Topical Therapy As Adjuvant Treatment to Save a Limb With Critical Ischemia From Extensive and Deep Diabetic Foot Infection When Revascularization Is Not Feasible

Shen, Jiann-Jong; Liu, Chin-Jui; Lo, Shun-Chun; Chen, Yu‐Tsung; Chang, Chang‐Cheng

doi:10.1097/won.0000000000000211

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…In fact, osteomyelitis was identified as a significant predictor of wound healing [ 48 ] and amputation [ 79 ] in a Nigerian multi-center observational study. Unfortunately, systemic antibiotics have limited delivery to chronic wound sites, especially in the presence of a bacterial biofilm, so new therapies have been focused on topical delivery of drugs with varied release mechanisms [ 80 , 81 ].…”

Section: Pathophysiology Associated With Diabetic Wound Healingmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

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Diabetes mellitus is an increasingly prevalent chronic metabolic disease characterized by prolonged hyperglycemia that leads to long-term health consequences. It is estimated that impaired healing of diabetic wounds affects approximately 25% of all patients with diabetes mellitus, often resulting in lower limb amputation, with subsequent high economic and psychosocial costs. The hyperglycemic environment promotes the formation of biofilms and makes diabetic wounds difficult to treat. In this review, we present updates regarding recent advances in our understanding of the pathophysiology of diabetic wounds focusing on impaired angiogenesis, neuropathy, sub-optimal chronic inflammatory response, barrier disruption, and subsequent polymicrobial infection, followed by current and future treatment strategies designed to tackle the various pathologies associated with diabetic wounds. Given the alarming increase in the prevalence of diabetes, and subsequently diabetic wounds, it is imperative that future treatment strategies target multiple causes of impaired healing in diabetic wounds.

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Section: Pathophysiology Associated With Diabetic Wound Healingmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

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“…For this property, Ag is used in different preparations in medicine, for example in wound healing applications. Ag‐impregnated hydrofiber wound dressing was proposed in diabetic foot ulcer healing, since the peripheral poor circulation limited antimicrobial therapy . “ In vitro ” and “ in vivo ” experiments suggested that antimicrobial Ag nanoparticles impregnated into antifouling zwitterionic hydrogels can be used successfully in wound healing .…”

Section: Introductionmentioning

confidence: 99%

“…Ag-impregnated hydrofiber wound dressing was proposed in diabetic foot ulcer healing, since the peripheral poor circulation limited antimicrobial therapy. 29 "In vitro" and "in vivo" experiments suggested that antimicrobial Ag nanoparticles impregnated into antifouling zwitterionic hydrogels can be used successfully in wound healing. 30 Moreover, Ag nanoparticles contained in chitosanpolyethylene oxide nanofiber mats were able to inhibit Staphylococcus aureus and Escherichia coli, two bacteria infecting commonly wound burn.…”

Section: Introductionmentioning

confidence: 99%

Biocompatibility versus peritoneal mesothelial cells of polypropylene prostheses for hernia repair, coated with a thin silica/silver layer

et al. 2016

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Hernias are generally repaired using synthetic prostheses. Infection may already be present or develop during implantation. Based on the increasing resistance to antibiotics, and the well-known antimicrobial properties of silver (Ag), the possibility of coating hernia prostheses with a nanostructured layer containing Ag was explored. Prostheses (Clear Mesh Composite [CMC]) made up of two polypropylene layers (macroporous light mesh and thin transparent film) were tested with human mesothelial cells from omentum biopsies. Mesotheliocytes modulate abdominal wall healing producing cytokines, growth factors, and adhesion molecules. Evaluating the growth of these cells on CMC or film alone showed that cell numbers on CMC increased over time, and were higher than those on film alone. Vimentin immunostaining confirmed the cells to be mesotheliocytes. Subsequently, the biocompatibility of mesh layer, coated or not with a thin layer of Ag/SiO -nanoclusters, was analyzed, showing no difference in absence or presence of Ag/SiO . Differently, TGF-β2 production, involved in tissue repair and fibrosis, increased in the presence of Ag/SiO . Moreover, Ag/SiO -coated mesh showed antibacterial properties. In conclusion, the mesh layer coated with Ag/SiO afforded cell growth, and showed antibacterial activity. Coating only the mesh layer did not decrease film transparency, and did not favor the formation of adhesions on the visceral side. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1586-1593, 2017.

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“…Type of trauma Nature of trauma Reported trauma/precipitating event Metal nail penetrated shoe while gardening 77 Patient trod on two toothpicks 71 Piece of shell walking barefoot on beach 54 Puncture wound to the foot while working in his yard whilst wearing slippers 77 Self-injury wound, to relieve severe pruritus by piercing skin with sharp implements 102 Small screw embedded in slipper 76 Thumb tack embedded in heel 96 Thumb tack embedded in shoe 97 Thumb tack embedded in toe whilst walking barefoot 96 Tip of hypodermic needle penetrated third toe of right foot causing swelling and cellulitis 74 Trod on a clout nail which pierced boot a119…”

Section: Mechanicalmentioning

confidence: 99%

The reported external traumas among people with diabetes‐related foot ulcers and their outcomes: A systematic review of case reports

Abu‐Qamar

Kemp

Whitehead

2022

International Wound Journal

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The objective of this systematic review was to collate evidence published in case reports on the reported origins of external traumas that contribute to the development of diabetic foot ulcers and their outcomes. The review also aimed to suggest reporting criteria for external traumas contributing to the development of diabetic foot ulcers. The search strategy led to the identification of 1224 articles across six electronic databases. Additional articles were also sourced from other electronic platforms (Google scholar) and the reference lists of the included case reports. Ninety-four articles met the inclusion criteria and were published between 1989 and 2020. The included case reports were independently assessed for methodological quality using a Joanna Briggs Institute (JBI) checklist. Following the verbatim extraction of data, the JBI three steps approach to "meta-aggregation" for managing qualitative data was used to synthesise the data on external traumas that contributed to the development of foot ulcers along with the reported outcome. Information on the included case report characteristics was also extracted. The case reports included 155 patients. Average age was 57.2 years with a range from 17 to 86 years. External traumas were mainly experienced in the domestic setting and were categorised into two main categories, mechanical trauma (n = 87, 60%) or burns (n = 58, 40%). The most frequently reported origins of external trauma were contact with a hot surface, animal bites, friction, and puncture wounds. Although healing was the most frequent outcome, a prolonged time was recorded for the ulcers to heal highlighting the importance of prevention. Prevention might not eradicate origins of external trauma 100%, showing the importance of patient and/or family role in monitoring domestic risks, early detection of ulcer and seeking immediate professional care. Foot ulcers need to be reported against standardised criteria considering local characteristics of the ulcer and the individual's general profile.

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Topical Therapy As Adjuvant Treatment to Save a Limb With Critical Ischemia From Extensive and Deep Diabetic Foot Infection When Revascularization Is Not Feasible

Abstract: We found that a silver-impregnated hydrofiber dressing, combined with antiplatelet medications, allowed the patient to avoid amputation despite 2 deep and extensively infected DFUs with critical limb ischemia when revascularization was not feasible.

Cited by 4 publications

References 13 publications

Diabetic Wound-Healing Science

Diabetic Wound-Healing Science

Biocompatibility versus peritoneal mesothelial cells of polypropylene prostheses for hernia repair, coated with a thin silica/silver layer

The reported external traumas among people with diabetes‐related foot ulcers and their outcomes: A systematic review of case reports

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