| Enews you can use! |
|
HMPdiabetesWatch.com weekly Enews
Please signup today! |
|
|
|
|
|
|
|
|
Diabetic Foot Ulcers
It has been estimated that diabetic foot ulcers occur in 15 percent of patients with diabetes. Out of these patients, six percent will be hospitalized due to infection of the ulcer or other complications. See below for articles that discuss various modalities for treating diabetic foot ulcers.
Clinical Results Related to the Use of the TissueTech Autograft System in the Treatment of Diabetic Foot Ulceration
Abstract: The application of tissue-engineering technology to wound healing has resulted in the development of a number of living skin equivalents, which have become a viable option in the treatment of chronic wounds. Unique among technologies of tissue engineering of skin is the TissueTech® Autograft System (FIDIA Advanced Biopolymers, Abano Terme, Italy), as it incorporates an autologous dermal substitute (Hyalograft® 3D, FIDIA Advanced Biopolymers) and an autologous epidermal replacement (Laserskin®, FIDIA Advanced Biopolymers). Each includes a matrix consisting of a hyaluronic acid ester (FIDIA Advanced Biopolymers) to promote cellular migration and graft take. Randomized clinical trials and extensive clinical experience have shown positive results in the treatment of diabetic foot ulcers using TTAS with high healing rates and excellent safety profile. A large retrospective analysis was conducted to assess the characteristics and outcomes of all chronic ulcers treated with TTAS from January 1997 to December 2000. Data deriving from the subgroup of the 401 diabetic foot ulcers are presented in this study. This group consisted of 104 neuropathic, 115 neuroischemic, 114 ischemic, and 58 post-surgical ulcers. Most of the ulcers treated were very large (85% with area greater than 5cm2) and full thickness or deep (85%), particularly in the neuroischemic and ischemic ulcer groups. The percentage of healed ulcers was high in all the subgroups (70.3% in the total diabetic foot population with 63.5% healed within 4 months), and the rate of recurrences was low, with 8.2 percent at a mean observation time from healing of 240 days in the total ulcer population. According to the available clinical evidence, TTAS can be effectively and safely used for the treatment of diabetic foot ulcers.
Featured Content from Wounds Research
|
Standard, Appropriate, and Advanced Care and Medical-Legal Considerations: Part One?Diabetic Foot Ulcerations (B)
Abstract: Administration of prompt and appropriate care for diabetic foot ulcerations is necessary to reduce complications, which may lead to limb loss. An understanding of standard, appropriate, and advanced care may assist the physician in making the most optimal decision when treating diabetic foot ulcers. An overview of the diabetic foot, its associative problems, considerations when reviewing the diabetic patient, and approaches to treatment are presented in this article. Clinicians are encouraged to review each patient individually to determine their specific needs and to administer the most appropriate care.
Featured Content from Wounds Research
|
The Inter-rater Reliability of the Clinical Signs and Symptoms Checklist in Diabetic Foot Ulcers
The Clinical Signs and Symptoms Checklist is a tool designed to measure 12 clinical signs and symptoms of localized chronic wound infection. Since its initial development, this Checklist has been revised to include sanguineous drainage. To examine the inter-rater reliability of the revised Clinical Signs and Symptoms Checklist in diabetic foot ulcers, an observational, cross-sectional study was conducted in conjunction with a larger study examining the validity of each sign and symptom for identifying infection in diabetic foot ulcers. Two independent nurse observers assessed 64 diabetic foot ulcers in 64 patients using the Checklist. The reliability of each item was calculated using percent agreement and the Kappa coefficient. Total percent agreement ranged from 76% to 100%, and Kappa statistics ranged from .34 to 1.00. Study findings confirm that the Clinical Signs and Symptoms Checklist is a reliable tool for identifying the clinical signs and symptoms of localized infection in diabetic foot ulcers. KEYWORDS: wound infection, foot ulcer, diabetic foot, clinical signs and symptoms
Featured Content from Ostomy Wound Management
|
Treatment of Diabetic Foot Ulcers in Elderly Patients
Treatment of Diabetic Foot Ulcers in Elderly Patients Treatment of Diabetic Foot Ulcers in Elderly Patients By Kimberly K. Daugherty, Pharm.D., Aimee G. Adams, Pharm.D. and Peggy Piascik, Ph.D. Neuropathy, or impairment of nerve function, is the most important risk factor for the development of foot ulcers in diabetic patients. Treatment options for diabetic foot ulcers include debridement, off-loading, antibiotics, topical therapy (anti-infectives, becaplermin, cultured human dermis, and ...
Featured Content from Clinical Geriatrics
|
Risk Factors Associated with Healing Chronic Diabetic Foot Ulcers: The Importance of Hyperglycemia
Diabetic foot ulcer management presents a significant challenge for wound care clinicians; numerous approaches to encourage healing in these difficult wounds have been explored. To determine risk factors related to diabetic foot ulcer time to healing and closure, a secondary analysis of data from a prospective randomized study involving 245 patients treated with a bioengineered human dermal substitute (n = 130) or control treatment (n = 115) was conducted. Analyzed variables included age, race, gender, ulcer duration, initial ulcer size, initial hemoglobin (HgbA1c), average HgbA1c, change in HgbA1c, diabetes type, average hours of weight-bearing, study ulcer infection, history of smoking or alcohol use, and laboratory values. Time to healing was significantly affected by initial ulcer size (risk ratio 0.75, confidence interval 0.59?0.96), gender (risk ratio 2.01, confidence interval 1.20?3.40), and wound infection during the study (risk ratio 2.9, confidence interval 1.45?4.22). Initial ulcer size (>2 cm2), male gender, and an episode of infection during the study were associated with an increased risk of nonclosure after 12 weeks of care (P <0.05). In patients whose HgbA1C increased during the study (n = 101), 20.7% of all wounds and 21% of dermal substitute-managed wounds (n = 105) healed; whereas, in patients whose HgbA1C levels remained stable or decreased, 26.3% of all wounds and 47% of dermal substitute-managed wounds healed (P <0.05). Female gender, small ulcer size, and the absence of infection were found to have a positive effect on healing all diabetic foot ulcers; improved glucose control had a significant effect on healing wounds managed with the dermal substitute only. This is the first diabetic foot ulcer study to find a relationship between hyperglycemia and wound healing. Further research into factors that improve healing of wounds, including diabetic foot ulcers, is warranted. KEYWORDS: diabetes mellitus, foot ulcers, healing, risk factors, hyperglycemia
Featured Content from Ostomy Wound Management
|
Diabetic Foot Ulcers
Diabetic Foot Ulcers Evidence Corner: Diabetic Foot Ulcers - Laura Bolton, PhD Laura Bolton, PhD Dear Readers: Foot problems are the most frequent cause of hospitalization in diabetic patients. Evidence Summary: Healing Effects of Diabetic Foot Debridement Reference: Smith J. Debridement of diabetic foot ulcers (Cochrane Review). Methods: All randomized controlled trials (RCTs) comparing effect of debridement modalities on either complete diabetic foot ulcer healing or rate of diabetic foot...
Featured Content from Wounds Research
|
Emerging Treatments in Diabetic Wound Care
Abstract: This paper reviews the physiology of wound healing and properties of the ?ideal? dressing and also reviews advanced wound therapeutics and dressings, such as growth factors and biological skin substitutes.
Featured Content from Wounds Research
|
Honey-Based Dressings: Can They Have An Impact For Diabetic Foot Ulcers?
Although it has been in medicinal use for centuries, honey has seen a resurgence lately as a wound healing agent. These authors provide a closer look at the healing properties of honey and how honey-based dressings may help facilitate healing in diabetic foot ulcers.
Featured Content from Podiatry Today
|
CME Article - Management of the Diabetic Foot Ulcer
Educational Objectives 1. To define the risk factors associated with diabetic foot ulcers 2. To define the importance of appropriate shoes for the diabetic patient 3. To classify/grade a diabetic foot ulcer 4. To cite three categories of wound dressings and define their application to the diabetic foot ulcer The percentage of elderly in the total population of the United States is increasing annually. Shoes Shoes, which accommodate the elderly foot, may be of assistance in reducing pressure ...
Featured Content from Clinical Geriatrics
|
A Phase III Study to Evaluate the Safety and Efficacy of Recombinant Human Epidermal Growth Factor (REGEN-D? 150) in Healing Diabetic Foot Ulcers
Abstract: A phase III clinical trial was carried out to determine the safety and efficacy of recombinant human epidermal growth factor (rhEGF 150 mg/g; REGEN-D? 150, Bharat Biotech International Limited, Hyderabad, India) in healing diabetic foot ulcers. The study was a randomized, double-blind, multicenter, parallel study divided into 2 groups. The test group was administered the study drug, and the control group was administered placebo. Skin biopsy was done at baseline and after treatment to evaluate the degree of healing. Parameters, such as increase in collagen tissue, granulation tissue formation, skin epithelization, and microbial growth, were analyzed. The study data was subjected to statistical analysis to determine the significance between the test and the control groups. In the gel-treated group, at the end of 10 weeks, 69% of the ulcers healed, while in the placebo group, only 21% healed in 10 weeks. The study showed that patients with diabetic foot ulcers treated with rhEGF gel had a reduced wound healing time of 9 weeks compared to the patients treated with placebo. The study demonstrated the clinical safety and efficacy of rhEGF in accelerating healing of diabetic foot ulcers.
Featured Content from Wounds Research
|
|
|
|
