Medical Management of Diabetic Foot Infections

Bader, Mazen S.; Brooks, Annie

doi:10.3810/pgm.2012.03.2541

Cited by 7 publications

(4 citation statements)

References 95 publications

(127 reference statements)

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“…1 Adequate surgical debridement, effective antibiotic therapy, correction of metabolic abnormalities and proper wound management are essential for healing the chronic wounds of diabetic patients. 2, 3 Despite painstaking management, chronic wounds in the feet of diabetic patients frequently fail to heal completely. Therefore, many trials using bioengineered tissue or skin substitutes, growth factors, electronic stimulation or advanced moist wound therapy have been performed.…”

Section: Introductionmentioning

confidence: 99%

Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects

et al. 2013

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Non healing chronic wounds are difficult to treat in patients with diabetes and can result in severe medical problems for these patients and for society. Negative-pressure wound therapy (NPWT) has been adopted to treat intractable chronic wounds and has been reported to be effective. However, the mechanisms underlying the effects of this treatment have not been elucidated. To assess the vasculogenic effect of NPWT, we evaluated the systemic mobilization of endothelial progenitor cells (EPCs) during NPWT. Twenty-two of 29 consecutive patients who presented at the clinic of Seoul National Universty Hospital between December 2009 and November 2010 who underwent NPWT for diabetic foot infections or skin ulcers were included in this study. Peripheral blood samples were taken before NPWT (pre-NPWT) and 7–14 days after the initiation of NPWT (during-NPWT). Fluorescence-activated cell sorting (FACS) analysis showed that the number of cells in EPC-enriched fractions increased after NPWT, and the numbers of EPC colony forming units (CFUs) significantly increased during NPWT. We believe that NPWT is useful for treating patients with diabetic foot infections and skin ulcers, especially when these conditions are accompanied by peripheral arterial insufficiency. The systemic mobilization of EPCs during NPWT may be a mechanism for healing intractable wounds in diabetic patients with foot infections or skin defects via the formation of increased granulation tissue with numerous small blood vessels.

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Section: Introductionmentioning

confidence: 99%

Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects

et al. 2013

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“…Foot infections are a public health problem because they are difficult to eradicate and they lead to other complications like diabetic foot ulcers. The conventional treatments for foot infections include aggressive surgical debridement and antibiotic therapy (Bader & Brooks, 2012). However, some bacterial species have developed multidrug resistance to several antibiotics, making this a relevant public health problem.…”

Section: Resultsmentioning

confidence: 99%

Application of silver nanoparticles to reduce bacterial growth on leather for footwear manufacturing

Vega¹,

Guzmán²,

Pozos³

et al. 2021

JART

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Foot infections are difficult to eradicate, patients with diabetes mellitus among others are more susceptible to them, therefore preventive strategies and effective antimicrobial agents are needed. The antimicrobial properties of silver nanoparticles (AgNPs) are well known thus they are a trend for biomedical applications. The aim of this study was to investigate the antibacterial and antifungal activity of leather coated with AgNPs against two bacteria species Pseudomonas mendocina and Pseudomonas syringae, and the fungi Trichophyton mentagrophytes responsible for foot infections. Porcine leather was cut off and sprinkled with solutions containing various concentrations of metallic AgNPs. Inductively coupled plasma-atomic emission spectrometry (ICP-AES) and texture analysis of the leather were performed to quantify the silver metallic concentration metallic silver and to test the effect of AgNPs on leather softness. Antimicrobial activity was measured by agar diffusion test for zone of inhibition (ZoI). The textural analysis of the coated leather showed that the application of AgNPs diminished its softness in a concentration dependency manner. The results from the antimicrobial activity revealed that leather coated with 0.05% of metallic AgNPs had the best antibacterial effect. A decrease in the growth of T. mentagrophytes was observed on the leather coated with 0.25% of metallic AgNPs; however, this concentration was not enough to abolish fungal growing. In conclusion, the application of AgNPs to porcine leather decreased its softness but added beneficial antibacterial properties to avoid bacterial foot infections. Leather coated with AgNPs could be used as a suitable material to prevent foot infections and it could provide added value for shoes manufacturing.

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“…Adequate surgical debridement, effective antibiotic therapy, correction of metabolic abnormalities and proper wound management are essential for healing the intractable wounds of patients with diabetes . NPWT is an adjuvant therapy that uses negative pressure to evacuate infected fluid from the open wound through a sealed dressing and a tube that is connected to suction . This technique has enormous promise in treating battlefield casualties for whom access to first‐rate medical care may be limited.…”

Section: Introductionmentioning

confidence: 99%

Circulating fibrocyte mobilization in negative pressure wound therapy

Chen

Zhao

et al. 2017

J Cellular Molecular Medi

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Non-healing diabetic wounds are difficult to treat. They also create heavy financial burdens for both patients and society. Negative pressure wound therapy (NPWT) has been adopted to treat intractable wounds and has proved to be effective. However, the mechanisms that underlie the effects of this treatment are not entirely understood. Circulating fibrocytes are unique haematopoietic-derived stem cells that have been reported to play a pivotal role in wound healing. Here, we have investigated the effect of NPWT on fibrocyte mobilization and the role of fibrocyte mobilization in the healing of diabetic wounds during NPWT. We show that the NPWT group exhibited 2.6-fold to 12.1-fold greater numbers of tail vein-injected PKH-26-labelled fibrocytes in the diabetic wound sites compared with the control group. We also demonstrate that the fullthickness skin wounds treated with NPWT exhibit significantly reduced mRNA and protein expression, blood vessel density and proliferating cells when exogenous fibrocyte mobilization is inhibited. We speculate that systemic mobilization of fibrocytes during NPWT may be a mechanism for healing intractable wounds in a diabetic rat model experiment and that enhancement of cell mobilization may represent a potential treatment idea for intractable wound healing across all fields of surgery.

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Medical Management of Diabetic Foot Infections

Cited by 7 publications

References 95 publications

Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects

Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects

Application of silver nanoparticles to reduce bacterial growth on leather for footwear manufacturing

Circulating fibrocyte mobilization in negative pressure wound therapy

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