Role of an acidic environment in the treatment of diabetic foot infections: A review

Nagoba, Basavraj; Gavkare, Ajay; Rayate, Abhijit; Mumbre, Sachin; Rao, Arunkumar; Warad, Basavraj; Nanaware, Neeta; Jamadar, Nawab

doi:10.4239/wjd.v12.i9.1539

Cited by 12 publications

(8 citation statements)

References 66 publications

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“…)[ 3 , 16 - 20 ]. The adverse effects of topical antimicrobials are concerning[ 21 ]. The exact duration of antibiotics for different severities of DFU infections is unknown[ 8 , 22 ].…”

Section: Challenges During Management Of Dfumentioning

confidence: 99%

“…Conventionally available and naturally occurring acids are also used for the topical management of chronic and infected wounds like DFU. The acidic milieu favours wound healing by antimicrobial action as well as promoting inflammatory and proliferative phases[ 21 ].…”

Section: Acids In Wound Healingmentioning

confidence: 99%

“…The citric acid (MIC: 500-2500 μg/mL) and hypochlorous acid have antibacterial actions against common culprits in DFU. Despite being very effective against Pseudomonas , the action of acetic acid against other microbes is limited[ 21 ]. Boron derivatives (boric acid and sodium pentaborate pentahydrate) have broad antibacterial and antifungal actions[ 117 ].…”

Section: Acids In Wound Healingmentioning

confidence: 99%

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

Rayate¹,

Nagoba²,

Mumbre³

et al. 2023

World J Diabetes

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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...

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“…)[ 3 , 16 - 20 ]. The adverse effects of topical antimicrobials are concerning[ 21 ]. The exact duration of antibiotics for different severities of DFU infections is unknown[ 8 , 22 ].…”

Section: Challenges During Management Of Dfumentioning

confidence: 99%

Section: Acids In Wound Healingmentioning

confidence: 99%

Section: Acids In Wound Healingmentioning

confidence: 99%

See 1 more Smart Citation

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

Rayate¹,

Nagoba²,

Mumbre³

et al. 2023

World J Diabetes

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“…Antiseptics are a class of drugs that can prevent the growth or damage of microorganisms in living tissues or on the surface of living tissues. Halogenated compounds, alcohol-based agents, and biguanides are often used as antiseptics primarily for chronic wound care because they effectively inhibit bacterial reproduction and promote resistance to the external environment [ 51 , 52 ]. (4) Alginate dressing: Alginate dressing consists of alginate salts, which are highly absorbent and hemostatic and suitable for highly exuding wounds.…”

Section: Diabetic Wounds and Diabetic Dressingsmentioning

confidence: 99%

Advances in the Preparation of Nanofiber Dressings by Electrospinning for Promoting Diabetic Wound Healing

Liu

Feng

et al. 2022

Biomolecules

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Chronic diabetic wounds are one of the main complications of diabetes, manifested by persistent inflammation, decreased epithelialization motility, and impaired wound healing. This will not only lead to the repeated hospitalization of patients, but also bear expensive hospitalization costs. In severe cases, it can lead to amputation, sepsis or death. Electrospun nanofibers membranes have the characteristics of high porosity, high specific surface area, and easy functionalization of structure, so they can be used as a safe and effective platform in the treatment of diabetic wounds and have great application potential. This article briefly reviewed the pathogenesis of chronic diabetic wounds and the types of dressings commonly used, and then reviewed the development of electrospinning technology in recent years and the advantages of electrospun nanofibers in the treatment of diabetic wounds. Finally, the reports of different types of nanofiber dressings on diabetic wounds are summarized, and the method of using multi-drug combination therapy in diabetic wounds is emphasized, which provides new ideas for the effective treatment of diabetic wounds.

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“…Diabetic foot ulcers are one of the most challenging complications of diabetes[ 2 - 4 ]. Previous study found that a group of traditional Chinese medicine (TCM) ( e.g.…”

Section: To the Editormentioning

confidence: 99%

More studies are necessary to establish the effectiveness of Jinhuang powder in the treatment of diabetic foot

Yan

et al. 2022

WJD

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Diabetes mellitus is a common global public health problem that can cause serious illness and premature death. Diabetic foot ulcer, one of the complications of diabetes, is a major cause of morbidity and mortality and is associated with many other devastating complications. Previous study found that a group of traditional Chinese medicine (TCM) can be used for treating diabetic foot ulcers. More and more attention is being paid to the use of Chinese medicine to heal diabetic feet. Under the guidance of relevant theories of traditional Chinese medicine, more studies are needed to reveal the key active components and related signal pathways of TCM in the treatment of diabetic foot ulcer. One clinical study explored the treatment of diabetic foot with infection combined moist exposed burn ointment with Jinhuang powder. However, large-scale multi-center, double blind, randomized, placebo-controlled clinical trials and animal studies are necessary to establish the effectiveness of Jinhuang powder in the treatment of diabetic foot.

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Role of an acidic environment in the treatment of diabetic foot infections: A review

Cited by 12 publications

References 66 publications

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

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

Advances in the Preparation of Nanofiber Dressings by Electrospinning for Promoting Diabetic Wound Healing

More studies are necessary to establish the effectiveness of Jinhuang powder in the treatment of diabetic foot

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