A prospective, randomised, controlled, multicentre clinical trial examining healing rates, safety and cost to closure of an acellular reticular allogenic human dermis versus standard of care in the treatment of chronic diabetic foot ulcers

This study's goal was to compare clinical outcomes of a novel, open‐structure human reticular acellular dermis matrix (HR‐ADM) to facilitate wound closure in non‐healing diabetic foot ulcers (DFUs) versus DFUs treated with standard of care (SOC). Following a 2‐week screening period in which DFUs were treated with offloading and moist wound care, patients were randomised to either SOC alone or HR‐ADM plus SOC applied weekly for up to 12 weeks. At 6 weeks, the primary outcome time, 65% of the HR‐ADM‐treated DFUs healed (13/20) compared with 5% (1/20) of DFUs that received SOC alone. At 12 weeks, the proportions of DFUs healed were 80% and 20%, respectively. Mean time to heal within 12 weeks was 40 days for the HR‐ADM group compared with 77 days for the SOC group. There was no incidence of increased adverse or serious adverse events between groups or any adverse events related to the graft. Mean and median graft costs to closure per healed wound in the HR‐ADM group were $1475 and $963, respectively. Weekly application of HR‐ADM is an effective intervention for promoting closure of non‐healing DFUs.
Source: International Wound Journal - Category: Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research

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ConclusionNeedle flexor tenotomies are a relatively safe and effective treatment compared to tenotomies done by scalpel, both as treatment for ulcers and to prevent formation of new ulcers associated with hammer, mallet and claw toe deformities. As a side note, transfer complications are avoidable if all toes on one or both feet are tenotomized in one procedure.
Source: Journal of Clinical and Translational Endocrinology - Category: Endocrinology Source Type: research
Peripheral arterial disease (PAD) is a highly prevalent, yet underdiagnosed, condition [1]. Although frequently asymptomatic, it is a leading cause of leg pain, claudication, ulceration, gangrene, and even amputation. On the other hand, patients with type 2 diabetes (T2DM) are more likely to develop PAD than do the non-diabetic subjects. Furthermore, they are affected by more severe and extensive form of the disease that tends to involve more distal arteries, progress more quickly, and also it is more likely to lead to ischemic ulceration and amputation [2].
Source: Primary Care Diabetes - Category: Primary Care Authors: Tags: Original research Source Type: research
Publication date: Available online 9 October 2019Source: Journal of Herbal MedicineAuthor(s): Lokesh K Mishra, Dipayan Sarkar, Rao Mentreddy, Kalidas ShettyAbstractBasil (Ocimum spp.) is an important herb from the Lamiaceae family with a long history of use in traditional medicine and food applications. Thus, targeting basil varieties for developing herbal medicines against non-communicable chronic diseases (NCDs) such as type 2 diabetes has significant merit. The aim of this study was to screen Asian basil varieties with therapeutic potential for type 2 diabetes targeting relevant phenolic bioactive-linked antioxidant, an...
Source: Journal of Herbal Medicine - Category: Complementary Medicine Source Type: research
Source: Infection and Drug Resistance - Category: Infectious Diseases Tags: Infection and Drug Resistance Source Type: research
In this study, there was a high prevalence of the EMRSA-15 clone presenting multiple resistances in diabetic foot ulcers making these infections complicated to treat leading to a higher morbidity and mortality in diabetic patients.
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
We describe and analyse the features of rat bites in 2 patients with diabetic neuropathic feet and highlight 8 clinical features that should raise suspicion and alert the clinician to this possibility.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Brief Observation Source Type: research
uml; Ç Abstract BACKGROUND: Recent studies showed no reduction in major amputation rates after introduction of a multidisciplinary team (MDT) approach for the treatment of diabetic foot ulcer. The efficacy of MDTs in the current standard of care is being questioned. This retrospective single-center study evaluated the efficacy of an outpatient MDT approach on limb salvage and ulcer healing in treating diabetic foot ulcers. METHODS: Patients with a diabetic foot ulcer treated before (2015) and after (2017) implementation of an MDT in a single center were compared. The MDT met weekly and consisted of a v...
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
AbstractIntroductionDiabetic foot ulcers develop with deviations in the distribution of plantar pressure. It is difficult to interpret any alteration in plantar pressure under different conditions of type 2 diabetes mellitus (T2DM). The aim of this study was to gain a better insight into the variations in plantar pressure with increased duration of diabetes.MethodsPlantar pressure was examined in 1196 participants with or without T2DM. Subjects with normal glucose tolerance (NGT) and impaired glucose tolerance (IGT) were assigned to control groups, and those with T2DM were divided into five groups according to diabetes dur...
Source: Diabetes Therapy - Category: Endocrinology Source Type: research
Conditions:   Diabetic Foot Ulcer;   Peripheral Neuropathy;   Treatment Adherence and Compliance Intervention:   Device: External shoe lift Sponsor:   Universidad Complutense de Madrid Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Authors: Namgoong S, Jung SY, Han SK, Kim AR, Dhong ES Abstract Current treatment guidelines for biofilm-associated infections (BAI) recommend repeated sharp/surgical debridement followed by treatment with antimicrobial agents until the wound becomes self-sustaining in terms of a positive wound-healing trajectory. However, complete removal of a biofilm is unlikely, and biofilms reform rapidly. We have treated BAI in patients with chronic diabetic ulcers using a meshed skin graft combined with negative pressure wound therapy (NPWT) immediately after surgical debridement, rather than waiting until the development of ...
Source: Journal of Plastic Surgery and Hand Surgery - Category: Surgery Tags: J Plast Surg Hand Surg Source Type: research
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