Managing Diabetic Foot Ulcers

Fowler, Evonne; Vesely, Noreen; Pelfrey, M; JORDAN, SHETONA; Amberry, Thomas

doi:10.1097/00004045-199906000-00005

Cited by 3 publications

(4 citation statements)

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“…DFU: Again, the underlying complications associated with ulcer pathology must be appropriately addressed. With DFU, these include controlling infection, ensuring glycemic control, and initiation of therapeutic off‐loading to avoid wound exacerbation and aid healing 35,42–45,56 …”

Section: Resultsmentioning

confidence: 99%

“…These included draft guidelines developed by professional societies, as well as Cochrane meta-analyses of wound care clinical trials and established practice patterns or guidelines sanctioned by managed care and third-party payors. [1][2][3]5,[32][33][34] Additional searches of the English-language literature were conducted, utilizing the following search strings and limited to the past 7 years: 8,10,16,36 ; patient and wound bed preparation [37][38][39][40][41] ; wound treatment, including Apligraf s application 5,9,15,16,18,30,31 ; follow-up and continued management of underlying pathology: weight off-loading in DFU, 35,[42][43][44] compression therapy in VLU ulcers [45][46][47] ; healing outcomes 48,49 ; and indices of success and criteria for reapplication of the product. Developed draft guidelines included flowchart algorithms, as well as accompanying explanatory figure legends.…”

Section: Methodsmentioning

confidence: 99%

“…Preliminary (draft) guidelines were developed, based on the review of existing medical literature. Draft guidelines encompassed confirmation of diagnosis 3,4,34,35 ; appropriate patient selection 8,10,16,36 ; patient and wound bed preparation 37–41 ; wound treatment, including Apligraf ® application 5,9,15,16,18,30,31 ; follow‐up and continued management of underlying pathology: weight off‐loading in DFU, 35,42–44 compression therapy in VLU ulcers 45–47 ; healing outcomes 48,49 ; and indices of success and criteria for reapplication of the product. Developed draft guidelines included flowchart algorithms, as well as accompanying explanatory figure legends.…”

Section: Methodsmentioning

confidence: 99%

“…With DFU, these include controlling infection, ensuring glycemic control, and initiation of therapeutic off-loading to avoid wound exacerbation and aid healing. 35,[42][43][44][45]56…”

Section: Concomitant Factor Controlmentioning

confidence: 99%

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Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf^®) in the treatment of lower‐extremity ulcers

Cavorsi

Vicari

Wirthlin

et al. 2006

Wound Repair Regeneration

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Tissue-engineered skin substitutes such as Apligraf have emerged over the past 20 years as among the most carefully studied and efficacious of the advanced wound modalities. These products have been proven as effective enhancements to general wound care, promoting wound closure particularly in instances where conventional wound care fails. Marketed for hard-to-heal wounds since 1998, Apligraf has become part of standard wound care in many wound centers across the United States. Despite this situation, few general wound care guidelines incorporate advanced and active wound-healing technologies, such as tissue-engineered skin products. Because of this deficiency, appropriate patient selection and proper use of these product remain largely unaddressed within the general wound care community. Here, we describe the development of guidelines surrounding optimal use of the bilayered living cell therapy, Apligraf, in the treatment of the two types of lower extremity ulcers for which the product is FDA approved: venous leg ulcer and diabetic foot ulcer. The guidelines detailed in this article focus on the identification and selection of patients who are at risk for failure of standard wound care therapy and thus appropriate for Apligraf treatment. The intended audience for these guidelines is the general wound care practitioner, for whom the developed treatment algorithms and accompanying figure legends should provide practical, user-friendly direction simplifying both patient selection and appropriate use of Apligraf within the context of good wound-healing practice.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…With DFU, these include controlling infection, ensuring glycemic control, and initiation of therapeutic off-loading to avoid wound exacerbation and aid healing. 35,[42][43][44][45]56…”

Section: Concomitant Factor Controlmentioning

confidence: 99%

See 2 more Smart Citations

Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf^®) in the treatment of lower‐extremity ulcers

Cavorsi

Vicari

Wirthlin

et al. 2006

Wound Repair Regeneration

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Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

Jesús¹,

Medina²,

Troche³

et al. 2007

International Wound Journal

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The use of antiseptics in wound care is often controversial and there is definitely a need for a non toxic, highly disinfective agent. This study assessed the efficacy of a neutral pH superoxidised aqueous solution (NpHSS) for infection control, odour reduction and surrounding skin and tissue damage on infected diabetic foot ulcerations. From November 2003 to March 2004, 45 patients with type 2 diabetes were randomised into a single-blind clinical trial comparing NpHSS (intervention group; n = 21) versus conventional disinfectant (control group; n = 16). All patients received comprehensive care including surgical debridement as appropriate, moist wound care, intensive glucose control and broad spectrum antibiotics. Treatment groups were matched in terms of sex, age (61.9 +/- 11.9 versus 67.8 +/- 11.6), years of diabetes duration (16.4 +/- 8.1 versus 17 +/- 10.2), obesity, HgAlc (7.1 +/- 2 versus 6.7 +/- 1.8), initial fasting glycaemia (163 +/- 59 versus 152 +/- 65.8 mg/dl), ulcer duration/week (13.7 +/- 24 versus 15.1 +/- 16.3), B/A Index (0.9 +/- 0.5 versus 1.14 +/- 0.7), depth and extent of infection/periwound cellulitis (groups B and C of the Tampico Hospital Classification) as well as aetiology (P = 0.647). Odour reduction was achieved in all NpHSS patients (100% versus 25%; P < 0.01) and surrounding cellulitis diminished (P < 0.001) in 17 patients (80.9% versus 43.7%). Nineteen patients in the NpHSS group showed advancement to granulating tissue stage (90.4% versus 62.5%; P = 0.05) with significantly less tissue toxicity (94% versus 31.2%; P < 0.01). A non toxic, NpHSS, as part of a comprehensive care regimen, may be more efficacious in infection control, odour and erythema reduction than conventional disinfectants in treatment of diabetic foot infections.

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The Diabetic Foot Research in Arabs’ Countries

Alzahrani¹,

Badahdah²,

Bamakrid³

et al. 2013

OJEMD

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Objective: To review all the studies on diabetic foot disorders (DFDs) that were published on the PubMed ® site aiming to identify the contributions of the different Arabs' countries in the world scientific literature on this topic. Methods: The PubMed ® site was searched using different key words for searching all the abstracts on Diabetes mellitus (DM) and DFDs published from Arabs' League countries (n = 22). For this review, the 22 countries were classified into 3 groups: Group 1 (G1): Gulf Council Countries (GCC) countries (n = 6), Group 2 (G2): African Arabs' countries (n = 10), Group 3 (G3): Asian and/or Eastern Mediterranean Arabs' countries (n = 6). All the abstracts on DM coming from all of the 22 Arabs' countries were initially reviewed to locate the ones related to DFDs' management. All of the articles related to DFDs were reviewed by the senior author. A publication index was created to allow a comparison between the productivity of various countries and correlate that to the population number. Results: By April 2012, a total of 906 articles were published on DM, out of them 115 (11.6%) were related to DFDs. The largest number of DM/DFDs research came from G1 countries (n = 437/51) followed by G2 (n = 307/38) and finally G3 (n = 162/26). The percentages of the studies related to DFDs were therefore: 11.6%, 12.3% and 20.6% respectively. Saudi Arabia was the top on the list of all studied countries with 31 studies related to DFDs out of the 187 on DM (16.5%). Conclusion: More research on DFDs is needed in most of the Arabs' countries particularly those in the GCC region which reported very high prevalence rates and are expected to hold these rates for the coming decades. Also, special attention is needed for those lowincome Arabs' countries that had no contributions in DFDs' research.

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Managing Diabetic Foot Ulcers

Cited by 3 publications

References 0 publications

Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf^®) in the treatment of lower‐extremity ulcers

Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf^®) in the treatment of lower‐extremity ulcers

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

The Diabetic Foot Research in Arabs’ Countries

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Managing Diabetic Foot Ulcers

Cited by 3 publications

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Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf®) in the treatment of lower‐extremity ulcers

Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf®) in the treatment of lower‐extremity ulcers

Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections

The Diabetic Foot Research in Arabs’ Countries

Contact Info

Product

Resources

About

Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf^®) in the treatment of lower‐extremity ulcers

Best‐practice algorithms for the use of a bilayered living cell therapy (Apligraf^®) in the treatment of lower‐extremity ulcers