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diabetic foot ulceration

Veena Vijayakumar, Sushanta K Samal, Smita Mohanty, Sanjay K Nayak
Currently, diabetes mellitus (DM) accelerated diabetic foot ulcer (DFU) remains vivacious health problem related with delayed healing and high amputation rates which leads to enormous clinical obligation. Keeping in view of the foregoing, researchers have been made in their efforts to develop novel materials which accelerate delayed wound healing in the diabetic patient and reduce the adversative influences of DFUs. The most prominent materials used for the wound healing application have biocompatibility, low cytotoxicity, excellent biodegradable properties, and antimicrobial activity properties...
October 17, 2018: International Journal of Biological Macromolecules
Si-Qian Gao, Chen Chang, Jun-Jun Li, Ying Li, Xiao-Qian Niu, Dan-Ping Zhang, Long-Jian Li, Jian-Qing Gao
Nonhealing chronic wounds on foot induced by diabetes is a complicated pathologic process. They are mainly caused by impaired neovascularization, neuropathy, and excessive inflammation. A strategy, which can accelerate the vessel network formation as well as inhibit inflammatory response at the same time, makes it possible for effective diabetic ulcers treatment. Co-delivery of multiple drugs with complementary bioactivity offers a strategy to properly treat diabetic wound. We previously demonstrated that hydroxysafflor yellow A (HSYA) could accelerate diabetic wound healing through promoting angiogenesis and reducing inflammatory response...
November 2018: Drug Delivery
Chris Boodoo, Julie A Perry, General Leung, Karen M Cross, Wanrudee Isaranuwatchai
BACKGROUND: One of the most common (and costly) complications of diabetes are diabetic foot ulcers, which often result in lower-extremity amputation. Regular foot care can reduce complications; however, roughly half of Canadians with diabetes do not participate in screening. We sought to evaluate the economic effects of using telemonitoring for diabetic foot ulcer prevention using mathematical modelling. METHODS: We used Markov modelling to compare current screening standards (standard care) to population-wide and targeted (high-risk) telemonitoring programs in a hypothetical cohort of Canadian patients aged 60 years...
October 2018: CMAJ Open
Sonal Sekhar M, Unnikrishnan M K, Gabriel Sunil Rodrigues, Navya Vyas, Chiranjay Mukhopadhyay
PURPOSE: Diabetic foot infections (DFIs) are major public health concerns. In the view of the ever increasing burden of multidrug-resistant (MDR) organisms, improving the use of antimicrobial agents (AMAs) is a national priority. Objective of the study was to determine antimicrobial susceptibility (AMS) pattern of aerobes in DFIs. METHODS: A cross-sectional study was conducted for a period of 3 years at Department of Surgery, Kasturba hospital, Manipal, India during which, 260 DFUs patients admitted in the general surgery wards were enrolled for the study...
July 11, 2018: Foot
Viktor Zoltán Szabó, György Lázár, Béla Borda, Csaba Lengyel, Tamás Várkonyi, Zoltán Hódi, Bernadett Borda
The authors summarize the medical history of a patient with impaired healing of a wound in the sole of foot. The 63-year-old male patient had a second-degree burn in the sole of the left foot as he stepped on the hot concrete after taking off his slipper. On admission to our department, local wound management had already been started, his wound showed no healing tendency. Bilateral X-ray was performed of his left leg, osteomyelitis was not confirmed, soft tissue drainage was applied, and bacterial culture from the wound confirmed methicillin-resistant Staphylococcus aureus infection...
October 2018: Orvosi Hetilap
Brian M Schmidt, Crystal M Holmes, Wen Ye, Rodica Pop-Busui
AIMS/HYPOTHESIS: Diabetes foot complications remain very prevalent in US and worldwide, and a major risk for devastating amputations. We evaluated the impact of establishing a fully integrated and specialized Podiatry service into a large tertiary academic health system to implement structured and targeted preventative foot care on limb salvage rates. METHODS: Cross-sectional cohorts' data mining analysis of all encounters for diabetes and any foot complications between 2000-2005 and 2010-2015, preceding and after full implementation of podiatry service, respectively...
October 16, 2018: Current Diabetes Reviews
Crystal L Ramanujam, Thomas Zgonis
"A systematic review was undertaken to assess the outcomes of local random flaps in diabetic foot wound closure. The review was conducted using the following databases: Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Excerpta Medica dataBASE, Google Scholar, MEDLINE, Ovid, and PubMed. Search terms were local random flap, diabetes, foot, wound, ulceration, neuropathy, tissue transfer, V-Y, bilobed, monolobed, rotational, advancement, transpositional, rhomboid, and Limberg. English language studies, studies published from 1997 to 2017, patients with diabetes mellitus treated for foot wounds, use of local random flaps, follow-up period of 6 months or more postoperatively, documentation of healing rates, complications, and need for revisional surgery were included...
October 17, 2018: Foot & Ankle Specialist
Jennefer B J Zwaferink, Juha M Hijmans, Claudia M Schrijver, Laura K Schrijver, Klaas Postema, Jaap J van Netten
BACKGROUND: Mechanical noise may improve somatosensation at the dorsal side of the foot, but the effect at the plantar side of the foot, the side most at risk for foot ulceration, is unknown. Moreover, techniques used in research so far have several problems that limit applicability in daily practice. Piezoelectric actuators may provide mechanical noise with better clinical applicability. We assessed the effects of piezoelectric actuators generating mechanical noise on the vibration perception threshold (VPT) at the plantar side of the foot in people with diabetic neuropathy...
October 17, 2018: Journal of Diabetes Science and Technology
Zhenmi Liu, Jo C Dumville, Robert J Hinchliffe, Nicky Cullum, Fran Game, Nikki Stubbs, Michael Sweeting, Frank Peinemann
BACKGROUND: Foot wounds in people with diabetes mellitus (DM) are a common and serious global health issue. People with DM are prone to developing foot ulcers and, if these do not heal, they may also undergo foot amputation surgery resulting in postoperative wounds. Negative pressure wound therapy (NPWT) is a technology that is currently used widely in wound care. NPWT involves the application of a wound dressing attached to a vacuum suction machine. A carefully controlled negative pressure (or vacuum) sucks wound and tissue fluid away from the treated area into a canister...
October 17, 2018: Cochrane Database of Systematic Reviews
Carla Jiménez-Jiménez, Maribel Lara-Chica, Belén Palomares, Juan Antonio Collado, J Lopez-Miranda, Eduardo Muñoz, Marco A Calzado
N-acyl-dopamines are endolipids with neuroprotective, antiinflammatory and immunomodulatory properties. Previously, we showed the ability of these compounds to induce HIF-1α stabilization. Hypoxia and HIF-1α play an important role in the most relevant stages of diabetic pathogenesis. This work analyzes the possible role of these molecules on beta cell differentiation, insulin production and diabetic foot ulcer. Hypoxia response pathway has been characterized in beta-cell differentiation in rat pancreatic acinar cell line and human islet-derived precursor cells...
November 2018: Biochimica et biophysica acta. Molecular cell research
Lucia Michailidis, Shan M Bergin, Terry P Haines, Cylie M Williams
OBJECTIVE: Current clinical practice varies around debridement techniques used to promote healing of diabetes-related foot ulcers. This randomised controlled study will compare healing rates for diabetes-related foot ulcers treated with low frequency ultrasonic debridement versus non-surgical sharps debridement. Individuals with diabetes-related foot ulcers being managed by podiatry at a metropolitan hospital were screened against study criteria. Eligible participants were randomly allocated to either the non-surgical sharps debridement group or the low frequency ultrasonic debridement group and received weekly treatment for 6 months...
October 16, 2018: BMC Research Notes
Xu Zhang, Di Sun, GuiChun Jiang
BACKGROUND: There is a wide variety of dressings currently available for the treatment of diabetic foot ulcers (DFUs), and due to the lack of evidence from head-to-head randomized controlled trials (RCTs), the relative effects of any of these dressings in DFU patients remains unclear. The purpose of this study was to compare the efficacy of nine dressings in healing DFU. METHODS: MEDLINE (PubMed), EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched...
October 15, 2018: Journal of Diabetes
Mehmet Erdogan, Mustafa Kulaksizoglu, Asli Tetik, Soner Solmaz, Ali Sahin Kucukaslan, Zuhal Eroglu
OBJECTIVET: his study aims to evaluate the influence of eNOS G894T and VEGF C936T gene polymorphism in diabetic foot ulcers. METHOD: We studied 50 patients with diabetic foot ulcers and 57 diabetic patients without diabetic foot ulcer and as a control group of 75 healthy individuals. RESULTS: The genotype eNOS distribution did not differ between Type 2 Diabetic Patients group and Diabetic Foot Ulcer group (P>0.05). The frequency of the polymorphic T allele in Type 2 Diabetic Patients were significantly higher than the control group (42...
June 26, 2018: Foot
Robert Kushmakov, Jason Gandhi, Omar Seyam, Wendy Jiang, Gunjan Joshi, Noel L Smith, Sardar Ali Khan
Diabetic foot ulcers (DFU) are a burden to the diabetic community. With increasing medical bills, to unsuccessful treatment, those suffering from DFUs can use alternative therapeutics. First seen in the mid-1800s, ozone (O3 ) is thought to be unstable, due to inherent molecular nature. With the help of pharmaceutical science, various O3 treatments have flourished in the medical community to help those suffering from DFUs. Promising results are seen through numerous studies. Usually, a mixture of both O2 and O3 is seen in pressurized machines as administered to the foot ulcer...
July 2018: Medical Gas Research
A Searle, M J Spink, V H Chuter
BACKGROUND: An association between equinus and plantar pressure may be important for people with diabetes, as elevated plantar pressure has been linked with foot ulcer development. To determine the prevalence of equinus in community dwelling people with diabetes and to examine any association between presence of equinus and forefoot plantar pressures. METHODS: Barefoot (Tekscan HR Mat™) and in-shoe (Novel Pedar-X®) plantar pressure variables, non-weight bearing ankle range of motion and neuropathy status were assessed in 136 adults with diabetes (52...
October 5, 2018: Clinical Biomechanics
James W Albers, Ryan Jacobson
Aim: To assess lower extremity decompression nerve surgery (DNS) to treat the consequences of diabetic distal symmetric peripheral neuropathy (DPN). Research design and methods: MEDLINE, PubMed, and related registries were searched through December 2017 to identify randomized, quasi-randomized or observational trials that evaluated the efficacy of lower extremity DNS on pain relief (primary outcome) or other secondary outcomes. Observational studies were included, given investigators' reluctance to use sham surgery controls...
2018: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Muhammad Yasin, Shaista Zafar, Hazir Rahman, Taj Ali Khan, Shabnum Nazir, Salman Shah, Muhammad Dawood, Shahbaz Ahmad, Abdul Basit, Shahid Niaz Khan, Shamim Saleha
OBJECTIVE: Studies on diabetic foot ulcers (DFU) involving a representative sample of patients in Pakistan are scarce. This study aimed to determine baseline characteristics of infected DFUs in patients hospitalised at the Pakistan Institute of Medical Sciences Islamabad. METHOD: In this cross-sectional study, carried out during May 2015 and June 2016, foot ulcer characteristics of patients with DFUs were investigated and documented. From infected DFUs, aerobic bacterial pathogens were isolated, identified and evaluated for antimicrobial susceptibility...
October 1, 2018: Journal of Wound Care
Andreas F Mavrogenis, Panayiotis D Megaloikonomos, Thekla Antoniadou, Vasilios G Igoumenou, Georgios N Panagopoulos, Leonidas Dimopoulos, Konstantinos G Moulakakis, George S Sfyroeras, Andreas Lazaris
The lifetime risk for diabetic patients to develop a diabetic foot ulcer (DFU) is 25%. In these patients, the risk of amputation is increased and the outcome deteriorates.More than 50% of non-traumatic lower-extremity amputations are related to DFU infections and 85% of all lower-extremity amputations in patients with diabetes are preceded by an ulcer; up to 70% of diabetic patients with a DFU-related amputation die within five years of their amputation.Optimal management of patients with DFUs must include clinical awareness, adequate blood glucose control, periodic foot inspection, custom therapeutic footwear, off-loading in high-risk patients, local wound care, diagnosis and control of osteomyelitis and ischaemia...
September 2018: EFORT Open Reviews
Bernd Ploderer, Ross Brown, Leonard Si Da Seng, Peter A Lazzarini, Jaap J van Netten
BACKGROUND: Without effective self-care, people with diabetic foot ulcers (DFUs) are at risk of prolonged healing times, hospitalization, amputation, and reduced quality of life. Despite these consequences, adherence to DFU self-care remains low. New strategies are needed to engage people in the self-care of their DFUs. OBJECTIVE: This study aimed to evaluate the usability and potential usefulness of a new mobile phone app to engage people with DFUs in self-care...
October 10, 2018: JMIR diabetes
Rasmus Bo Jansen, Bo Jørgensen, Per E Holstein, Klaus Kirketerp Møller, Ole Lander Svendsen
AIMS: Charcot foot is a rare but disabling complication to diabetic neuropathy, and can cause permanent, limb-threatening deformities. The aim of this study was to investigate a population of patients a Charcot foot on a case-by-case basis, in order to assess the consequences of an acute Charcot foot and its complications. METHODS: The study was conducted a retrospective study of patients admitted to the Copenhagen Wound Healing Center between 1996 and 2015 with the diagnosis of Charcot foot (DM14...
September 29, 2018: Journal of Diabetes and its Complications
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