Diabetic foot ulceration and amputation

Burns, Stephanie; Jan, Yih‐Kuen

doi:10.5772/48003

Cited by 14 publications

(20 citation statements)

References 117 publications

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“…In this paper we have analyzed variations in the cutaneous blood flow caused by local cooling and heating measured using LDF. In the basal conditions all subjects had a similar level of perfusion, which is slightly higher in DM2 patients, which is fully coincide with [5,33].…”

Section: Discussionsupporting

confidence: 60%

Spectral analysis of the blood flow in the foot microvascular bed during thermal testing in patients with diabetes mellitus

Mizeva

Zharkikh

Dremin

et al. 2018

Microvascular Research

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Timely diagnostics of microcirculatory system abnormalities, which are the most severe diabetic complications, is one of the major problems facing modern health care. Functional abnormalities manifest themselves earlier than the structural ones, and therefore their assessment is the issue of primary importance. In this study Laser Doppler flowmetry, a noninvasive technique for the cutaneous blood flow monitoring, was utilized together with local temperature tests and wavelet analysis. The study of the blood flow in the microvascular bed of toes was carried out in the control group of 40 healthy subjects and in two groups of 17 type 1 and 23 type 2 diabetic patients. The local temperature tests demonstrated that the diabetic patients have impaired vasodilation in response to local heating. The tendency for impaired low frequency pulsations of the blood flow associated with endothelial and neurogenic activities in both diabetes groups was observed. Local thermal tests induced variations in perfusion and its spectral characteristics, which were different in the groups under study. In our opinion, the obtained preliminary results can be a basis for further research and provide a deeper understanding of pathological processes that drive microvascular abnormalities caused by diabetes mellitus.

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Section: Discussionsupporting

confidence: 60%

Spectral analysis of the blood flow in the foot microvascular bed during thermal testing in patients with diabetes mellitus

Mizeva

Zharkikh

Dremin

et al. 2018

Microvascular Research

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“…The increase in PPG at the first toe and first metatarsal head areas in diabetics may be attributed to a significant limitation of motion at the metatarsophalangeal joints. The exact pathogenesis of the limited joint mobility in diabetics remains unclear but is thought to be related to the high stiffness of quasi-linear viscoelasticity in the soft tissues (Lung and Jan, 2012 ; Jan et al, 2013a ) and the progressive stiffening of the collagen-containing tissues due to accumulation of advanced glycation end products (AGEs) (Burns and Jan, 2012 ). The diabetic foot with limited motion at the metatarsophalangeal joints significantly reduces shock absorbing ability and may cause an abnormal plantar pressure distribution (Zimny et al, 2004 ; D’Ambrogi et al, 2005 ).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Diabetic foot ulcers remain one of the most serious complications of diabetes mellitus (Burns and Jan, 2012 ). It is estimated that 15% of diabetics will develop a foot ulcer during their lifetime, and 2–3% of the population may develop a foot ulcer annually (Burns and Jan, 2012 ). In 2000–2001, the cost of treating a diabetic foot ulcer averaged $13,179 per episode, which increased with severity level (Stockl et al, 2004 ).…”

Section: Introductionmentioning

confidence: 99%

“…In 2007, the total cost of treatment was $58 billion in the United States (American Diabetes Association, 2008 ). Diabetic peripheral neuropathy causes not only loss of protective sensation but also changes in the soft tissues of the foot as well as dryness of the skin that can lead to excessive formation of callus (Burns and Jan, 2012 ; Jan et al, 2013a , b ). These changes affect ambulatory function that may lead to high plantar pressures in diabetics (Lung and Jan, 2012 ; Jan et al, 2013a ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Quantifying Dynamic Changes in Plantar Pressure Gradient in Diabetics with Peripheral Neuropathy

Lung

Hsiao-Wecksler

Burns

et al. 2016

Front. Bioeng. Biotechnol.

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Diabetic foot ulcers remain one of the most serious complications of diabetes. Peak plantar pressure (PPP) and peak pressure gradient (PPG) during walking have been shown to be associated with the development of diabetic foot ulcers. To gain further insight into the mechanical etiology of diabetic foot ulcers, examination of the pressure gradient angle (PGA) has been recently proposed. The PGA quantifies directional variation or orientation of the pressure gradient during walking and provides a measure of whether pressure gradient patterns are concentrated or dispersed along the plantar surface. We hypothesized that diabetics at risk of foot ulceration would have smaller PGA in key plantar regions, suggesting less movement of the pressure gradient over time. A total of 27 participants were studied, including 19 diabetics with peripheral neuropathy and 8 non-diabetic control subjects. A foot pressure measurement system was used to measure plantar pressures during walking. PPP, PPG, and PGA were calculated for four foot regions – first toe (T1), first metatarsal head (M1), second metatarsal head (M2), and heel (HL). Consistent with prior studies, PPP and PPG were significantly larger in the diabetic group compared with non-diabetic controls in the T1 and M1 regions, but not M2 or HL. For example, PPP was 165% (P = 0.02) and PPG was 214% (P < 0.001) larger in T1. PGA was found to be significantly smaller in the diabetic group in T1 (46%, P = 0.04), suggesting a more concentrated pressure gradient pattern under the toe. The proposed PGA may improve our understanding of the role of pressure gradient on the risk of diabetic foot ulcers.

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Treatment of Mixed Infections in Wounds

Ahmed

Boateng

2020

Therapeutic Dressings and Wound Healing Applications

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2.1 Background 2.2 Aetiology of Diabetic Foot Ulcers 2.3 Standard of Care for Treatment of Diabetic Foot Ulcers 2.4 Commonly Used Wound Dressings for Diabetic Foot Ulcers and Their Mechanism of Action 2.5 Absorbent and Superabsorbent Dressings 2.6 Alginates 2.7 Films 2.8 Foams 2.9 Honeys 2.10 Hydrogels 2.11 The Role of a Split Thickness Skin Graft in Diabetic Foot Ulcers 2.12 Negative Pressure Wound Therapy 2.13 Larval Therapy 2.14 Clinical Case Studies from Multidisciplinary Diabetic Foot Clinic 2.14.1 Neuropathic Wound 2.14.2 Ischaemic Wound 2.14.3 Neuro-Ischaemic Wound 2.14.4 Osteomyelitis 2.14.5 Charcot's Foot 2.14.6 Necrotising Fasciitis in a Patient with Diabetes 2.15 Summary Acknowledgements References

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Diabetic foot ulceration and amputation

Cited by 14 publications

References 117 publications

Spectral analysis of the blood flow in the foot microvascular bed during thermal testing in patients with diabetes mellitus

Spectral analysis of the blood flow in the foot microvascular bed during thermal testing in patients with diabetes mellitus

Quantifying Dynamic Changes in Plantar Pressure Gradient in Diabetics with Peripheral Neuropathy

Treatment of Mixed Infections in Wounds

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