The diabetic foot ulcer

Reardon, Rebecca; Simring, Dominic; Kim, Boyoung; Mortensen, J. C.; Williams, Deepak; Leslie, Anthony

doi:10.31128/ajgp-11-19-5161

Cited by 130 publications

(110 citation statements)

References 14 publications

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“…Poor long-term glycemic control, diabetic peripheral neuropathy, diabetic peripheral vasculopathy, and local infection may all contribute to the development of DF. Patients with DF who do not receive effective treatment to manage their disease may suffer from reduced skin blood flow, nutritional deficiencies, and decreased body defenses leading to diabetic foot ulcers (DFUs) [ 2 , 3 ]. In patients with DM, the infection is not easy to clear due to the pathological basis such as poor local blood supply and impaired immune defense function, while the involvement of multiple inflammatory factors leading to systemic inflammation is an important reason that affects the development of DFU into gangrene, osteomyelitis, and even amputation [ 4 ].…”

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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“…They are also associated with high mortality risk, which is similar to overall five-year cancer mortality [1]. It is estimated that 19-34% of people with diabetes will develop a foot ulcer in their lifetime, and many of these will result in a digit or lower limb amputation [2]. Every year in Australia, there are 10,000 hospital admissions for DFU, with approximately 4400 of these resulting in an amputation [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…The hydroxylation also provides essential tensile strength to the newly formed collagen, which would otherwise not stretch without tearing [ 9 ]. Tensile strength is important in healed wounds; if it is not sufficient, wounds may break down, leading to re-ulceration [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Associations between Nutrients and Foot Ulceration in Diabetes: A Systematic Review

et al. 2021

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We reviewed the literature to evaluate potential associations between vitamins, nutrients, nutritional status or nutritional interventions and presence or healing of foot ulceration in diabetes. Embase, Medline, PubMed, and the Cochrane Library were searched for studies published prior to September 2020. We assessed eligible studies for the association between nutritional status or interventions and foot ulcers. Fifteen studies met the inclusion criteria and were included in this review. Overall, there is a correlation between poor nutritional status and the presence of foot ulceration or a delay in healing. However, there is not enough data to reach conclusions about whether the relationships are causal or only association. Further research is required to test whether any forms of nutritional supplementation improve foot ulcer healing.

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“…Globally, 422 million people have been diagnosed with diabetes, of which, approximately 15% develop leg ulcers [ 1 ]. Early treatment is the key to reducing the amputation rate in diabetic foot patients [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Production of an Animal Model of Semi-Yin and Semi-Yang Syndrome with Diabetic Ulcers and Study of Its Pathological and Metabolic Features

Liu

Shi

Xiong

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. To create an animal model for diabetic ulcers with semi-Yin and semi-Yang (SYSY) syndrome and to study the pathological and metabolic features of SYSY syndrome. Methods. Firstly, based on the clinical characteristics of the SYSY syndrome of diabetic ulcer, an animal model of diabetic ulcers with SYSY syndrome being full-thickness skin defects was created by injecting streptozotocin (STZ) intraperitoneally, infecting with Staphylococcus aureus, and gastrically administering senna. Secondly, the content and distribution patterns of collagen fibers, the expression of neutrophils and macrophage markers, angiogenesis, and the expression of IL-1β and IL-10 in the rats with Yang syndrome, Yin syndrome, and SYSY syndrome of diabetic ulcers at different time points were detected. Representative traditional Chinese medicine (TCM) ointment of Yang syndrome, Yin syndrome, and SYSY syndrome was used to treat this animal model. The above indexes in each treatment group were detected. Finally, metabonomics was used to detect and analyze the changes of differential metabolites related to macrophage metabolism in Yang, Yin, and SYSY syndromes at different time points. Results. An animal model of diabetic ulcers with SYSY syndrome was established. The pathological features of the SYSY syndrome group were chronic low-grade inflammatory reactions. On the third day, the SYSY syndrome group displayed lower expression of CD16, CD68, CD163, IL-1β, and metabolites related to M1-type macrophages compared with other groups. On the seventh day, the SYSY syndrome group showed lower expression of CD31, IL-10, myeloperoxidase, and metabolites related to M2-type macrophages. Treatment with Chong He Ointment, a representative TCM ointment for SYSY syndrome, reversed the expression levels of these indexes and promoted wound healing in the SYSY group. Conclusion. SYSY syndrome presents a persistent pathological state of low inflammation, which may be caused by an insufficient activation of the M1-type metabolic pathway in macrophages in the early acute inflammatory stage, resulting in the incomplete clearance of pathogens and debris and continuous stimulation of macrophages to initiate the M1-type metabolic pathway. CD163, CD31, IL-10, and citric acid can be used as potential specific markers for the recovery and progression of SYSY syndrome.

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The diabetic foot ulcer

Cited by 130 publications

References 14 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

Associations between Nutrients and Foot Ulceration in Diabetes: A Systematic Review

Production of an Animal Model of Semi-Yin and Semi-Yang Syndrome with Diabetic Ulcers and Study of Its Pathological and Metabolic Features

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