The Use of a Novel Super-Oxidized Solution on Top of Standard Treatment in the Home Care Management of Postsurgical Lesions of the Diabetic Foot Reduces Reinfections and Shortens Healing Time

Iacopi, Elisabetta; Abbruzzese, Lorenza; Goretti, Chiara; Riitano, Nicola; Piaggesi, Alberto

doi:10.1177/1534734618795593

Cited by 6 publications

(8 citation statements)

References 32 publications

(42 reference statements)

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“…A single study of a silver based dressing 23 that reported this outcome also showed an increase in the number of infections in the intervention group although no between group statistical analysis was presented with this result. A single study comparing superoxidised solution to a control 30 reported significantly lower rates of reinfection in the intervention arm, but this study was at high risk of bias.…”

Section: Resultsmentioning

confidence: 75%

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Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: A systematic review

Chen,

Vilorio,

Dhatariya

et al. 2024

Diabetes Metabolism Res

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BackgroundIt is critical that interventions used to enhance the healing of chronic foot ulcers in diabetes are backed by high‐quality evidence and cost‐effectiveness. In previous years, the systematic review accompanying guidelines published by the International Working Group of the Diabetic Foot performed 4‐yearly updates of previous searches, including trials of prospective, cross‐sectional and case‐control design.AimsDue to a need to re‐evaluate older studies against newer standards of reporting and assessment of risk of bias, we performed a whole new search from conception, but limiting studies to randomised control trials only.Materials and MethodsFor this systematic review, we searched PubMed, Scopus and Web of Science databases for published studies on randomised control trials of interventions to enhance healing of diabetes‐related foot ulcers. We only included trials comparing interventions to standard of care. Two independent reviewers selected articles for inclusion and assessed relevant outcomes as well as methodological quality.ResultsThe literature search identified 22,250 articles, of which 262 were selected for full text review across 10 categories of interventions. Overall, the certainty of evidence for a majority of wound healing interventions was low or very low, with moderate evidence existing for two interventions (sucrose‐octasulfate and leucocyte, platelet and fibrin patch) and low quality evidence for a further four (hyperbaric oxygen, topical oxygen, placental derived products and negative pressure wound therapy). The majority of interventions had insufficient evidence.ConclusionOverall, the evidence to support any other intervention to enhance wound healing is lacking and further high‐quality randomised control trials are encouraged.

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Section: Resultsmentioning

confidence: 75%

“…A study comparing a superoxidised solution to standard of care also reported on time to healing 30 . Despite there being no difference in complete wound healing overall at 6 months, time to healing was apparently significantly shorter by a mean of 82 days in the intervention arm compared to the control.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: A systematic review

Chen,

Vilorio,

Dhatariya

et al. 2024

Diabetes Metabolism Res

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“…Rationale: We found 12 studies 27–38 evaluating anti‐septic or antimicrobial dressings or topical antiseptic applications. Five evaluated the use of silver impregnated dressings in comparison with usual care 27–30,37 but all were considered at high or moderate risk of bias.…”

Section: Recommendationsmentioning

confidence: 99%

Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)

Chen,

Vilorio,

Dhatariya

et al. 2023

Diabetes Metabolism Res

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AimsPrinciples of wound management, including debridement, wound bed preparation, and newer technologies involving alternation of wound physiology to facilitate healing, are of utmost importance when attempting to heal a chronic diabetes‐related foot ulcer. However, the rising incidence and costs of diabetes‐related foot ulcer management necessitate that interventions to enhance wound healing of chronic diabetes‐related foot ulcers are supported by high‐quality evidence of efficacy and cost effectiveness when used in conjunction with established aspects of gold‐standard multidisciplinary care. This is the 2023 International Working Group on the Diabetic Foot (IWGDF) evidence‐based guideline on wound healing interventions to promote healing of foot ulcers in persons with diabetes. It serves as an update of the 2019 IWGDF guideline.Materials and MethodsWe followed the GRADE approach by devising clinical questions and important outcomes in the Patient‐Intervention‐Control‐Outcome (PICO) format, undertaking a systematic review, developing summary of judgements tables, and writing recommendations and rationale for each question. Each recommendation is based on the evidence found in the systematic review and, using the GRADE summary of judgement items, including desirable and undesirable effects, certainty of evidence, patient values, resources required, cost effectiveness, equity, feasibility, and acceptability, we formulated recommendations that were agreed by the authors and reviewed by independent experts and stakeholders.ResultsFrom the results of the systematic review and evidence‐to‐decision making process, we were able to make 29 separate recommendations. We made a number of conditional supportive recommendations for the use of interventions to improve healing of foot ulcers in people with diabetes. These include the use of sucrose octasulfate dressings, the use of negative pressure wound therapies for post‐operative wounds, the use of placental‐derived products, the use of the autologous leucocyte/platelet/fibrin patch, the use of topical oxygen therapy, and the use of hyperbaric oxygen. Although in all cases it was stressed that these should be used where best standard of care was not able to heal the wound alone and where resources were available for the interventions.ConclusionsThese wound healing recommendations should support improved outcomes for people with diabetes and ulcers of the foot, and we hope that widescale implementation will follow. However, although the certainty of much of the evidence on which to base the recommendations is improving, it remains poor overall. We encourage not more, but better quality trials including those with a health economic analysis, into this area.

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“…The AOS was found to have broad-spectrum microbicidal activity, and was neither toxic nor sensitizing to skin, mucosal membranes, or eyes. ( 9 – 11 ).…”

Section: Introductionmentioning

confidence: 99%

“…Clinical reports have demonstrated the efficacy of AOS formulation 1 when incorporated into the management of chronic wounds, with improved clinical outcomes following both inpatient and outpatient treatment ( 9 – 11 ). Low pH, hypochlorous acid, and high redox potential account for the broad-spectrum activity of AOS against microorganisms, including M. ulcerans , which is able to survive harsh decontamination procedures ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of an Acid-Oxidizing Solution against Mycobacterium ulcerans

Warryn

Pluschke

2022

Antimicrob Agents Chemother

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For the treatment of chronic wounds, acid-oxidising solutions (AOSs) with broad-spectrum microbicidal activity without disturbing granulation tissue formation, have been developed. We found AOSs to efficiently kill Mycobacterium ulcerans , the causative agent of Buruli ulcer, which is able to survive harsh decontamination treatments. Topical AOS treatment of Buruli ulcer lesions may support the recommended antibiotic therapy (oral rifampicin and clarithromycin), prevent contamination of the environment by the mycobacteria, and control secondary infections, which are a prevalent wound management problem in resource-poor Buruli ulcer endemic settings.

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The Use of a Novel Super-Oxidized Solution on Top of Standard Treatment in the Home Care Management of Postsurgical Lesions of the Diabetic Foot Reduces Reinfections and Shortens Healing Time

Cited by 6 publications

References 32 publications

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: A systematic review

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: A systematic review

Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)

Efficacy of an Acid-Oxidizing Solution against Mycobacterium ulcerans

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