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diabetic foot infection AND/OR diabetic foot ulcer

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
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
Mesut Mutluoglu, Gunalp Uzun, Michael Bennett, Peter Germonpré, David Smart, Daniel Mathieu
Diabetic foot ulcers (DFUs) are one of the most common indications for hyperbaric oxygen treatment (HBOT). The role of HBOT in DFUs is often debated. Recent evidence based guidelines, while recommending its use, urge further studies to identify the patient subgroups most likely to benefit from HBOT. A recent study in Diabetes Care aimed to assess the efficacy of HBOT in reducing the need for major amputation and improving wound healing in patients with chronic DFUs. In this study, patients with Wagner grade 2-4 diabetic foot lesions were randomly assigned to have HBOT (30 sessions/90 min/244 kPa) or sham treatment (30 sessions/90 min/air/125 kPa)...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
Gamze Akkus, Mehtap Evran, Dilek Gungor, Mehmet Karakas, Murat Sert, Tamer Tetiker
OBJECTIVE: Impaired cellular immunity and reduced phagocytic function of polymorphonuclear leukocytes facilitate the development of skin fungal and bacterial infections due to uncontrolled hyperglycemia in diabetic patients. In our study, we aimed to assess onychomycosis and/or tinea pedis frequency in diabetic patients, and effects on the development of chronic complications, particularly foot ulcer. METHODS: We included 227 diabetic patients in the study. Forty-three patients had diabetic foot ulcer...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Thomas Serena, Heather Connell, Sharon McConnell, Keyur Patel, Bryan Doner, Matthew Sabo, Michael Miller, Laura Serena, Lam T Le, David Goldsmith, Jane Chung
OBJECTIVE: The purpose of this retrospective registry data analysis was to explore the effectiveness of a novel multivalent topical ointment (Terrasil Infection Control Wound Care Ointment; Aspiera Medical, Woonsocket, Rhode Island), containing a patented mineral complex and 0.2% benzethonium chloride in the treatment of nonhealing acute and chronic wounds. DESIGN: Aspiera Medical designed a registry to capture physician experiences and treatment results with Terrasil Infection Control Wound Care Ointment...
October 2016: Advances in Skin & Wound Care
Bianca L Price, Andrew M Lovering, Frank L Bowling, Curtis B Dobson
Diabetes has major implications for public health, with diabetic foot ulcers (DFUs) being responsible for significant morbidity and mortality. A key factor in the development of non-healing ulcers is infection, which often leads to the development of biofilm, gangrene and amputation. A novel approach to treating DFUs is the local release of antibiotics from calcium sulfate beads. We have developed a novel model system to study and compare the release and efficacy of antibiotics released locally, using collagen as a substrate for biofilm growth, and incorporating serum to mimic the biochemical complexity of the wound environment...
September 12, 2016: Antimicrobial Agents and Chemotherapy
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 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 (DFU), a common and costly complication of diabetes, and its association with healing and clinical complications...
August 23, 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
Dane K Wukich, Katherine M Raspovic
BACKGROUND: Patients with diabetic foot disease are at an increased risk for lower extremity amputation (LEA), premature mortality, and reduced health-related quality of life. In the setting of chronic infection, significant tissue loss, and/or an unstable deformity, limb salvage may not be possible, and major amputation is necessary. METHODS: The primary goal of this study was to review the literature with an emphasis on the functional aspects associated with successful limb salvage versus major LEA...
September 2016: Plastic and Reconstructive Surgery
K Nagasaki, H Obara, K Tanaka, K Koyano, A Asamia, Y Kitagawa
OBJECTIVE: We retrospectively assessed the effectiveness of peripheral nerve crushing (Smithwick operation) in relieving intractable chronic pain associated with foot ulcers caused by diabetes mellitus (DM) or atherosclerosis. METHOD: From April 2009 to April 2012, patients underwent peripheral nerve crushing in the leg affected by foot ulceration. The cause of ulceration was either DM alone, atherosclerosis alone, or both DM and atherosclerosis. Because sensation in the foot is associated with five nerves: the tibial, deep peroneal, superficial peroneal, sural, and saphenous, one or more of these nerves were crushed over a length of 1...
August 2016: Journal of Wound Care
D H B Ubayawansa, W Y M Abeysekera, M M A J Kumara
OBJECTIVE: To determine the epidemiology and conditions frequently seen in major lower extremity amputation. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Teaching Hospital Karapitiya, Sri Lanka, from October 2013 to September 2014. METHODOLOGY: Major lower limb amputations were identified according to ICD-10 criteria. Data was retrospectively collected. Type of the amputation, indication for the amputation, gender and age of the patients, and mortality were noted...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Reinout van Crevel, Steven van de Vijver, David A J Moore
Tropical countries are experiencing a substantial rise in type 2 diabetes, which is often undiagnosed or poorly controlled. Since diabetes is a risk factor for many infectious diseases, this increase probably adds to the large infectious disease burden in tropical countries. We reviewed the literature to investigate the interface between diabetes and infections in tropical countries, including the WHO-defined neglected tropical diseases. Although solid data are sparse, patients with diabetes living in tropical countries most likely face increased risks of common and health-care-associated infections, as well as infected foot ulcers, which often lead to amputation...
August 4, 2016: Lancet Diabetes & Endocrinology
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
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
Eran Tamir, Aharon S Finestone, Erez Avisar, Gabriel Agar
BACKGROUND: Patients with peripheral neuropathy and pressure under a relatively plantar deviated metatarsal head frequently develop plantar foot ulcers. When conservative management with orthotics and shoes does not cure the ulcer, surgical metatarsal osteotomy may be indicated to relieve the pressure and enable the ulcer to heal. The purpose of this study is to evaluate the use of a mini-invasive floating metatarsal osteotomy in treating recalcitrant ulcers or recurrent ulcers plantar to the metatarsal heads in patients with diabetes mellitus (DM) related neuropathy...
2016: Journal of Orthopaedic Surgery and Research
Catherine Dunyach-Remy, Christelle Ngba Essebe, Albert Sotto, Jean-Philippe Lavigne
Infection of foot ulcers is a common, often severe and costly complication in diabetes. Diabetic foot infections (DFI) are mainly polymicrobial, and Staphylococcus aureus is the most frequent pathogen isolated. The numerous virulence factors and toxins produced by S. aureus during an infection are well characterized. However, some particular features could be observed in DFI. The aim of this review is to describe the role of S. aureus in DFI and the implication of its toxins in the establishment of the infection...
2016: Toxins
Kobe Van Bael, Geerhardus Van der Tempel, Isabelle Claus, Sabrina Speybrouck, Johan De Coster, Sylvie De Laere, Erik Debing, Dimitri Aerden
BACKGROUND: Diabetic foot ulceration is the leading cause of major amputation in the developed world. Plantar neuropathic ulcers at the forefoot can be managed conservatively with off-loading, but treatment is not invariably successful. Achilles tendon lengthening procedures aim at increasing dorsiflexion and decreasing forefoot pressure but can be associated with complications and require prolonged postoperative immobilization to prevent tendon rupture. We assessed the feasibility and clinical outcome of a comparative minimal invasive procedure: the gastrocnemius fascia release...
August 18, 2016: Acta Chirurgica Belgica
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