Wundbehandlung bei Diabetes und diabetischem Fußulkus

Riedel, Ulrike; Schüßler, E; Härtel, Dirk; Keiler, A; Nestoris, S.; Stege, Helger

doi:10.1007/s00105-020-04699-9

Cited by 15 publications

(17 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with DF who do not receive effective treatment to manage their disease may suffer from reduced skin blood flow, nutritional deficiencies, and decreased body defenses leading to diabetic foot ulcers (DFUs) [ 2 , 3 ]. In patients with DM, the infection is not easy to clear due to the pathological basis such as poor local blood supply and impaired immune defense function, while the involvement of multiple inflammatory factors leading to systemic inflammation is an important reason that affects the development of DFU into gangrene, osteomyelitis, and even amputation [ 4 ]. Therefore, the correct treatment of DFU patients can be of great significance.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

Chu

Tao

2021

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Diabetic foot ulcers (DFUs) have a high disability rate and have a great impact on patients and society, and the search for effective and economical treatment options is a major clinical concern. In this study, 112 patients with DFU admitted to two hospitals from October 2018 to November 2020 were randomly divided into 56 cases each in the single group treated with Prontosan gel dressing and the joint group treated on silver ion dressing combined with Prontosan gel dressing. Both groups of patients were evaluated for efficacy after 30 days of treatment. The number of days for debridement, granulation tissue growth time, epithelial tissue formation time, and wound healing time were observed and recorded in both groups. The trauma area, visual analogue score (VAS), and levels of inflammatory factors such as vascular endothelial adhesion molecule-1 (VCAM-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) were recorded before and after treatment in both groups. The occurrence of adverse reactions such as edema, fever, infection, and rash during treatment was recorded in both groups for safety assessment. Comparison of the abovementioned data showed that the clinical efficacy of the joint group was significantly higher than that of the single group. The number of days to clear wounds, granulation tissue growth time, epithelial tissue formation time, and wound healing time were significantly lower in the joint group than in the single group. The trauma area, VAS score, VCAM-1, IL-6, TNF-α, and CRP levels decreased in both groups after treatment compared with the pretreatment levels, with the joint group being lower than the single group. The results also showed that the difference in the overall incidence of adverse reactions between the two groups was not statistically significant, and the incidence was low and transient. In addition to the usual treatment regimen of blood glucose control and improvement of microcirculation for patients with DFU, combined treatment with silver ionomer dressings and Prontosan gel dressings can promote ulcer healing and improve foot wound regression. It has a stronger antibacterial effect and can more effectively reduce the inflammatory response of the ulcerated surface with fewer adverse effects, making it an effective and safe method for the treatment of DFU, and has implications for promotion.

show abstract

Section: Introductionmentioning

confidence: 99%

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

Chu

Tao

2021

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

show abstract

“…Diabetic patients have suffered from delayed wound healing for decades in both developed and developing countries ( Öhnstedt et al, 2019 ; Riedel et al, 2020 ; Thewjitcharoen et al, 2020 ; Kosachunhanun et al, 2012 ). One of the major contributors that causes impaired tissue repair in diabetic wounds is oxidative stress-induced DNA damage, which interrupts the proliferative and inflammatory phases of wound healing ( Patel et al, 2019 ; Rogulj et al, 2017 ).…”

Section: Resultsmentioning

confidence: 99%

“…Diabetes is a life-threatening disease that causes systemic tissue damage and multiorgan dysfunctions, mainly chronic hyperglycemia. Kerner and Brückel (2014) Diabetic ulceration is one of the most common chronic wounds that has more than 70% recurrence in diabetic patients in 5 years of treatment ( Riedel et al, 2020 ; Reiber et al, 1998 ). Impaired wound healing has become a predominant complication in diabetic patients who eventually have a high risk of limb amputation ( Nunan et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

B1 siRNA Increases de novo DNA Methylation of B1 Elements and Promotes Wound Healing in Diabetic Rats

Yasom

Khumsri

Boonsongserm

et al. 2022

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

Alu (B1 in rodents) hypomethylation, commonly found in diabetes mellitus patients, increases DNA damage and, consequently, delays the healing process. Alu siRNA increases Alu methylation, reduces DNA damage, and promotes cell proliferation.Aim: To explore whether B1 siRNA treatment restores B1 hypomethylation, resulting in a reduction in DNA damage and acceleration of the healing process in diabetic rat wounds.Methods: We generated splinted-excisional wounds in a streptozotocin (STZ)-induced type I diabetic rat model and treated the wounds with B1 siRNA/Ca-P nanoparticles to generate de novo DNA methylation in B1 intersperse elements. After treatment, we investigated B1 methylation levels, wound closure rate, wound histopathological structure, and DNA damage markers in diabetic wounds compared to nondiabetic wounds.Results: We reported that STZ-induced diabetic rat wounds exhibited B1 hypomethylation, wound repair defects, anatomical feature defects, and greater DNA damage compared to normal rats. We also determined that B1 siRNA treatment by Ca-P nanoparticle delivery restored a decrease in B1 methylation levels, remedied delayed wound healing, and improved the histological appearance of the wounds by reducing DNA damage.Conclusion: B1 hypomethylation is inducible in an STZ-induced type I diabetes rat model. Restoration of B1 hypomethylation using B1 siRNA leads to increased genome stability and improved wound repair in diabetes. Thus, B1 siRNA intervention may be a promising strategy for reprogramming DNA methylation to treat or prevent DNA damage-related diseases.

show abstract

“…Трудности, с которыми встречаются врачи, занимающиеся данной патологией, заключаются в отягощенном коморбидном фоне, мультифокальном атеросклерозе и частом наличии инфекционного процесса в диабетических язвах. типа составила 1,96 % (n = 1), СД 2 типа -98,04 % (n = 50), что соответствует данным мировой литературы [21]. Так, в китайском исследовании Тонга из 445 пациентов с сахарным диабетом 98,4 % составляли больные с СД 2 типа.…”

Section: Discussionunclassified

Multidisciplinary approach in the treatment of patients with diabetic foot syndrome. Experience of Almazov National Medical Research Centrе

Soloviev

Dalmatova

Цветкова

et al. 2023

jour

View full text Add to dashboard Cite

Objective Evaluate the effectiveness of the multidisciplinary specialists team in Almazov National Medical Research Centrе to the treatment of patients with the neuroischemic form of diabetic foot syndrome in a multi-field hospital.Materials and methods We made retrospective analysis of the multidisciplinary approach to the treatment of patients with a neuroischemic form of diabetic foot syndrome who were hospitalized to Almazov National Medical Research Centrе during the period from January 2018 to July 2020 (inclusively). The patients were treated in the clinic of the Almazov National Medical Research Centrе during one hospitalization period. The investigation includes patients over 18 years old with a diabetes mellitus who were performed revascularization at the vascular surgery clinic Almazov National Medical Research Centrе. Patients with a secondary diabetes mellitus, immunosuppressive therapy were excluded from the study. 51 patients with neuroischemic form of diabetic foot syndrome were specifically selected for analysis. We gathered all information about them till August 2022. So, the period of observation was from 2 years 8 months (32 months) to 4 years 8 months (56 months). The mediana time was 44 months (3.67 years). All inclusive patients had a diabetic ulcer on the foot. The outcomes of this study were the healing or non-healing of diabetic foot ulcers, major amputation or death (from all causes).Results Successful healing of ulcers or postoperative wounds at the time of contact with the patient or his relatives, was with 45 patients (88.3 %). In more than half of the patients (56.86 %) healing of ulcers and wounds was occurred in the 3 months after operation.70.59 % (n = 36) patients were performed orthopedic organ-preserving reconstructions on the feet in the hospital. 6 patients (11.7 %) were performed initially revascularization according to the “less affected pathway” principle which didn’t heal the ulcers in the postoperative period and leaded to repeated surgery to restore blood flow according to the angiosomal principle. For 9 patients (17.64 %) it was required to perform repeated orthopedic intervention on the foot during the current hospitalization. The causes of complications were: stent thrombosis (n=3), intimal dissections (n = 2) and distal embolism (n = 1). The reasons for repeated orthopedic surgery were marginal necrosis in the postoperative wounds. Optimal revascularization wasn’t achieved with 10 (19.6 %) patients. Despite this in 4 (7.84 %) cases ulcers was healed. In two cases, 3.92 % (n = 2) suboptimal revascularization was associated with the lack of technical possibility in revascularization of the lower leg arteries with satisfactory revascularization of the femoral-popliteal segment. Indirect revascularization with no effect was performed in 4 cases (7.84 %). 6 major amputations (11.7 %) were performed during the observation period, 1 major amputation during the current hospitalization and 5 in the long-term period. The Kaplan-Mayer three-year survival rate was 80 %.Conclusion The analysis of the results of a multidisciplinary approach to the treatment of patients with diabetic foot syndrome demonstrated an improvement in the preservation of the limbs, reduced of bone-plastic reconstructions, reduсtion of hospitalization time and improving the lives of patients.

show abstract

Wundbehandlung bei Diabetes und diabetischem Fußulkus

Cited by 15 publications

References 18 publications

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

Clinical Study on the Efficacy of Silver Ion Dressing Combined with Prontosan Gel Dressing in the Treatment of Diabetic Foot Ulcers and the Effect on Serum Inflammatory Factors

B1 siRNA Increases de novo DNA Methylation of B1 Elements and Promotes Wound Healing in Diabetic Rats

Multidisciplinary approach in the treatment of patients with diabetic foot syndrome. Experience of Almazov National Medical Research Centrе

Contact Info

Product

Resources

About