This study investigated the clinical performance and safety of a sustained silver-releasing foam dressing, Contreet Foam, in the treatment of diabetic foot ulcers. Twenty-seven patients with diabetic foot ulcers of grade I or II (Wagner's classification) were followed for six weeks: one week run-in using Biatain dressings, four weeks' treatment with Contreet dressings. Four ulcers healed during the four-week treatment with Contreet 56% in average. Contreet Foam showed good exudate management properties and was considered easy to use. Only two infections occurred showed that all six of the non-study ulcers developed an infection during the study. All ulcers (study ulcers as well as non-study ulcers) were treated according to good practice of diabetic wound care. There were no directions for the treatment of secondary wounds. No device-related adverse events were observed. This study demonstrated that Contreet Foam is safe and easy to use and effectively supports healing and good wound progress of diabetic foot ulcers.
Our case illustrates several important issues in the management of diabetic patients admitted to hospital with infection; the need to thoroughly examine the feet to ascertain any foot lesions and any underlying peripheral vascular disease or peripheral neuropathy, to treat aggressively any infected foot lesions to prevent serious complications of septicaemia and to consider rare conditions like endogenous endophthalmitis in any diabetic patient presenting with acute visual impairment and septicaemia.
Diabetic foot ulcers are common, difficult to manage and associated with increased morbidity and mortality. The role of dressings in their management is important, requiring an understanding of diabetic foot disease, wound physiology and dressing performance characteristics.
It has been suggested that 45% of lower limb amputations occur in patients with diabetes. Yet, in areas where there are specialist diabetic foot clinics, amputation rates fall. This was initially demonstrated by Edmonds et al2 and is now becoming the experience of many such clinics around the UK. The successful management of foot ulcers is dependent upon a multidisciplinary team approach, which must include both nuclear and peripheral health-care professionals, utilising a wide range of experience, skills and resources.
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