. A prospective, descriptive, 3-week post-marketing surveillance study was conducted across 3 wound care centers in the United States to evaluate the effectiveness of a collagen calcium alginate dressing on chronic wounds in conjunction with standard care (SC) practices (eg, offloading, debridement, compression) to support healing. Eligible participants had to be >18 years of age, have at least 1 chronic wound, and no known sensitivity to collagen...
April 2018: Ostomy/wound Management
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
#10
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/29718811/a-total-offloading-foot-brace-for-treatment-of-diabetic-foot-ulcers-results-from-a-halted-randomized-controlled-trial
#11
David J Johnson, Barbara J Saar, Andrew J Shevitz, Ann H Kim, Lori Hammer, Daniel E Kendrick, Pamela Moorehead, Vikram S Kashyap
INTRODUCTION: Foot offloading is the mainstay treatment for plantar diabetic foot ulcers (DFUs). OBJECTIVE: This multicenter, single-blinded, randomized controlled trial evaluates the efficacy of a total offloading foot brace for healing plantar DFUs. MATERIALS AND METHODS: Seventeen patients were randomized to standard therapy (ie, reducing stress and pressure via mechanical offloading) or offloading foot brace. Comparison of plantar pressures was performed using digital pressure sensing films...
April 18, 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29715071/accelerated-healing-of-a-diabetic-foot-ulcer-using-autologous-stromal-vascular-fraction-suspended-in-platelet-rich-plasma
#12
Triantafyllos Didangelos, George Koliakos, Kokkona Kouzi, George Arsos, Katerina Kotzampassi, Konstantinos Tziomalos, Dimitrios Karamanos, Apostolos I Hatzitolios
We describe the case of a Type I diabetic patient with a refractory foot ulcer that remained unhealed for 2 years despite conventional therapy. Autologous adipose-derived stromal vascular fraction suspended in autologous platelet-rich plasma was applied to the wound, which completely healed within 1 month. The wound remained closed with no complications for a 2-year follow-up. Reporting of this and similar cases may lead to larger clinical trials that will prove the efficacy of this therapy that may offer accelerated healing and lessen the financial burden of more expensive therapeutic modalities...
April 2018: Regenerative Medicine
https://www.readbyqxmd.com/read/29696071/building-a-scalable-diabetic-limb-preservation-program-four-steps-to-success
#13
Tanzim Khan, Laura Shin, Stephanie Woelfel, Vincent Rowe, Brittany L Wilson, David G Armstrong
Over the past generation, limb preservation programs and diabetic foot services have begun to proliferate within academic health science centers as well as within health-care systems in general. We describe four key components for a successful program that, developed sequentially with temporal overlap, can allow the program to scale. The first component includes establishment of a 'hot foot line' for urgent emergency department/inpatient referral. The second includes development of a wound-healing clinic to address outpatient care through to remission...
2018: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/29695061/use-of-leukocyte-platelet-l-prf-rich-fibrin-in-diabetic-foot-ulcer-with-osteomyelitis-three-clinical-cases-report
#14
Alessandro Crisci, Giuseppe Marotta, Anna Licito, Edda Serra, Giulio Benincasa, Michela Crisci
In this study, the use of fibrin rich in leukocytes and platelets (L-PRF) was explored to heal osteomyelitis ulcers in a diabetic foot. The goal was to standardize the utilization of L-PRF in patients with osteomyelitis to direct it for healing. L-PRF was obtained autologously from the peripheral blood of the diabetic patients ( n = 3) having osteomyelitis and skin lesions for at least six months. The L-PRF and supernatant serum were inserted into the skin lesion to the bone after a surgical debridement. The evolution of lesions over time was analyzed...
April 24, 2018: Diseases (Basel)
https://www.readbyqxmd.com/read/29685567/minimally-invasive-treatment-of-ankle-fractures-in-patients-at-high-risk-of-soft-tissue-wound-healing-complications
#15
REVIEW
Sherif Mohamed Abdelgaid, Ahmed Fawaz Moursy, Eyad Abd Allah Elgebaly, Aly Mohamed Aboelenien
The complex nature of ankle fractures is magnified when seen in patients at high risk of soft tissue wound healing complications. The major categories include associated soft tissue injury, diabetes, tobacco use, peripheral vascular disease, malnutrition, alcoholism, and corticosteroid use. Because of the potential for wound dehiscence and infection with open reduction and internal fixation of ankle fractures in these patients, minimally invasive procedures have been described. The aims of the present study were to assess the possibility for, and evaluate the results and complications of, minimally invasive techniques for different types of malleolar fractures in high-risk patients...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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
#16
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/29682897/an-aseptically-processed-acellular-reticular-allogenic-human-dermis-improves-healing-in-diabetic-foot-ulcers-a-prospective-randomised-controlled-multicentre-follow-up-trial
#17
Charles M Zelen, Dennis P Orgill, Thomas E Serena, Robert E Galiano, Marissa J Carter, Lawrence A DiDomenico, Jennifer Keller, Jarrod P Kaufman, William W Li
Aseptically processed human reticular acellular dermal matrix (HR-ADM) has been previously shown to improve wound closure in 40 diabetic patients with non-healing foot ulcers. The study was extended to 40 additional patients (80 in total) to validate and extend the original findings. The entire cohort of 80 patients underwent appropriate offloading and standard of care (SOC) during a 2-week screening period and, after meeting eligibility criteria, were randomised to receive weekly applications of HR-ADM plus SOC or SOC alone for up to 12 weeks...
April 22, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29679687/a-novel-technique-indocyanine-green-angiography-to-prognosticate-healing-of-foot-ulcer-in-critical-limb-ischemia
#18
Hiten M Patel, Shahzad S Bulsara, Shubhabrata Banerjee, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: To predict wound healing in patients with critical limb ischemia(CLI) is ongoing issue. Currents methods like ankle-brachial index (ABI), color doppler and transcutaneous oxygen pressure (TCPO2 ), CT angiography are lacking in demonstrating regional perfusion. Indocyanine green angiography (ICGA) has the potential to provide regional perfusion information lacking in other methods. To demonstrate successes of revascularization procedure in CLI patients based on ICGA data this study was conducted...
April 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29661917/association-of-hemoglobin-a-1c-and-wound-healing-in-diabetic-foot-ulcers
#19
Betiel K Fesseha, Christopher J Abularrage, Kathryn F Hines, Ronald Sherman, Priscilla Frost, Susan Langan, Joseph Canner, Kendall C Likes, Sayed M Hosseini, Gwendolyne Jack, Caitlin W Hicks, Swaytha Yalamanchi, Nestoras Mathioudakis
OBJECTIVE: This study evaluated the association between hemoglobin A1c (A1C) and wound outcomes in patients with diabetic foot ulcers (DFUs). RESEARCH DESIGN AND METHODS: We conducted a retrospective analysis of an ongoing prospective, clinic-based study of patients with DFUs treated at an academic institution during a 4.7-year period. Data from 270 participants and 584 wounds were included in the analysis. Cox proportional hazards regression was used to assess the incidence of wound healing at any follow-up time in relation to categories of baseline A1C and the incidence of long-term (≥90 days) wound healing in relation to tertiles of nadir A1C change and mean A1C change from baseline, adjusted for potential confounders...
April 16, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29651391/the-wound-healing-effects-of-herbal-cream-containing-oliveria-decumbens-and-pelargonium-graveolens-essential-oils-in-diabetic-foot-ulcer-model
#20
Mohaddese Mahboubi, Mohsen Taghizadeh, Tahereh Khamechian, Omid Reza Tamtaji, Rasoul Mokhtari, Sayyed Alireza Talaei
BACKGROUND: The number of diabetic patients in adult population is increasing. All this population are at risk of developing diabetic foot ulcers (DFUs) that are associated with unwanted ailments and high mortality. In spite of current therapies for DFUs, further therapies are needed to help the patients. METHODS: The efficacy of herbal cream containing Pelargonium graveolens and Oliveria decombens essential oils was evaluated topically for treatment of DFUs in rat animal model in comparison with two other herbal formulas containing each essential oil alone, placebo (the basic formula without active ingredients) and normal saline as control groups...
January 2018: World Journal of Plastic Surgery
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