Current scenario of traditional medicines in management of diabetic foot ulcers: A review

Abstract

Diabetic foot infections and diabetic foot ulcers (DFU) cause significant suffering and are often recurring. DFU have three important pathogenic factors, namely, microangiopathy causing local tissue anoxia, neuropathy making the foot prone to injuries from trivial trauma, and local tissue hyperglycaemia favouring infection and delaying the wound healing. DFU have been the leading cause for non-traumatic amputations of part or whole of the limb. Western medicines focus mainly on euglycaemia, antimicrobials, debridement and wound cover with grafts, and off-loading techniques. Advances in euglycaemic control, foot care and footwear, systemic antimicrobial therapy, and overall health care access and delivery, have resulted in an overall decrease in amputations. However, the process of wound care after adequate debridement remains a major cost burden globally, especially in developing nations. This process revolves around two basic concerns regarding control/eradication of local infection and promotion of faster healing in a chronic DFU without recurrence. Wound modulation with various dressings and techniques are often a costly affair. Some aspects of the topical therapy with modern/Western medicines are frequently not addressed. Cost of and compliance to these therapies are important as both the wounds and their treatment are “chronic.” Naturally occurring agents/medications from traditional medicine systems have been used frequently in different cultures and nations, though without adequate clinical base/relevance. Traditional Chinese medicine involves restoring yin-yang balance, regulating the ‘chi’, and promoting local blood circulation. Traditional medicines from India have been emphasizing on ‘naturally’ available products to control wound infection and promote all the aspects of wound healing. There is one more group of chemicals which are not pharmaceutical agents but can create acidic milieu in the wound to satisfy the above-mentioned basic concerns. Various natural and plant derived products ( e.g ., honey, aloe vera, oils, and calendula) and maggots are also used for wound healing purposes. We believe that patients with a chronic wound are so tired physically, emotionally, and financially that they usually accept native traditional medicine which has the same cultural base, belief, and faith. Many of these products have never been tested in accordance to “evidence-based medicine.” There are usually case reports and experience-based reports about these products. Recently, there have been some trials ( in vitro and in vivo ) to verify the claims of usage of traditional medicines in management of DFU. Such studies show that these natural products enhance the healing process by controlling infection, stimulating granulation tissue, antimicrobial action, promoting fibroblastic activity and collagen deposition, etc. In this review, we attempt to study and analyse the available literature on results of topical tradit...

Comparison Between Ordinary Dressing And Total Cast Offloading Dressing In Diabetic Foot Ulcer Patients.

“…complete ulcer healing rate was significantly higher in the total cast offloading group compared to the ordinary dressing group. This finding aligns with the results from Armstrong et al, who reported superior outcomes with offloading devices in managing plantar diabetic foot ulcers compared to non-offloading methods Rayate AS et al(2023)[7]. The higher effectiveness of total cast offloading is likely due to the reduction of pressure at the ulcer site, which is crucial for healingKhan MS et al(2023)[8].…”

The Effectiveness of Wound Dressing with Virana Sanjeevi Thailam (VST) in the Management of Madhumegha Viranam – A Case Report

“…The primary treatment comprises of topical dressings, an ideal dressing material should promote reepithelization, maintain moisture environment, possess antimicrobial properties, prevent further trauma and absorb exudates. As the available dressing options have limitations, none seem sufficient to ensure a successful, complete, non-recurring healing and are often possess costly affairs (10,11,12). Traditional medicines may be used in overcoming these difficulties.…”

“…The medicinal properties of these ingredients described in the text Agathiyar Gunavagadam also supports its wound healing properties (8,13). Sesame oil is rich in biologically active components such as linoleic acid, linolenic acids, lignans such as sesamin, sesamolin, and sesaminol, natural vitamin E, and phytosterols (12,14). Semecarpus a n a c a rd i u m L i n n .…”

Efektivitas penggunaan terapi topical herbal pada perawatan ulkus kaki diabetik: A systematic literature review

“…Saat ini telah terjadi peningkatan yang signifikan dalam mengeksplorasi obat alternatif yang berasal dari sumber daya alam, terutama tanaman obat dengan tujuan pencegahan dan pengobatan kondisi kaki diabetik. Mengobati kaki diabetik dengan pengobatan tradisional sering dilakukan terutama di negara-negara miskin karena biaya yang lebih murah, efek samping kecil, dan kurangnya akses ke dokter bedah vaskular (Rayate, Nagoba, Mumbre, Mavani, Gavkare, & Deshpande, 2023). Berbagai produk herbal topikal digunakan untuk menyembuhkan kaki diabetik, dan banyak penelitian telah menyelidiki apakah efisiensi serta efektivitasnya dalam penyembuhan UKD (Bekele, Berhanu, Sefera, & Babu, 2022;Ansari, Akther, Khan, Islam, Masud, Rahman, & Abdel-Wahab, 2022).…”