Increasing Transcutaneous Oxygen Pressure in Patients With Neuroischemic Diabetic Foot Ulcers Treated With a Sucrose Octasulfate Dressing: A Pilot Study

Abstract

Regarding the positive clinical outcomes of sucrose octasulfate impregnated dressing documented in neuroischemic diabetic foot ulcers (DFUs), we aimed to evaluate the microcirculatory status in patients with neuroischemic DFU through the use of sucrose octasulfate dressing. Eleven patients with neuroischemic DFU were included in a prospective pilot study between July 2019 and March 2020. We evaluated the effect in transcutaneous oxygen pressure (TcPO2; mm Hg) values within the use of a sucrose octasulfate dressing in the course of the healing process of neuroischemic DFUs (UrgoStart Contact, Laboratoires Urgo Medical). TcPO2 values were assessed at day 0 and monthly until wound healing was achieved. Additionally, wound healing process was evaluated using the Wollina score system and wound area surface, at day 0 and monthly until 20 weeks of follow-up or wound healing first occurred. TcPO2 values showed a significant increase between day 0 (29.45 ± 7.38 mm Hg) and wound closure (46.54 ± 11.45 mm Hg, P = .016), after dressing application. Wollina wound scores showed a significant improvement (4.2 ± 1.7 at day 0 to 5.4 ± 1.3 at the end of the study; P = .004). Median wound area at day 0 was 1.30 cm2, interquartile range [1.60-1] cm2, and 0.5 cm2 at week 4, interquartile range [1.1-0.1], P < .001. Median healing time was 8 weeks, interquartile range [8-5]. Treating a neuroischemic DFU with a sucrose octasulfate dressing in the standard of care showed an increase in skin oxygen pressure.

Distribution of multidrug-resistant bacterial infections in diabetic foot ulcers and risk factors for drug resistance: a retrospective analysis

“…Some studies have found that nerve defect wound is a risk factor for MDROs infection, which is consistent with the results of this survey ( Laakso et al, 2017 ; Datta et al, 2019 ; Lazaro-Martinez et al, 2022 ). Amin et al found that DFU patients with nerve ischemic wounds had a seven-fold increased risk of MDROs infection ( Amin & Doupis, 2016 ).…”

Diabetic Wound-Healing Science

“…In the treatment of neuroischemic DFUs, a multicenter, randomized controlled trial found sucrose octasulfate dressings significantly improved wound closure in 48% of patients compared to the control (30%) [ 177 ]. Follow-up studies found sucrose octasulfate dressings improved transcutaneous oxygen pressure, and early treatment of DFUs with these dressings could lower treatment costs while improving wound healing rates [ 178 , 179 ]. A recent review by the Agency for Healthcare Research and Quality has identified 76 skin substitute products currently sold in the United States, with a majority being acellular products made up of decellularized dermal, placental, or animal tissue [ 233 ].…”

Risk factors for multidrug-resistant bacterial infections in patients with diabetic foot ulcers: a systematic review and meta-analysis

“…The category of diabetes, as well as the type and size of ulcers are also risk factors for MDRO infection. About half of all diabetic most ulcers belong to neuroischemic ulcers (27,28), which can destroy the microcirculation, hamper the nutrient absorption of local tissues, delay wound healing, and lead to the occurrence of MDRO infections. Also, when the ulcer area is ≥4 cm 2 , the risk of MDRO infections is also increased.…”