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Diabetic wound care

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https://www.readbyqxmd.com/read/29350654/autolytic-debridement-and-management-of-bacterial-load-with-an-occlusive-hydroactive-deressing-impregnated-with-polyhexamethylene-biguanide
#1
Stefano Mancini, Roberto Cuomo, Mauro Poggialini, Carlo D'Aniello, Giuseppe Botta
BACKGROUND: Debridement and control of bacterial load are key-points of wound care. The aim of this study is to evaluate the effectiveness of autolytic debridement and management of bacterial load (bioburden) of an occlusive hydro-active dressing impregnated with polyhexamethylene biguanide (PHMB). METHODS: We used an occlusive dressing of hydro-active for leg ulcers' treatment (TenderWet-plus® - Hartmann).  Inclusion criteria were: presence of a fibrinous ulcer with multiple etiopathogenesis, in absence of clinical infection, no hypersecretion and diameter within 5 cm...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29346146/use-of-oxidized-regenerated-cellulose-collagen-matrix-in-chronic-diabetic-foot-ulcers-a-systematic-review
#2
Gisele Chicone, Viviane Fernandes de Carvalho, André Oliveira Paggiaro
OBJECTIVE: Diabetic wounds that do not heal completely usually exhibit inflammatory markers, increased protease activity, and reduced levels of growth factors and cell count. A systematic review was performed to determine whether there is enough evidence to support the use of an oxidized regenerated cellulose/collagen matrix (ORC+C) to treat diabetic foot ulcers (DFUs). METHODS: Study authors analyzed randomized controlled trials (RCTs) on ORC+C dressings for the treatment of DFUs...
February 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29336265/efficacy-of-aloe-vera-plantago-major-gel-in-diabetic-foot-ulcer-a-randomized-double-blind-clinical-trial
#3
Younes Najafian, Zahra Mazloum Khorasani, Mona Najaf Najafi, Shokouhsadat Hamedi, Marjan Mahjour, Zohre Feyzabadi
BACKGROUND: Diabetic foot ulcer (DFU) is one of the most common complications of diabetic patients. Mostly, non-healing DFU leads to infection, gangrene, amputation and even death. High costs and poor healing of the wounds need a new treatment such as alternative medicine. So, the aim of this study was to evaluate the efficacy of Aloe vera/ Plantago major gel (Plantavera gel) in healing of DFU. METHODS: Forty patients with DFU enrolled in a double-blind randomized clinical trial...
January 14, 2018: Current Drug Discovery Technologies
https://www.readbyqxmd.com/read/29332930/bullosis-diabeticorum-a-rare-presentation-with-immunoglobulin-g-igg-deposition-related-vasculopathy-case-report-and-focused-review
#4
Hardik Sonani, Sohail Abdul Salim, Vishnu V Garla, Anna Wile, Venkataraman Palabindala
BACKGROUND Bullosis diabeticorum (BD) is a condition characterized by recurrent, spontaneous, and non-inflammatory blistering in patients with poorly controlled diabetes mellitus. While etiopathogenesis remains unclear, roles of neuropathy, vasculopathy and UV light are hypothesized. Most literature reports negative direct and indirect immunofluorescence findings in diabetics with bullous eruptions. Porphyria cutanea tarda, bullous pemphigoid, epidermolysis bullosa, and pseudoporphyria are other differential diagnoses of bullous lesions, and they must be excluded...
January 15, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29305548/epidemiology-clinical-characteristics-and-antimicrobial-susceptibility-profiles-of-human-clinical-isolates-of-staphylococcus-intermedius-group
#5
Melanie L Yarbrough, William Lainhart, C A Burnham
The veterinary pathogens in Staphylococcus intermedius group (SIG) are increasingly recognized as causes of human infection. Shared features between SIG and Staphylococcus aureus may result in misidentification of SIG in human clinical cultures. This study examined the clinical and microbiological characteristics of isolates recovered at a tertiary care academic medical center. From 2013 to 2015, 81 SIG isolates were recovered from 62 patients. Patients were commonly ≥ 50 years old, diabetic, or immunocompromised...
January 5, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29304937/an-economic-evaluation-of-the-impact-cost-and-medicare-policy-implications-of-chronic-nonhealing-wounds
#6
Samuel R Nussbaum, Marissa J Carter, Caroline E Fife, Joan DaVanzo, Randall Haught, Marcia Nusgart, Donna Cartwright
OBJECTIVE: The aim of this study was to determine the cost of chronic wound care for Medicare beneficiaries in aggregate, by wound type and by setting. METHODS: This retrospective analysis of the Medicare 5% Limited Data Set for calendar year 2014 included beneficiaries who experienced episodes of care for one or more of the following: arterial ulcers, chronic ulcers, diabetic foot ulcers, diabetic infections, pressure ulcers, skin disorders, skin infections, surgical wounds, surgical infections, traumatic wounds, venous ulcers, or venous infections...
January 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29295546/zinc-in-wound-healing-modulation
#7
REVIEW
Pei-Hui Lin, Matthew Sermersheim, Haichang Li, Peter H U Lee, Steven M Steinberg, Jianjie Ma
Wound care is a major healthcare expenditure. Treatment of burns, surgical and trauma wounds, diabetic lower limb ulcers and skin wounds is a major medical challenge with current therapies largely focused on supportive care measures. Successful wound repair requires a series of tightly coordinated steps including coagulation, inflammation, angiogenesis, new tissue formation and extracellular matrix remodelling. Zinc is an essential trace element (micronutrient) which plays important roles in human physiology...
December 24, 2017: Nutrients
https://www.readbyqxmd.com/read/29277539/skin-wound-healing-is-accelerated-by-a-lipid-mixture-representing-major-lipid-components-of-chamaecyparis-obtusa-plant-extract
#8
Byung Eui Kim, Elena Goleva, Clifton F Hall, Sang Hyun Park, Un Ha Lee, Anne M Brauweiler, Joanne E Streib, Brittany N Richers, Gwuicheol Kim, Donald Y M Leung
In chronic non-healing wounds, the healing process is disrupted and wounds are often infected with bacteria. About 85% of lower extremity amputations in diabetes are attributed to deep infection of foot ulcers. Therefore, infection control is critical for wound care. In this study, we analyzed lipid composition of Chamaecyparis (C) obtusa extract, and describe the wound healing properties of its combination of ten major lipid components. A 10 lipid mixture upregulated HBD-3 and LL-37 through the olfactory receptor 2AT4, and induced phosphorylation of extracellular signal-regulated kinases and p38 mitogen-activated protein kinases in primary human keratinocytes...
December 22, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/29275068/sucrose-octasulfate-dressing-versus-control-dressing-in-patients-with-neuroischaemic-diabetic-foot-ulcers-explorer-an-international-multicentre-double-blind-randomised-controlled-trial
#9
Michael Edmonds, José Luis Lázaro-Martínez, Jesus Manuel Alfayate-García, Jacques Martini, Jean-Michel Petit, Gerry Rayman, Ralf Lobmann, Luigi Uccioli, Anne Sauvadet, Serge Bohbot, Jean-Charles Kerihuel, Alberto Piaggesi
BACKGROUND: Diabetic foot ulcers are serious and challenging wounds associated with high risk of infection and lower-limb amputation. Ulcers are deemed neuroischaemic if peripheral neuropathy and peripheral artery disease are both present. No satisfactory treatment for neuroischaemic ulcers currently exists, and no evidence supports one particular dressing. We aimed to assess the effect of a sucrose octasulfate dressing versus a control dressing on wound closure in patients with neuroischaemic diabetic foot ulcers...
December 20, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29274639/the-changing-roles-of-community-nurses-the-case-of-health-plan-nurses-in-israel
#10
Rachel Nissanholtz-Gannot, Bruce Rosen, Miriam Hirschfeld
BACKGROUND: In Israel, approximately one-third of the country's nurses work in community settings - primarily as salaried employees in Israel's four non-profit health plans. Many health system leaders believe that the roles of health plan nurses have changed significantly in recent years due to a mix of universal developments (such as population aging and academization of the profession) and Israel-specific changes (such as the introduction of extensive quality monitoring in primary care)...
December 23, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29261560/the-effect-of-foot-exercises-on-wound-healing-in-type-2-diabetic-patients-with-a-foot-ulcer
#11
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...
December 19, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29260243/-perioperative-handling-of-antidiabetic-drugs
#12
REVIEW
J Wagner, V Luber, J F Lock, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
Diabetes mellitus is the most frequent metabolic disorder in the western world with a prevalence of 3% in adults under 65 years of age and 14.3% in adults over 65 years of age. Due to the increasing age of our population, the number of patients taking oral antidiabetic drugs has increased. Thus, operating physicians must make a risk-adapted decision whether the medication can be continued perioperatively or if certain drugs must be paused, and if so, with what risks. Operative interventions can lead to a number of metabolic shifts, which change the normal glucose metabolism...
December 19, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29248237/the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-correlates-with-cost-of-care-for-diabetic-foot-ulcers-treated-in-a-multidisciplinary-setting
#13
Caitlin W Hicks, Joseph K Canner, Hikmet Karagozlu, Nestoras Mathioudakis, Ronald L Sherman, James H Black, Christopher J Abularrage
OBJECTIVE: We have previously demonstrated that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing time in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. Our aim was to assess whether the charges and costs associated with DFU care increase with higher WIfI stages. METHODS: All patients presenting to our multidisciplinary diabetic limb preservation service from June 2012 to June 2016 were enrolled in a prospective database...
December 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29243399/diabetic-foot-ulcer-management-in-clinical-practice-in-the-uk-costs-and-outcomes
#14
Julian F Guest, Graham W Fuller, Peter Vowden
The aim of this study was to estimate the patterns of care and annual levels of health care resource use attributable to managing diabetic foot ulcers (DFUs) in clinical practice by the UK's National Health Service (NHS), and the associated costs of patient management. This was a retrospective cohort analysis of the records of 130 patients with a newly diagnosed DFU in The Health Improvement Network (THIN) database. Patients' characteristics, wound-related health outcomes and health care resource use were quantified, and the total NHS cost of patient management was estimated at 2015-2016 prices...
December 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29232436/cellular-versus-acellular-grafts-for-diabetic-foot-ulcers-altering-the-protocol-to-improve-recruitment-to-a-comparative-efficacy-trial
#15
Catherine N Tchanque-Fossuo, Sara E Dahle, Hadar Lev-Tov, Chin-Shang Li, R Rivkah Isseroff
Diabetic foot ulcers (DFUs) have a substantial impact on public health. The standard of care (SOC) for DFUs consists of a multidisciplinary approach involving glycemic control, wound care with debridement of necrotic tissue, application of a moist dressing, infection control, use of off-loading devices, and patient education. New therapeutic devices aim to target the extracellular matrix (ECM) that is impaired in DFU; however, there is insufficient data on the effectiveness of such therapies along with lack of evidence on their long-term effectiveness...
November 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29220878/a-qualitative-study-of-the-experience-of-lower-extremity-wounds-and-amputations-among-people-with-diabetes-in-philadelphia
#16
Frances K Barg, Peter F Cronholm, Ebony E Easley, Trocon Davis, Michelle Hampton, D Scot Malay, Cornelius Donohue, Jinsup Song, Stephen R Thom, David J Margolis
The purpose of this study was to explore perceptions among people with type 2 diabetes about foot ulcers and lower extremity amputations. This was a qualitative observational study utilizing open-ended, semistructured interviews of 39 people with diabetes who were purposively selected because they had either a foot ulcer (n = 19) or a lower extremity amputation (n = 20). Interviews were audio-recorded, deidentified, and entered into NVivo 10.0 for coding and analysis. Our integrated analytic approach combined inductively and deductively derived codes that were applied to all transcripts...
December 8, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29188676/autologous-lipotransfer-versus-stromal-vascular-fraction-enriched-lipoinjection-for-diabetic-foot-wounds-healing-a-pilot-study
#17
G Vicenti, G Solarino, V Pesce, L Moretti, A Notarnicola, M Carrozzo, F Rifino, B Moretti
Chronic ulcers of the lower limbs represent a significant social and economic burden. Diabetes is a strong risk factor for development of chronic lesions. Adult stem cells and growth factors derived from the adipose tissue are among the most promising therapeutic strategies for hard to heal wounds. Fat grafts have been used for several decades to treat soft tissue deformities, but despite its excellent characteristics, the outcome was unpredictable, due to partial necrosis and resorption of the graft. Stem cells’ enrichment of these grafts or their injection into the edges of the ulcers have shown encouraging results in various experimental settings...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29182584/adjuvant-biological-therapies-in-chronic-leg-ulcers
#18
REVIEW
Natalia Burgos-Alonso, Igone Lobato, Igone Hernández, Kepa San Sebastian, Begoña Rodríguez, Gontzal Grandes, Isabel Andia
Current biological treatments for non-healing wounds aim to address the common deviations in healing mechanisms, mainly inflammation, inadequate angiogenesis and reduced synthesis of extracellular matrix. In this context, regenerative medicine strategies, i.e., platelet rich plasmas and mesenchymal stromal cell products, may form part of adjuvant interventions in an integral patient management. We synthesized the clinical experience on ulcer management using these two categories of biological adjuvants. The results of ten controlled trials that are included in this systematic review favor the use of mesenchymal stromal cell based-adjuvants for impaired wound healing, but the number and quality of studies is moderate-low and are complicated by the diversity of biological products...
November 28, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29181642/laser-photobiomodulation-in-pressure-ulcer-healing-of-human-diabetic-patients-gene-expression-analysis-of-inflammatory-biochemical-markers
#19
Anelice Calixto Ruh, Lúcio Frigo, Marcos Fernando Xisto Braga Cavalcanti, Paulo Svidnicki, Viviane Nogaroto Vicari, Rodrigo Alvaro Brandão Lopes-Martins, Ernesto Cesar Pinto Leal Junior, Natalia De Isla, Francesca Diomede, Oriana Trubiani, Giovani Marino Favero
Pressure ulcers (PU) are wounds located mainly on bone surfaces where the tissue under pressure suffers ischemia leading to cellular lesion and necrosis , its causes and the healing process depend on several factors. The aim of this study was evaluating the gene expression of inflammatory/reparative factors: IL6, TNF, VEGF, and TGF, which take part in the tissue healing process under effects of low-level laser therapy (LLLT). In order to perform lesion area analysis, PUs were photographed and computer analyzed...
January 2018: Lasers in Medical Science
https://www.readbyqxmd.com/read/29166252/low-intensity-exercise-accelerates-wound-healing-in-diabetic-mice
#20
Todd Keylock, Lee Meserve, Amber Wolfe
INTRODUCTION: Moderate-intensity aerobic exercise has been noted to improve wound healing rates in mice and people, but different intensities of exercise may have different impacts on healing rates. It is important to determine the most beneficial exercise intensity for improving wound healing in people with type 2 diabetes to help prevent wounds from becoming chronic, greatly reduce pain and immobility, and lower the high cost of health care associated with treatment. OBJECTIVE: The purpose of this study is to determine the impact of low-intensity exercise compared with high-intensity exercise in terms of the rate of wound healing in diabetic mice...
November 20, 2017: Wounds: a Compendium of Clinical Research and Practice
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