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Rongfeng Shi, Yinpeng Jin, Chuanwu Cao, Shilong Han, Xiaowen Shao, Lingyu Meng, Jie Cheng, Meiling Zhang, Jiayi Zheng, Jun Xu, Maoquan Li
BACKGROUND: Diabetic foot ulcer (DFU) is an intractable diabetic complication. Patients suffering from diabetes mellitus (DM) frequently present with infected DFUs. In this study, a wound healing model on diabetic rat foot was established to mimic the pathophysiology of clinical patients who suffer from DFUs. Our study aimed to explore the localization of human adipose-derived stem cells (hADSCs) and the role of these cells in the repair of foot ulcerated tissue in diabetic rats, and thus to estimate the possibilities of adipose-derived stem cells for diabetic wound therapy...
October 22, 2016: Stem Cell Research & Therapy
Kashif Rahim, Shamim Saleha, Xudong Zhu, Liang Huo, Abdul Basit, Octavio Luiz Franco
A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers...
October 14, 2016: Microbial Ecology
Janelle Yu, Suzanne Lu, Ann-Marie McLaren, Julie A Perry, Karen M Cross
Diabetic foot ulcers (DFUs) are a significant problem in an aging population. 15% of diabetics develop a DFU over their lifetime, which can lead to potential amputation. The 5-year survival rate after amputation is 31%, which is greater than the lifetime risk of mortality from cancer. Topical oxygen is a promising technique for the adjunctive therapy of chronic wounds including DFUs, but few controlled studies exist to support its clinical adoption. The aim of this study was to compare a portable topical oxygen delivery system in patients with non-healing DFUs to standard best practice...
October 12, 2016: Wound Repair and Regeneration
A M Mahon, C MacGilchrist, C McIntosh, T O'Brien
BACKGROUND: Diabetes mellitus, coined the 'Black Death of the Twenty-First Century', is associated with complications, including foot ulceration with potential loss of limb. There is a need for development of new wound therapies through completion of robust clinical trials. AIMS: To profile demographics and wound characteristics of an Irish cohort with diabetes, forecast eligibility for entry to a clinical trial of advanced wound therapeutics, and adjust criteria to optimize eligibility for enrolment...
October 11, 2016: Irish Journal of Medical Science
Byung-Joon Jeon, Hwan Jun Choi, Jin Seok Kang, Min Sung Tak, Eun Soo Park
Diabetes mellitus is a common metabolic disorder. Among various complications, diabetic neuropathy and peripheral vascular disorders are closely associated with diabetic foot ulcers (DFUs). Lower extremity ulcers and amputations are ongoing problems among individuals with diabetes. There are several classification systems for DFUs; however, no prognostic system has to date been accepted as the gold standard or the optimum prediction tool for amputations. A retrospective study was designed. Demographic data and baseline laboratory data were gathered and scored or evaluated using five representative DFU classification systems...
October 10, 2016: International Wound Journal
M Martinson, N Martinson
OBJECTIVE: To compare the relative product cost and clinical outcomes of four skin substitutes used as adjunctive treatments for diabetic foot ulcers (DFUs). METHOD: Medicare claims data from 2011 to 2014 were used to identify beneficiaries with diabetes and foot ulcers. Patients treated with one of four types of skin substitute (Apligraf, Dermagraft, OASIS, and MatriStem) were identified. The skin substitutes were compared on episode length; amputation rate; skin substitute utilisation; and skin substitute costs...
October 2016: Journal of Wound Care
B Marcus
OBJECTIVE: Cryopreserved amniotic suspension allograft (CASA) is a regenerative tissue suspension containing amniotic membrane and amniotic fluid components used for soft-tissue repair, replacement, and reconstruction. The aim of this case series is to examine its effects in different wound types. METHOD: In a retrospective series CASA was applied to chronic non-healing wounds. All patients were treated at a single center between June 2013 and December 2014. The criterion for application of CASA was lack of progress toward wound healing despite standard treatments and adjuvant therapies...
October 2016: Journal of Wound Care
Jie Zhao, Wuquan Deng, Yuping Zhang, Yanling Zheng, Lina Zhou, Johnson Boey, David G Armstrong, Gangyi Yang, Ziwen Liang, Bing Chen
Serum cystatin C (CysC) has been identified as a possible potential biomarker in a variety of diabetic complications, including diabetic peripheral neuropathy and peripheral artery disease. We aimed to examine the association between CysC and diabetic foot ulceration (DFU) in patients with type 2 diabetes (T2D). 411 patients with T2D were enrolled in this cross-sectional study at a university hospital. Clinical manifestations and biochemical parameters were compared between DFU group and non-DFU group. The association between serum CysC and DFU was explored by binary logistic regression analysis...
2016: Journal of Diabetes Research
Leonard Henry Joseph, Aatit Paungmali, John Dixon, Liz Holey, Amaramalar Selvi Naicker, Ohnmar Htwe
This study investigated the therapeutic effects of connective tissue manipulation (CTM) in diabetic foot ulcer (DFU). A total of 20 participants (10 in CTM group and 10 in conventional treatment group (CG)) with DFU underwent the conventional DFU treatment. In addition, the CTM group received CTM twice per week for 6 weeks. The percentage wound area reduction (PWAR) and bacterial colonization count (BCC) in log10 colony-forming units (CFU) per ml wound fluid was evaluated at baseline and six weeks. Results showed a significant change in PWAR in CTM (p < 0...
July 2016: Journal of Bodywork and Movement Therapies
Jie Zhang, Xin-Juan Sun, Jin'an Chen, Zhi Wei Hu, Lei Wang, Dong Mei Gu, Ai-Ping Wang
BACKGROUND: miR-126 may increase angiogenesis in patients with diabetic foot ulcers (DFUs) treated with maggot debridement therapy (MDT). METHODS: Real-time quantitative PCR was used to detect expression of miR-126 mRNA in the peripheral blood among the non-diabetic population, type 2 diabetes mellitus patients without DFU, and patients with DFUs of type 2 diabetes mellitus. The expression of miR-126 mRNA in the peripheral blood of patients with DFUs was observed before and after MDT...
July 28, 2016: Journal of Diabetes and its Complications
Liang Liang, Rivka C Stone, Olivera Stojadinovic, Horacio Ramirez, Irena Pastar, Anna G Maione, Avi Smith, Vanessa Yanez, Aristides Veves, Robert S Kirsner, Jonathan A Garlick, Marjana Tomic-Canic
Diabetic foot ulcers (DFUs) are one of the major complications of diabetes. Its molecular pathology remains poorly understood, impeding the development of effective treatments. Although it has been established that multiple cell types, including fibroblasts, keratinocytes, macrophages, and endothelial cells, all contribute to inhibition of healing, less is known regarding contributions of individual cell type. Thus, we generated primary fibroblasts from nonhealing DFUs and evaluated their cellular and molecular properties in comparison to nondiabetic foot fibroblasts (NFFs)...
September 8, 2016: Wound Repair and Regeneration
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 the 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, a common and costly complication of diabetes, and its association with healing and clinical complications...
August 24, 2016: Journal of Investigative Dermatology
Michael B Strauss, Hojin Moon, Steven La, Alex Craig, Jose Ponce, Stuart Miller
INTRODUCTION: Uncontrolled deformity, deep infection, and/or ischemia-hypoxia are highly associated with healing challenges of diabetic foot ulcers (DFUs). This paper reports the occurrences of these factors that the authors label the "Troublesome Triad" (TT) in a prospective series of 62 patients with diabetes mellitus (DM), who were hospitalized because of their DFUs. MATERIALS AND METHODS: With Institutional Review Board approval, the authors gathered data in a prospective series of patients hospitalized because of lower extremity wounds...
August 2016: Wounds: a Compendium of Clinical Research and Practice
Lisa Heuch, Judith Streak Gomersall
BACKGROUND: The incidence of foot ulceration related to diabetes is increasing. Many foot care professionals recommend offloading measures as part of management strategies for modulating excess pressure to prevent development of diabetic foot ulcers (DFUs). These measures may include padding, insoles/orthotic devices and footwear. There is a lack of evidence-based guidance on the effectiveness of the different offloading options for preventing primary ulceration in those with diabetes...
July 2016: JBI Database of Systematic Reviews and Implementation Reports
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
Susana Pedras, Rui Carvalho, M Graça Pereira
PURPOSE: Diabetic foot ulcer (DFU) including amputation surgery has serious consequences for patients, the family and healthcare services. DFU affects not only the physical health-related quality of life (HRQoL) of patients but also their mental well-being. The aims of this study were to find the predictors of HRQoL after surgery, to analyse differences in HRQoL, before and after surgery, and to explore the moderating role of a first versus previous amputation(s) in the relationship between physical and mental HRQoL, before and after surgery, in patients with DFU...
August 5, 2016: International Journal of Behavioral Medicine
Robert G Frykberg, Gary W Gibbons, Jodi L Walters, Dane K Wukich, Farrell C Milstein
Complex diabetic foot ulcers (DFUs) with exposed tendon or bone remain a challenge. They are more susceptible to complications such as infection and amputation and require treatments that promote rapid development of granulation tissue and, ultimately, reepithelialisation. The clinical effectiveness of viable cryopreserved human placental membrane (vCHPM) for DFUs has been established in a level 1 trial. However, complex wounds with exposed deeper structures are typically excluded from randomised controlled clinical trials despite being common in clinical practice...
August 3, 2016: International Wound Journal
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
Melodie Blakely
BACKGROUND AND PURPOSE: Published guidelines for effective management of diabetic foot ulcers (DFU) include total contact casting (TCC). The purpose of this case study is to describe the application of best practice guidelines for the treatment of a diabetic foot ulcer (DFU) in a complex patient where TCC offloading could not be utilized. CASE DESCRIPTION: The patient was a 47 year-old female with a five-plus year history of a full-thickness DFU on the left plantar mid-foot...
March 4, 2016: Healthcare (Basel, Switzerland)
R J Abdo
OBJECTIVE: A diabetic foot ulcer (DFU) is one of the many potential complications associated with diabetes. If not effectively and rapidly treated, DFUs can result in lower extremity amputations. This prospective case series aimed to assess the effectiveness of a dehydrated amniotic-derived tissue allograft (DAMA), with regards to time to wound closure and total number of applications. METHOD: Patients were recruited with a neuropathic non-healing DFU(s) despite standard care for at least 4 weeks before the study...
July 2016: Journal of Wound Care
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