A Severe Diabetic Foot Ulcer With Intermediate Cuneiform Displacement and Multidrug-Resistant Pseudomonas aeruginosa Infection: A Rare Case Report

Chai, Wei; Wang, Yuqing; Jiao, Fengjuan; Wu, Yili; Wang, Shuai

doi:10.3389/fmed.2020.00131

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…Silver ion dressing on the ulcerated surface of diabetic foot can form a local antibacterial environment to reduce the chance of bacterial infection and, thus, reduce local secretion, with bactericidal and antibacterial effects and absorption of wound exudate [ 10 , 11 ]. Prontosan gel has a long-lasting preventive effect against bacterial biofilm, provides moisture to the wound, and can cause autolysis of necrotic tissue in the DF to promote wound healing [ 12 ]. Both dressings are widely used in the treatment of DFU and have good results, but there are relatively few reports on the efficacy of their combined application on DFU.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

Chu

Tao

2021

Evidence-Based Complementary and Alternative Medicine

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Diabetic foot ulcers (DFUs) have a high disability rate and have a great impact on patients and society, and the search for effective and economical treatment options is a major clinical concern. In this study, 112 patients with DFU admitted to two hospitals from October 2018 to November 2020 were randomly divided into 56 cases each in the single group treated with Prontosan gel dressing and the joint group treated on silver ion dressing combined with Prontosan gel dressing. Both groups of patients were evaluated for efficacy after 30 days of treatment. The number of days for debridement, granulation tissue growth time, epithelial tissue formation time, and wound healing time were observed and recorded in both groups. The trauma area, visual analogue score (VAS), and levels of inflammatory factors such as vascular endothelial adhesion molecule-1 (VCAM-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were recorded before and after treatment in both groups. The occurrence of adverse reactions such as edema, fever, infection, and rash during treatment was recorded in both groups for safety assessment. Comparison of the abovementioned data showed that the clinical efficacy of the joint group was significantly higher than that of the single group. The number of days to clear wounds, granulation tissue growth time, epithelial tissue formation time, and wound healing time were significantly lower in the joint group than in the single group. The trauma area, VAS score, VCAM-1, IL-6, TNF-α, and CRP levels decreased in both groups after treatment compared with the pretreatment levels, with the joint group being lower than the single group. The results also showed that the difference in the overall incidence of adverse reactions between the two groups was not statistically significant, and the incidence was low and transient. In addition to the usual treatment regimen of blood glucose control and improvement of microcirculation for patients with DFU, combined treatment with silver ionomer dressings and Prontosan gel dressings can promote ulcer healing and improve foot wound regression. It has a stronger antibacterial effect and can more effectively reduce the inflammatory response of the ulcerated surface with fewer adverse effects, making it an effective and safe method for the treatment of DFU, and has implications for promotion.

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Section: Introductionmentioning

confidence: 99%

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

Chu

Tao

2021

Evidence-Based Complementary and Alternative Medicine

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“…[50][51][52] There are several clinical studies documenting the effect of PHMB solutions on wound bioburden in a variety of wound types (Table 4). Chronic wounds such as venous leg ulcers, 50,51,53,54 diabetic foot ulcers, 53,56,57 pressure ulcers, 53,58 and malignant wounds 59 have all benefitted from treatment including the use of PHMB solutions. Burn wounds 60 and acute wounds such as surgical wounds, [61][62][63] skin graft donor site wounds, 64 and traumatic wounds 65 have also shown positive results for PHMB solution irrigation in terms of reducing wound bioburden.…”

Section: Phmb Solutionsmentioning

confidence: 99%

Polyhexamethylene biguanide and its antimicrobial role in wound healing: a narrative review

Rippon

Rogers²,

Ousey

2023

J Wound Care

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A wound offers an ideal environment for the growth and proliferation of a variety of microorganisms which, in some cases, may lead to localised or even systemic infections that can be catastrophic for the patient; the development of biofilms exacerbates these infections. Over the past few decades, there has been a progressive development of antimicrobial resistance (AMR) in microorganisms across the board in healthcare sectors. Such resistant microorganisms have arisen primarily due to the misuse and overuse of antimicrobial treatments, and the subsequent ability of microorganisms to rapidly change and mutate as a defence mechanism against treatment (e.g., antibiotics). These resistant microorganisms are now at such a level that they are of grave concern to the World Health Organization (WHO), and are one of the leading causes of illness and mortality in the 21st century. Treatment of such infections becomes imperative but presents a significant challenge for the clinician in that treatment must be effective but not add to the development of new microbes with AMR. The strategy of antimicrobial stewardship (AMS) has stemmed from the need to counteract these resistant microorganisms and requires that current antimicrobial treatments be used wisely to prevent amplification of AMR. It also requires new, improved or alternative methods of treatment that will not worsen the situation. Thus, any antimicrobial treatment should be effective while not causing further development of resistance. Some antiseptics fall into this category and, in particular, polyhexamethylene hydrochloride biguanide (PHMB) has certain characteristics that make it an ideal solution to this problem of AMR, specifically within wound care applications. PHMB is a broad-spectrum antimicrobial that kills bacteria, fungi, parasites and certain viruses with a high therapeutic index, and is widely used in clinics, homes and industry. It has been used for many years and has not been shown to cause development of resistance; it is safe (non-cytotoxic), not causing damage to newly growing wound tissue. Importantly there is substantial evidence for its effective use in wound care applications, providing a sound basis for evidence-based practice. This review presents the evidence for the use of PHMB treatments in wound care and its alignment with AMS for the prevention and treatment of wound infection.

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“…However, once the infection is identified, it is recommended to perform antibiotic susceptibility tests of the bacterial isolates[ 151 - 153 ]. There are several classes of antibiotics that are proposed as a monotherapy or as a combination therapy for eradication of P. aeruginosa in DFIs, including fluroquinolones, aminoglycosides, and colistin[ 83 , 84 , 143 , 147 , 151 , 152 ].…”

Section: The Most Prevalent Bacterial Dfismentioning

confidence: 99%

What’s old is new again: Insights into diabetic foot microbiome

Rajab¹,

Hegazy²

2023

World J Diabetes

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Diabetes is a chronic disease that is considered one of the most stubborn global health problems that continues to defy the efforts of scientists and physicians. The prevalence of diabetes in the global population continues to grow to alarming levels year after year, causing an increase in the incidence of diabetes complications and health care costs all over the world. One major complication of diabetes is the high susceptibility to infections especially in the lower limbs due to the immunocompromised state of diabetic patients, which is considered a definitive factor in all cases. Diabetic foot infections continue to be one of the most common infections in diabetic patients that are associated with a high risk of serious complications such as bone infection, limb amputations, and life-threatening systemic infections. In this review, we discussed the circumstances associated with the high risk of infection in diabetic patients as well as some of the most commonly isolated pathogens from diabetic foot infections and the related virulence behavior. In addition, we shed light on the different treatment strategies that aim at eradicating the infection.

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A Severe Diabetic Foot Ulcer With Intermediate Cuneiform Displacement and Multidrug-Resistant Pseudomonas aeruginosa Infection: A Rare Case Report

Cited by 9 publications

References 19 publications

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

Polyhexamethylene biguanide and its antimicrobial role in wound healing: a narrative review

What’s old is new again: Insights into diabetic foot microbiome

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