Diabetes Mellitus Wound Research Articles

Supercritical Carbon Dioxide-decellularized Porcine Acellular Dermal Matrix combined with Autologous Adipose-derived Stem Cells: Its Role in Accelerated Diabetic Wound Healing.

Diabetes mellitus (DM) causes impaired wound healing by affecting one or more of the biological mechanisms of hemostasis, inflammation, proliferation, and remodeling and a large number of cell types, extracellular components, growth factors, and cytokines. Interventions targeted toward these mechanisms might accelerate the wound healing process. To evaluate the wound healing efficacy of supercritical carbon dioxide (scCO2)-decellularized porcine acellular dermal matrix (ADM) combined with autologous adipose-derived stem cells (ASCs) in streptozotocin (STZ)-induced DM rats. DM was induced by injecting rats with STZ; dorsal full-thickness skin (5 × 5 cm2) was created and treated with and without ASCs-scCO2-treated ADM to evaluate the wound healing rate through histological examination, fluorescence microscopic observation, and immunohistochemical analysis. In the present study, complete decellularization of the porcine dermal matrix was achieved through scCO2. Isolation of ASCs was conducted and evaluated using CD29+/CD31-/CD45-/CD90+ markers in flow cytometry, which indicated that more than 90% of cells were ASCs. The percentage of cells labeled with CD29+ and CD90+ was found to be 97.50% and 99.69%, respectively. The wound healing rate increased in all groups relative to the group with the DM wound without treatment. DM wound treated with ADM-ASCs showed significantly higher (p < 0.01) wound healing rate than DM wound without treatment. ADM-ASC-treated rats showed significantly increased epidermal growth factor, Ki67, and prolyl 4-hydroxylase and significantly decreased CD45 compared with the group with the DM wound without treatment. The intervention comprising ADM decellularized from porcine skin by using scCO2 and ASCs was proven to improve diabetic wound healing. ADM-ASCs had a positive effect on epidermal regeneration, anti-inflammation, collagen production and processing, and cell proliferation; thus, it accelerated wound healing.

CD271 promotes STZ-induced diabetic wound healing and regulates epidermal stem cell survival in the presence of the pTrkA receptor.

Diabetes mellitus (DM) often causes delayed wound healing in patients, which can lead to limb loss, disability, and even death. Many conventional therapeutic strategies have been proposed, but there is still no effective therapy for DM wounds. This study aimed to explore the effects of CD271 and phosphorylated tyrosine kinase receptor A (pTrkA) on the migration and proliferation abilities of epidermal stem cells (eSCs) and on the activation of DM wound healing. We investigated the interventional effects of CD271-overexpressing eSC (CD271 eSC) treatment and pTrkA inhibition (through k252a treatment) on delayed wound healing using mice with streptozotocin-induced DM. The migration and proliferation abilities of control eSCs, CD271 eSCs, and k252a-treated CD271 eSCs were observed under high-glucose conditions. Decreases in CD271 and increases in pTrkA were observed in DM mouse skin compared with control mouse skin; in addition, the rate of wound closure in DM mice was promoted by CD271 eSC treatment but delayed by pTrkA inhibition. Furthermore, the CD271 eSC migration and proliferation were greater than of control eSCs. Compared with that of CD271 eSCs, the number of CD271+k252a eSCs decreased significantly under high-glucose conditions. In parallel, the expression levels of the pERK, pAkt, and pJNK pathways increased in CD271 eSCs and decreased in CD271+k252a eSCs under high glucose. Our findings demonstrate that CD271 and pTrkA affect DM wound closure by promoting the eSC migration and proliferation. This mechanism involving the pERK, pAkt, and pJNK pathways might be a new therapeutic target for the treatment of delayed wound re-epithelialization in DM.

The Effect of Topical Toman Fish (Channa micropeltes) Extract on Macrophages and Lymphocytes in Diabetes Mellitus Wound Healing

Oral administration of Toman fish extract is proven to accelerate wound healing in rat model of Diabetes Mellitus. Toman fish extract contains albumin which may elevate antioxidant level and reduce inflammation. These changes will later enhance cell proliferation and inflammatory cell activity in wound healing process. This study was aimed to determine the topical application effect of 20% toman fish extract on macrophages and lymphocytes in Diabetes Mellitus wound healing. It was an experimental research using post-test only with control group design. This study was performed on 36 diabetic male wistar rats which was comprised of negative control group without given any treatment, 20% Toman fish extract ointment group and 10% Haruan fish (Channa striata) extract ointment group. Rats were sacrificed on day 4, 8, and 14 to investigate wounded area with biopsy technique which later obtained histological preparation using Haematoxylin-Eosin staining. The preparation was then observed using microscope to count macrophages and lymphocytes number. One-Way ANOVA test demonstrated a significant difference in macrophage number on day 4 (p=0.002), day 8 (p=0.000), day 14 (p=0.000). The result of the test also indicated a significant difference in lymphocyte number on day 4 (p=0.001), day 8 (p=0.001), and day 14 (p=0.001). Furthermore, Post Hoc LSD test resulted in a significant difference (p<0.05) of macrophage and lymphocyte in day four, eight, and fourteen among all treatment groups. Toman fish extract ointment at 20% concentration for topical application may raise the number of macrophage and lymphocyte than those of negative control and 10% haruan fish extract ointment on day 4 and 8 with gradual decrease on day 14.

THE EFFECT OF GIANT SNAKEHEAD(Channa micropeltes)EXTRACT ON THE NUMBER OF MACROPHAGE IN DIABETES MELITUS WOUND HEALING (Research report)

Background :Giant snakehead contains albumin and omega-6 fatty acids which play an important role in diabetes mellitus wound healing. Wounds in people with diabetes mellitus have low level of albumin, thus inhibiting the macrophage function. Objective : To prove the effect of giant snakehead extract of 16mL/Kg dose of rats’ weight toward the number of macrophage on wistar rats’ back wounds with diabetes mellitus in day 4 , 8 and 14. Method and Materials : This study applied pure experimental method with posttest-only control design. This study 36 wistar rats as sample which divided into 9 groups; group of giant snakehead extract with 16mL/Kg dose of rats’ weight, positive control group using haruan fish extract with 13.54mL/Kg dose of rats’ weight, and negative control group using BR2 feed. Result s : The test result of One-way ANOVAon day 4 (p=0.022), day 8 (p=0.251) and day 14 (0.028). The test result of Post-hoc LSD showedthat there wereno significant differences on day 4 and 14 (p>00.5) between the groups of the giant snakehead extract and haruan fish extract. There wassignificant difference (p<00.5) between groups of the giant snakehead extract and BR2 feed. Conclusion : It can be concluded that giant snakehead extract at 16 mL / kg dose administered orally may increase the number of macrophage in wistar rat (Rattusnovergicus) induced diabetes mellitus back woundon day 4 and decreased macrophage cell count onday 8 and day 14.

Molecular Concept of Diabetic Wound Healing: Effective Role of Herbal Remedies.

The incidence of diabetes mellitus (DM) is on the rise, worldwide. One of the main complications in DM is delayed wound healing and it often requires amputation. Various drugs were used to treat DM but they presented with adverse effects. Often, patients failed to comply with such treatment. This opened the door for complementary and alternative medicine. In the present review, we explored the molecular concept of wound healing occurring in different stages with special emphasis to DM. We also highlighted the potential herbal products such as NF3 (Chinese 2-Herb Formula), Zicao, Jing Wan Hong ointment, Aleo vera, mixture of Adiantum capillus-veneris, Commiphora molmol, Aloe vera, and henna, Phenol-rich compound sweet gel, Jinchuang ointment, San-huang-sheng-fu (S) oil, Yi Bu A Jie extract, Astragali Radix (AR) and Rehmanniae Radix (RR), Yiqi Huayu, Tangzu yuyang ointment, Shengji Huayu recipe, Angelica sinensis, Lithospermun erythrorhison, Hippophae rhamnoides L., Curcuma longa and Momordica charantia that could be used effectively to treat DM wounds. Future clinical trials are needed for designing potential drugs which may be effective in treating DM wounds.

KNOWLEDGE OF FAMILY PREVENTING DIABETIC WOUND IN DIABETES MELITUS PATIENT

Background Diabetes mellitus (DM) is one of the major health problems. in the world. The number of DM cases in North Sulawesi Province in 2016 increased with the number of 4.525 in 2015 to 5.261 patients in 2016, 60% of these patients had diabetic wounds. (Ministry of Health, 2016). The aim of this study was to determine the relationship of knowledge about wound prevention with the incidence of diabetic wounds. Methods This research uses a quantitative approach with a cross-sectional design. The research sample of 50 respondents was a Family of DM patients who seek treatment in the Internal Medicine Room of the Pancaran Kasih GMIM Hospital Manado. Results showed that most respondents lack knowledge with 33 respondents (66%) and were identified with the incidence of diabetic injuries. Test results show the relationship between patient knowledge about DM Wound Prevention with the incidence of DM Wound is p-value = 0,000 (α = 0.05). Conclusion there is a significant relationship between patient knowledge about DM Wound Prevention with the incidence of DM Wound. This findings Suggestions for health workers caring for DM patients, in order to improve education about wound care with a variety of educational methods.

Herbs for Effective Treatment of Diabetes Mellitus Wounds: Medicinal Chemistry and Future Therapeutic Options.

The incidence of diabetes mellitus (DM) has increased globally. Various complications such as blindness, nephropathy leading to renal failure, neuropathy, foot ulceration, amputation, and disturbance in autonomic nervous system were reported. Although, allopathy treatment still remains the treatment of choice, there is a need to look at the easy availability, patient compliance and cheaper cost of the drugs used in day-day practice. In this regard, complementary and alternative medicine has a greater role to play. Numerous plant extracts were shown to exhibit antihyperglycemic properties. In the present review, we surfed published literature in Pubmed and google databases with regard to the herbs used for DM wound treatment. We also discuss the possible mechanism of wound healing in DM with regard to advanced glycation end products, inflammation, macrophages, non-leukocytic cells such as keratinocytes, fibroblasts and endothelial cells, matrix metalloproteinase and miRNA. The review opens the door for effective treatment of DM wounds with plant extracts and plan future treatment options.

THE EFFECT OF TOMAN FISH EXTRACT (Channa Micropeltes) ONNEUTROPHILIN DIABETES MELLITUSWOUND HEALING (In Vivo Study in the Back of Male Wistar Mice (Ratus Novergicus)

Background: Toman fishcontains albumin and unsaturated fatty acids which can be an alternative of diabetes mellitus wounds healing process. People with diabetes mellitus have their neutrophil decreased. Albumin increases the number of neutrophil. Unsaturated fatty acid decreases the number of neutrophil . Purpose : To prove the effect of toman fish extract of 16 ml/Kg BW mice orally on thenumber of neutrophil in day 2, 4, and 8 of male wistarmice with diabetic wound. Materials and Method: This research applied pure experimental research method with posttest only control design. This research took 36 wistarmice which weredivided into negative control group which is given BR2 feed, treatment group which is giventoman fish extract in 16 mL/Kg BW mice and positive control group which is given haruan fish extract in 13.54 mL/Kg BW mice . The Result : One-way ANOVAshowedthat there wassignificant differenceof all groups in day 2 (p=0.000), day 4 (p=0.000) and day 8 (p=0.000). Post-Hoc LSD test for the average of neutrophil number showedthat there was significant difference (p<0.05) between the negative control group, treatment group and the positive control group. Conclusion : Toman fish extract has an effect which increasesthe number ofneutrophil in day 2 and decreasesthe number of neutrophil in day 4 and 8 on the healing of diabetic wound in mice .

The characterization of a full-thickness excision open foot wound model in n5-streptozotocin (STZ)-induced type 2 diabetic rats that mimics diabetic foot ulcer in terms of reduced blood circulation, higher C-reactive protein, elevated inflammation, and reduced cell proliferation.

Delayed foot wound healing is a major complication attributed to hyperglycemia in type 2 diabetes mellitus (DM) patients, and these wounds may develop into foot ulcers. There are at least two types of DM wound models used in rodents to study delayed wound healing. However, clinically relevant animal models are not common. Most models use type 1 DM rodents or wounds created on the back rather than on the foot. An open full-thickness excision wound on the footpad of type 2 DM rats is more clinically relevant, but such a model has not yet been characterized systematically. The objective of this study was to investigate and characterize how DM affected a full-thickness excision open foot wound in n5-streptozotocin (n5-STZ)-induced type 2 DM rats. We hypothesized that elevated inflammation, reduced blood circulation, and cell proliferation due to hyperglycemia could delay the wound healing of DM rats. The wounds of DM rats were compared with those of non-DM rats (Ctrl) at Days 1 and 8 post wounding. The wound healing process of the DM rats was significantly delayed compared with that of the Ctrl rats. The DM rats also had higher C-reactive protein (CRP) and lower blood circulation and proliferating cell nuclear antigen (PCNA) in DM wounds. This confirmed that elevated inflammation and reduced blood flow and cell proliferation delayed foot wound healing in the n5-STZ rats. Hence, this open foot wound animal model provides a good approach to study the process of delayed wound healing.

TINGKAT PENGETAHUAN PASIEN TENTANG PERAWATAN LUKA DIABETES MELITUS DI RUMAH SAKIT PTPN II BANGKATAN BINJAI TAHUN 2016

Diabetic wounds are injuries that occur in patients with diabetics involving disorders of the peripheral and autonomic nerves. Every year more than one million people with diabetes lose one of their legs as one of the complications of diabetes, this means that every 30 seconds one leg is lost due to diabetes somewhere in the world. The purpose of this study was to determine the level of knowledge of patients in the treatment of diabetes mellitus wounds in PTPN II Hospital Binjai Departure in 2016. The method of this study was descriptive observational. The population in this study were all patients treated at the Women's Room at PTPN II Bangkat Binjai Hospital, totaling 20 people. The sample in this study amounted to 10 people with accidental sampling techniques. The results of this study indicate that the Knowledge Level of Patients About Diabetes Wound Care in the Women's Room of PTPN II Hospital Binjai Departure in 2016 which is interpreted is good knowledge as many as 6 people (60%), enough as many as 2 people (20%) and less than 2 people (20%). 3. It is expected that patients will be able to prevent Diabetes Injuries by controlling blood glucose, using footwear, treating toenails, foot care and foot exercises. If Complications with Diabetes Injuries have occurred, the patient is expected to be able to treat diabetic wounds properly.Keywords: Patient Knowledge, Diabetes Melitus Wound Care

Alginate and DNA Gels Are Suitable Delivery Systems for Diabetic Wound Healing.

Diabetic foot ulcers (DFU) represent a severe health problem and an unmet clinical challenge. In this study, we tested the efficacy of novel biomaterials in improving wound healing in mouse models of diabetes mellitus (DM). The biomaterials are composed of alginate- and deoxyribonucleic acid (DNA)-based gels that allow incorporation of effector cells, such as outgrowth endothelial cells (OEC), and provide sustained release of bioactive factors, such as neuropeptides and growth factors, which have been previously validated in experimental models of DM wound healing or hind limb ischemia. We tested these biomaterials in mice and demonstrate that they are biocompatible and can be injected into the wound margins without major adverse effects. In addition, we show that the combination of OEC and the neuropeptide Substance P has a better healing outcome than the delivery of OEC alone, while subtherapeutic doses of vascular endothelial growth factor (VEGF) are required for the transplanted cells to exert their beneficial effects in wound healing. In summary, alginate and DNA scaffolds could serve as potential delivery systems for the next-generation DFU therapies.

Prevalence of Multiple Antibiotic Resistant Infections in Diabetic versus Nondiabetic Wounds.

Diabetes mellitus (DM) affects 23.6 million people in the USA and approximately 20–25% of diabetic patients will develop foot ulceration during the course of their disease. Up to a quarter of these patients will develop infections that will necessitate amputation. Although many studies report that the rates of antibiotic resistant infections have increased dramatically in the DM population over the last decade, to our knowledge there have been no reports directly comparing the rates of antibiotic resistant infections in DM versus non-DM wounds. We performed a retrospective study comparing the wound infections of 41 DM patients to those of 74 non-DM patients to test the hypothesis that infections with multidrug resistant organisms (MDRO) were more prevalent in the DM population. We found that 63.4% of DM and 50% of non-DM patients had MDRO infections, which was not statistically different. However, 61% of the DM patients had Pseudomonas infections compared to only 18.9% of non-DM patients. Furthermore, DM patients had significantly more coinfections with both Pseudomonas and Staphylococcus aureus. Though our initial hypothesis was incorrect, we demonstrated a significant correlation between Pseudomonas and Pseudomonas/S. aureus coinfections within DM wounds.