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wound healing in diabetic foot

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
Jie Gao, Gang Zhao, Wei Li, Jiayuan Zhang, Yanling Che, Meiyu Song, Shan Gao, Bin Zeng, Yuanhong Wang
Endothelial progenitor cells (EPCs) are involved in diabetes-associated complications, including diabetic foot ulcer (DFU). Recent reports showed that miR-155 downregulation promotes wound healing in diabetic rats and ameliorates endothelial injury induced by high glucose, but its role in DFU is unknown. We found that miR-155 was overexpressed in EPCs from patients with DFU and in high glucose-induced EPCs from healthy people. Reductions in cell viability, migration, tube formation and nitric oxide production, as well as increases in lactated hydrogenase, cell apoptosis, and reactive oxygen species induced by high glucose, were enhanced by miR-155 overexpression and restrained by miR-155 inhibition...
March 12, 2018: Experimental Cell Research
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
Marek Kawecki, Jarosław Pasek, Grzegorz Cieślar, Aleksander Sieroń, Grzegorz Knefel, Mariusz Nowak, Justyna Glik
BACKGROUND: Diabetic foot ulcer is one of the major complications of diabetes mellitus in adults. OBJECTIVES: The aim of the study was to conduct a planimetry evaluation of the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of patients with vascular disorders caused by diabetic foot. MATERIAL AND METHODS: The study included 94 patients, 30 females (32%) and 64 males (68%), aged 33-76 years, with diabetes lasting 1.5-32 years, who underwent HBOT due to diabetic foot...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Sinuo Chen, Renren Li, Chun Cheng, Jing-Ying Xu, Caixia Jin, Furong Gao, Juan Wang, Jieping Zhang, Jingfa Zhang, Hong Wang, Lixia Lu, Guo-Tong Xu, Haibin Tian
Macrophages play critical roles in wound healing process. They switch from "classically activated" (M1) phenotype in the early inflammatory phase to "alternatively activated" (M2) phenotype in the later healing phase. However, the dynamic process of macrophage phenotype switching in diabetic wounds burdened with bacteria is unclear. In this report, Pseudomonas aeruginosa, frequently detected in diabetic foot ulcers, was inoculated into cutaneous wounds of db/db diabetic mice to mimic bacterium-infected diabetic wound healing...
March 7, 2018: Cell Biology International
David Russell, Leanne Atkin, April Betts, Caroline Dowsett, Francis Fatoye, Sarah Gardner, Julie Green, Chris Manu, Tracey McKenzie, Helena Meally, Louise Mitchell, Julie Mullings, Isaac Odeyemi, Andrew Sharpe, Gillian Yeowell, Nancy Devlin
OBJECTIVE: Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing...
March 2, 2018: Journal of Wound Care
Caitlin W Hicks, Joseph K Canner, Nestoras Mathioudakis, Ronald L Sherman, Kathryn Hines, Christopher Lippincott, James H Black, Christopher J Abularrage
BACKGROUND: Socioeconomic deprivation is associated with poor glycemic control and higher hospital admission rates in patients with diabetes. We sought to quantify the effects of neighborhood socioeconomic deprivation on wound healing among a cohort of patients with diabetic foot ulceration (DFU) treated in a multidisciplinary setting. METHODS: Socioeconomic disadvantage was calculated for all patients using the area deprivation index (ADI) stratified by quartile (from ADI-0: least through ADI-3: most)...
April 2018: Journal of Surgical Research
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Rabih A Chaer, Steven A Leers, Aureline Boitet, Michael J Singh, Eric S Hager
OBJECTIVE: Ischemic heel ulcerations are generally thought to carry a poor prognosis for limb salvage. We hypothesized that patients undergoing infrapopliteal revascularization for heel wounds, either bypass or endovascular intervention, would have lower wound healing rates and amputation-free survival than patients with forefoot wounds. METHODS: A retrospective chart review was performed of patients who presented between 2006 and 2013 to our institution with ischemic foot wounds and infrapopliteal arterial disease and underwent either pedal bypass or endovascular tibial artery intervention...
February 28, 2018: Annals of Vascular Surgery
Erica Y Xue, Laurel K Chandler, Stephen L Viviano, Jonathan D Keith
OBJECTIVE: Forward-looking infrared (FLIR) thermography technology uses a handheld camera that measures skin infrared emissivity, captures photographs, and can be analyzed through specialized software. Forward-looking infrared images can be used to analyze and correlate burn wound temperature with burn depth, burn progression, and the number of days needed for healing. FLIR ONE is a miniature, smartphone-compatible thermal imaging camera that has been used to assess inflammation in diabetic foot ulcers, as well as locating perforators in flap surgery...
February 28, 2018: Annals of Plastic Surgery
Anthony Tickner, Cheri Klinghard, Jonathan F Arnold, Valerie Marmolejo
INTRODUCTION: As the majority of diabetic foot ulcerations (DFUs) occur on the plantar foot, excessive pressure is a major contributing factor to delayed healing. The gold standard for offloading is the total contact cast (TCC); yet, TCC use is contraindicated in patients with ischemia. Lower extremity ischemia typically presents in the more severe end stages of peripheral arterial disease (PAD). As PAD exists on a severity spectrum from mild to severe, designation of a clear cutoff where TCC use is an absolute contraindication would assist those who treat DFUs on a daily basis...
February 2018: Wounds: a Compendium of Clinical Research and Practice
Aharon S Finestone, Eran Tamir, Guy Ron, Itay Wiser, Gabriel Agar
Background: Diabetic foot ulcers are frequently related to elevated pressure under a bony prominence. Conservative treatment includes offloading with orthopaedic shoes and custom made orthotics or plaster casts. While casting in plaster is usually effective in achieving primary closure of foot ulcers, recurrence rates are high. Minimally invasive surgical offloading that includes correction of foot deformities has good short and long term results. The surgery alleviates the pressure under the bony prominence, thus enabling prompt ulcer healing, negating the patient's dependence on expensive shoes and orthotics, with a lower chance of recurrence...
2018: Journal of Foot and Ankle Research
Shinsuke Mii, Atsushi Guntani, Eisuke Kawakubo, Kiyoshi Tanaka, Ryoichi Kyuragi
BACKGROUND: Few reports have described the effects of medication on the wound healing of ischemic ulcers after revascularization. This study was conducted to investigate the effects of cilostazol on wound healing in patients who underwent infrainguinal bypass for ischemic tissue loss. METHODS: Two hundred and sixty-three limbs undergoing de novo infrainguinal bypass for tissue loss from January 2004 to December 2015 were divided into two groups based on whether or not cilostazol was administered after surgery...
February 15, 2018: Annals of Vascular Surgery
Iván Delgado-Enciso, Violeta M Madrigal-Perez, Agustin Lara-Esqueda, Martha G Diaz-Sanchez, Jose Guzman-Esquivel, Luis E Rosas-Vizcaino, Oscar O Virgen-Jimenez, Juleny Kleiman-Trujillo, Maria R Lagarda-Canales, Gabriel Ceja-Espiritu, Viridiana Rangel-Salgado, Uriel A Lopez-Lemus, Josuel Delgado-Enciso, Agustin D Lara-Basulto, Alejandro D Soriano Hernández
Potassium permanganate has been reported to be an effective treatment for certain types of wounds. The aim of the present study was to evaluate the use of potassium permanganate in the treatment of diabetic foot ulcers. A single-blind, randomized, controlled clinical trial was conducted on patients with type 2 diabetes mellitus that presented with a foot ulcer persisting for >3 months. The control group (n=10) was treated with the current standard treatment, which comprises of measures for reducing pressure in the ulcerated area, daily cleansing of the ulcer with potable water and antiseptic wash solution, and the application of a disinfectant solution on the entire surface area of the ulcer; while the intervention group (n=15) received the standard treatment plus 5% topical potassium permanganate solution applied once a day for 21 days...
February 2018: Biomedical Reports
Mercedes Pérez-Recalde, Ignacio E Ruiz Arias, Élida B Hermida
BACKGROUND: Millions of people in the world suffer from chronic wounds of different etiologies such as diabetic foot and leg ulcers, without solutions nowadays. Molecules obtained from plants offer an alternative to aid wound healing. Strong evidence about essential oils (EO) anti-inflammatory and antimicrobial properties is thoroughly described in literature and their chemical compositions are well characterized. More recently, EO effects in experimental wounds have begun to be analyzed...
January 1, 2018: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
Tomasz Miłek, Krzysztof Baranowski, Piotr Zydlewski, Piotr Ciostek, Krzysztof Mlosek, Wojciech Olszewski
Introduction: It has been demonstrated that plasma growth factor (PGF) responsible for proliferation of smooth muscle cells and fibroblasts significantly shortens treatment duration. Aim: To determine the role of human growth factor in the healing of ulcers due to ischaemic diabetic foot syndrome (DFS) following previous angioplasty of the blood vessels of the lower leg and foot. Material and methods: The study group included 50 patients with ischaemic diabetic foot complicated by lower leg ulcers in which angioplasty of the stenotic arteries in the distal lower leg and foot was performed...
December 2017: Postȩpy Dermatologii i Alergologii
André Oliveira Paggiaro, Andriws Garcia Menezes, Alexandra Donizetti Ferrassi, Viviane Fernandes De Carvalho, Rolf Gemperli
OBJECTIVE: The amniotic membrane has biological properties that are beneficial to the wound healing process of diabetic foot ulcers (DFU). Our aim is to analyse the scientific evidence found in literature on the use of the amniotic membrane to stimulate DFU healing. METHOD: A systematic review of amniotic membrane's influence was undertaken, using the search terms 'placenta' 'diabetic foot' 'amnion' and biological dressing', assessing the outcomes 'wound healing' and 'wound healing time', in DFU...
February 1, 2018: Journal of Wound Care
Si-Qian Gao, Chen Chang, Xiao-Qian Niu, Long-Jian Li, Yan Zhang, Jian-Qing Gao
To investigate the effects of Hydroxysafflor Yellow A (HSYA), which is derived from safflower, on the proliferation, migration and angiogenesis of cells in vitro and its potential efficacy in vivo when topically applied to a diabetic wound. Human umbilical vein endothelial cells (HUVECs) and mouse macrophage cells (RAW264.7) were used to evaluate angiogenesis and anti-inflammatory activities, respectively. The influence of HSYA on the wound scratch assay was investigated in keratinocytes. A splinted excisional wound model in rats with TIDM induced by streptozotocin was used to assess the effects of wound healing...
January 31, 2018: European Journal of Pharmacology
Xiangxia Zeng, Yunliang Tang, Kaixiang Hu, Wang Jiao, Liu Ying, Lingyan Zhu, Jianying Liu, Jixiong Xu
RATIONALE: Diabetic foot ulcer (DFU) is a chronic complication of diabetes characterized by continuity, repeatability, and nonhealing. In recent years, mesenchymal stem cells hydrogel complex has been a new emerging technique in the treatment of DFU. The placenta-derived mesenchymal stem cells (PDMSCs) hydrogel is multipotent, and can secrete growth factors, cytokines, and immunomodulatory substances which could accelerate wound healing. PATIENT CONCERNS: In this case report, we present a 57-year-old female with type 2 diabetes mellitus and a 20-day DFU...
December 2017: Medicine (Baltimore)
Estelle Everett, Nestoras Mathioudakis
Diabetic foot ulcers (DFUs) are a serious complication of diabetes that results in significant morbidity and mortality. Mortality rates associated with the development of a DFU are estimated to be 5% in the first 12 months, and 5-year morality rates have been estimated at 42%. The standard practices in DFU management include surgical debridement, dressings to facilitate a moist wound environment and exudate control, wound off-loading, vascular assessment, and infection and glycemic control. These practices are best coordinated by a multidisciplinary diabetic foot wound clinic...
January 2018: Annals of the New York Academy of Sciences
Frank M Davis, Andrew Kimball, Anna Boniakowski, Katherine Gallagher
PURPOSE OF REVIEW: Diabetic foot ulcerations (DFU) affect 25% of patients with diabetes mellitus during their lifetime and constitute a major health problem as they are often recalcitrant to healing due to a constellation of both intrinsic and extrinsic factors. The purpose of this review is to (1) detail the current mechanistic understanding of DFU formation and (2) highlight future therapeutic targets. RECENT FINDINGS: From a molecular perspective, DFUs exhibit a chronic inflammatory predisposition...
January 23, 2018: Current Diabetes Reports
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