Healing Process Of Ulcers Research Articles

Efficacy of Topical Application of Chum Salmon (Oncorhynchus keta) Skin-derived Collagen Extracts in Improving Oral Traumatic Ulcer Healing

Background: Traumatic ulcer is a wound on the oral mucosa that often causes pain and impaired eating function. Healing of these wounds takes a long time and can interfere with an individual’s daily activities. One therapeutic approach that is being developed is the use of topical application of chum salmon skin-derived collagen extract. Collagen is the main component of the extracellular matrix and plays a major role in wound healing. The skin of chum salmon (Oncorhynchus keta) contains collagen that is effective for the treatment of wounds. Aim: The aim of this study was to evaluate the effectiveness of topical applications of chum salmon (O. keta) skin-derived collagen extracts in improving the healing of traumatic ulcers through analysis of neutrophil and macrophage numbers and collagen density. Materials and Methods: Twenty-four male Wistar rats were randomly divided into four groups consisting of six rats each. The labial mucosa of the lower lips of the rats was injured with heated amalgam stoppers to create oral traumatic ulcers. Group 1 was a control group; in Groups 2, 3, and 4, 25%, 50%, and 75% of collagen extracts from chum salmon (O. keta) skin were applied topically once a day for 7 days, respectively. The neutrophil and macrophage numbers were observed by hematoxylin and eosin staining. Masson’s Trichrome staining was used to analyze the collagen density. Data were analyzed using one-way analysis of variance and continued with post hoc least significant difference tests. Significance is considered if P < 0.05. Results: The oral traumatic ulcers gradually healed until day 7. The number of neutrophils and macrophages was significantly decreased in the treatment groups, and collagen density was increased, compared to the control group (P < 0.05). The decrease of neutrophil and macrophage numbers occurred significantly with the increased collagen extract concentrations (P < 0.05). Collagen density also increased significantly with the increased collagen extract concentrations (P < 0.05). Conclusion: Topical applications of chum salmon (O. keta) skin-derived collagen extracts accelerate the healing process of oral traumatic ulcers by decreasing neutrophil and macrophage numbers and increasing collagen density.

Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers

Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers

The Effect of Ozone Therapy Stimulation on Diabetes Wound Healing Process

<p>Health problems that are currently developing include diabetes mellitus (DM) with various complications including diabetic ulcers. Diabetic ulcers are the main cause of prolonged pain and even amputation in DM patients. Diabetic wounds are a complication of diabetes that often occurs in the extremities, increasing morbidity and lessens the patient's personal satisfaction. Ozone therapy is one method used to speed up the healing process for diabetic ulcers. This study plans to examine the impact of ozone treatment feeling on diabetic injury mending. The exploration strategy utilizes a semi exploratory technique with a pretest and posttest non-identical benchmark group plan. The testing strategy is a non-likelihood inspecting method.The population in this study were all patients suffering from diabetic wounds who received wound care at the Edwcare clinic in Langsa city. The respondents of this study were patients suffering from diabetic wounds who received wound care at the Edwacare wound care center in Langsa City, Indonesia consisting of 28 respondents who received modern wound care dressings and 28 respondents received wound care combined with modern dressings and ozone therapy. The research instrument for assessing wound severity used the Bates-Jensen Wound Assessment Tool. Data analysis used the Friedman and Kruskal Wallis tests. Based on the research results, it was found that there was a more significant effect between wound care using a combination of modern dressings and ozone therapy with a Mean Rank value of 39.75 compared to wound care that only received modern dressing wound care with a Mean Rank value of 17.25 with a value of p -value <0.05. The conclusion is that the effect of ozone stimulation significantly influences the healing process of diabetic wounds and is recommended as a nursing intervention that can be applied in treating diabetic wounds.</p><p><strong><em>Keywords: Diabetes mellitus, diabetic wounds, ozone therapy, stimulation</em></strong></p>

National expert consensus on the diagnosis and surgical treatment of diabetic foot ulcers complicated with lower extremity vasculopathy (2024 version)

Diabetic foot ulcers complicated with lower extremity vasculopathy possess the characteristics of high incidence, slow healing, and poor prognosis, which may eventually lead to amputation or even life-threatening if not treated properly. The treatment of complicated lower extremity vasculopathy is vital to improve the healing process of diabetic foot ulcers, which has gradually received attention in clinical practice. Recently, a number of clinical trials on diabetic foot ulcers complicated with lower extremity vasculopathy were reported. In order to further standardize the clinical diagnosis and treatment of diabetic foot ulcers complicated with lower extremity vasculopathy, an expert group headed by Burns and Trauma Branch of Chinese Geriatrics Society, Chinese Burn Association, and Wound Repair Professional Committee of Chinese Medical Doctor Association deliberated and compiled the National expert consensus on the diagnosis and surgical treatment of diabetic foot ulcers complicated with lower extremity vasculopathy (2024 version) together. This consensus is based on evidences from the literature, covers the disease characteristics, evidence-based evidence of clinical diagnosis and treatment, as well as the application of new technologies and new treatment approaches of diabetic foot ulcers complicated with lower extremity vasculopathy. The goal of this consensus is to provide clear guidance to practitioners on the best approaches for screening, diagnosing, and treating diabetic foot ulcers complicated with lower extremity vasculopathy in individuals, hoping to provide a normative clinical practice basis for medical staff engaged in the treatment of diabetic foot wounds.

Effectiveness of glutamine and arginine in wound healing of pressure ulcers: A systematic review protocol

IntroductionVarious nutrients play a physiological role in the healing process of pressure ulcers (PUs). Nutritional interventions include the administration of enteral nutritional supplements and formulas containing arginine, glutamine, and micronutrients. The aim of this systematic review is to evaluate the effectiveness of enteral nutritional supplements and formulas containing arginine and glutamine on wound-related outcomes. These include (1) time to healing, (2) changes in wound size, (3) local wound infection, (4) PU recurrence, and (5) PU-related pain. Materials and methodsThis protocol was developed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). A search will be conducted in the Cochrane Library, EMBASE, PubMed (MEDLINE), CINAHL (EBSCOhost interface) and Web of Science. In addition, a manual search will be conducted to identify relevant records. Except for systematic reviews, no restrictions will be placed on the study design, the population studied or the setting. Studies that do not address PUs, in vitro studies and studies that do not report wound-related outcomes will be excluded. Study selection, risk of bias assessment and data extraction will be performed independently by three researchers. Depending on the extent of heterogeneity of interventions, follow-up time and populations, results will be summarised either by meta-analysis or narrative synthesis. ConclusionsThis is the first systematic review to identify, evaluate and summarise the current evidence for enteral arginine and glutamine supplementation on wound-related outcomes in PUs. The review will provide a solid basis for deriving valid and clinically relevant conclusions in this area.

Diagnosis and treatment of diabetic foot ulcer complicated with lower extremity vasculopathy: Consensus recommendation from the Chinese Medical Association (CMA), Chinese Medical Doctor Association (CMDA).

Diabetic foot ulcer complicated with lower extremity vasculopathy is highly prevalent, slow healing and have a poor prognosis. The final progression leads to amputation, or may even be life-threatening, seriously affecting patients' quality of life. The treatment of lower extremity vasculopathy is the focus of clinical practice and is vital to improving the healing process of diabetic foot ulcers. Recently, a number of clinical trials on diabetic foot ulcers with lower extremity vasculopathy have been reported. A joint group of Chinese Medical Association (CMA) and Chinese Medical Doctor Association (CMDA) expert representatives reviewed and reached a consensus on the guidelines for the clinical diagnosis and treatment of this kind of disease. These guidelines are based on evidence from the literature and cover the pathogenesis of diabetic foot ulcers complicated with lower extremity vasculopathy and the application of new treatment approaches. These guidelines have been put forward to guide practitioners on the best approaches for screening, diagnosing and treating diabetic foot ulcers with lower extremity vasculopathy, with the aim of providing optimal, evidence-based management for medical personnel working with diabetic foot wound repair and treatment.

Neuropeptide W facilitates chronic gastric ulcer healing by the regulation of cyclooxygenase and NF-κB signaling pathways

AimsPutative beneficial effects of neuropeptide W (NPW) in the early phase of gastric ulcer healing process and the involvement of cyclooxygenase (COX) enzymes were investigated in an acetic acid-induced gastric ulcer model.Main methodsIn anesthetized male Sprague–Dawley rats, acetic acid was applied surgically on the serosa and then a COX-inhibitor (COX-2-selective NS-398, COX-1-selective ketorolac, or non-selective indomethacin; 2 mg/kg/day, 3 mg/kg/day or 5 mg/kg/day; respectively) or saline was injected intraperitoneally. One h after ulcer induction, omeprazole (20 mg/kg/day), NPW (0.1 μg/kg/day) or saline was intraperitoneally administered. Injections of NPW, COX-inhibitors, omeprazole or saline were continued for the following 2 days until rats were decapitated at the end of the third day.Key findingsNPW treatment depressed gastric prostaglandin (PG) I2 level, but not PGE2 level. Similar to omeprazole, NPW treatment significantly reduced gastric and serum tumor necrosis factor-alpha and interleukin-1 beta levels and depressed the upregulation of nuclear factor kappa B (NF-κB) and COX-2 expressions due to ulcer. In parallel with the histopathological findings, treatment with NPW suppressed ulcer-induced increases in myeloperoxidase activity and malondialdehyde level and replenished glutathione level. However, the inhibitory effect of NPW on myeloperoxidase activity and NPW-induced increase in glutathione were not observed in the presence of COX-1 inhibitor ketorolac or the non-selective COX-inhibitor indomethacin.SignificanceIn conclusion, NPW facilitated the healing of gastric injury in rats via the inhibition of pro-inflammatory cytokine production, oxidative stress and neutrophil infiltration as well as the downregulation of COX-2 protein and NF-κB gene expressions.

Biocellulose-based hydrogel dressing as a strategy for the management of chronic arterial wounds.

To evaluate using a biocellulose-based hydrogel as an adjuvant in the healing process of arterial ulcers. A prospective single group quasi-experimental study was carried out with chronic lower limb arterial ulcer patients. These patients received biocellulose-based hydrogel dressings and outpatient guidance on dressing and periodic reassessments. The primary outcomes were the ulcer-healing rate and product safety, which were assessed by ulcer area measured in photographic records of pre-treatment and posttreatment after 7, 30, and 60 days. Secondary outcomes were related to clinical assessment by the quality-of-life scores (SF-36 and EQ-5D) and pain, evaluated by the visual analogue scale (VAS). Seventeen participants were included, and one of them was excluded. Six patients (37%) had complete wound healing, and all patients had a significant reduction in the ulcer area during follow-up (233.6mm2 versus 2.7mm2) and reduction on the score PUSH 3.0 (p < 0.0001). The analysis of the SF-36 and EQ-5D questionnaires showed a statistically significant improvement in almost all parameters analyzed and with a reduction of pain assessed by the VAS. The biocellulose-based hydrogel was safe and showed a good perspective to promoting the necessary conditions to facilitate partial or complete healing of chronic arterial ulcers within a 60-day follow-up. Quality of life and pain were positively affected by the treatment.

Effect of Ankle Brachial Index (ABI) and Compression Therapy on Diabetic Foot Ulcer Healing.

Knowing the effect of compression therapy on the value of the Ankle Brachial Index in the healing process of Diabetic Foot Ulcer. This study used a quasi-experimental method with pretest-posttest with control group design with purposive sampling and non-equivalent control groups for eight weeks of treatment. Patients diagnosed with Diabetic Foot Ulcer have and have Peripheral Artery Disease, patient characteristics are homogenized, age >18 years, wound care every three days, Ankle Brachial Index values between 0.6-1.3 mmHg, research three clinics in Indonesia in February 2021. The population with Diabetic Foot Ulcer was screened by inclusion criteria with Ankle Brachial Index and Bates-Jensen Wound Assessment Tool instruments, a total of n=140; in the study, thirteen samples were excluded, the intervention group was given Compression Therapy n= 68, and the control group was compression stockings for eight weeks n=59, the data were statistically analyzed non-parametric test using Wilcoxon and Mann-Whitney U. Statistical analysis showed that the mean difference in paired group means was 26.4%. Meanwhile, in the mean analysis, the difference in the post-test healing of diabetic foot ulcers was 2.83%; p=0.000 and improvement of peripheral microcirculation was 33.02%; p=0.000 in the eighth week. Thus, compression therapy intervention in diabetic foot ulcer patients can improve peripheral microcirculation and increase Diabetic Foot Ulcers healing compared to the control group. Compression therapy tailored to the patient's needs and according to standard operating procedures can improve peripheral microcirculation, so that blood flow in the legs becomes normal; it can speed up the healing process of Diabetic Foot Ulcers.

Changes in gene expression in pressure ulcers debrided by different approaches - a pilot study.

Pressure ulcers (PUs), also known as pressure injuries, are chronic wounds that represent potential lifelong complications. Pressure ulcers of a deep category (III and IV) are often indicated for surgical treatment - debridement and surgical reconstruction. Sharp surgical debridement is widely used in the debridement of PUs; however, the Versajet® hydrosurgery system is becoming an increasingly popular tool for tangential excision in surgery due to its numerous advantages. This work focused on the expression of selected genes, especially those associated with oxidative stress, in PUs debrided by two approaches - sharp surgical debridement and debridement using Versajet® hydrosurgery system. Expression of following genes was evaluated: NFE2L2, ACTA2, NFKB1, VEGFA, MKI67, HMOX1, HMOX2, HIF1A, and SOD2. ACTB and PSMB were used as housekeeping genes. So far, five patients have been enrolled in the study. Preliminary results suggest no significant difference in gene expression with different pressure ulcer treatment approaches except NFE2L2, despite the macroscopic differences. However, the results revealed correlations between the expression of some genes, namely HIF1A and SOD2, VEGFA and SOD2 and VEGFA and HIF1A. These results may indicate a connection between hypoxia, oxidative stress, pressure ulcer healing processes and angiogenesis.

Risk Scale for Patients with Newly Diagnosed Diabetic Foot Ulcer - Which Patients May Experience Healing Failure or Need Revascularization

BackgroundThe healing process of diabetic foot ulcers (DFU) is associated with the risk of life-threatening complications. The aim of the study was to establish the most important risk factors which have an impact on the healing process. MethodsThe retrospective analysis was conducted on patients with diagnosed T2DM and newly diagnosed DFU. The observation lasted 12 months and the primary outcome was complete healing of the wounds, the secondary outcome was defined as a need for vascular intervention of the lower extremity (VI) or the occurrence of a new wound (NW). The data examined with a chi2 test analysis of the odds ratio in the SAS 9.4 program. Results64 patients cases (13 women and 51 men) with mean weight (101.48kgs (±22.4)), age (60.59 years old (±9.14)) were analyzed. The mean baseline area of the patient's wounds was 7.75cm2 (±16.46). The primary outcome was achieved by 42.19% (n=27). The NW occurred among 39.06% (n=25), and 21.88% (n=14) needed VI. The patients with the area of all wounds bigger than 5cm2 have a higher risk of having unhealed wounds (OR=7.58, p<0.05). Additionally, diagnosed anemia or cigarette smoking on the first visit was associated with a higher risk of NW (OR=9.5, p<0.05 and OR=3.8, p<0.05). None of the analyzed factors had an impact on the risk of VI. ConclusionsThe simple characterization of wounds and patients can be useful in estimating of risk of having an unhealed wound or the occurrence of a new wound 12 months after the first visit.

Cytoprotective Effects of Hydro-extracts of the Inner Bark of the Oak Tree Fruit (Jaft) on the Healing Process of Aspirin-Induced Gastric Ulcers in Rats

Introduction: A gastric ulcer is a mucosal lesion of the stomach that may occur after taking non-steroidal anti-inflammatory drugs such as aspirin, especially in cardiovascular diseases. The aim of this study was to evaluate the cytoprotective effects of the aqueous extract of oak (Jaft) against the mucosal damage effects of aspirin. Methods: Seventy-two female Wistar rats weighing 200‒240 g were prepared and divided into 6 groups. Groups I, II, and III received the Jaft extract at doses of 250 mg/kg/d, 500 mg/kg/d, and 750 mg/kg/d, respectively, and Group IV received omeprazole at a dose of 200 mg/kg/d. Groups V (patient’s control) and VI (healthy control) both received saline (0.9%) at 1 mL/kg/d . Mice were given aspirin (200 mg/kg/d) for inducing the gastric ulcer. After 14 days, they were anesthetized with ether, their stomachs were removed, and the blocks of tissue were prepared. The tissues were stained using the hematoxylin-eosin (H&amp;E) dye and analyzed by the Olympus light microscope and OLYSIA software. Finally, IBM SPSS 26.0 software was used for statistical analysis of the data. Results: The means±standard deviation (SD) of the mucosal thickness in groups taking the Jaft extracts (250, 500, and 700 mg) decreased compared to the aspirin group (P&lt;0.05). In addition, the mean±SD of the mucosal gland thickness and mucosal folds in group V (with aspirin) decreased compared to the 250, 500, and 700 extract groups (P&gt;0.05). The epithelial cell destruction, edema, venous congestion, and destruction of the capillaries of the mucosal and sub-mucosal areas in the extract groups decreased compared to the V group. Likewise, the number of mucosal cells in the gastric gland and the size of gastric parietal cells in the extract groups decreased compared to the V group. Conclusion: This study generally elucidated the cytoprotective effect of the Jaft extract in the mouse model of gastric ulcer.

Maggot debridement therapy stimulates wound healing by altering macrophage activation.

The purpose of this study is to determine the impact of maggot debridement therapy (MDT) on macrophages during the healing process of diabetic foot ulcers (DFU). The activation phenotype of macrophages during wound healing following MDT was evaluated using double staining immunohistochemistry (IHC). In addition, markers associated with macrophage activation were discovered using immunoblotting and real-time polymerase chain reaction (PCR). During the process of diabetic wound healing following MDT, the presence and over-expression of M2 macrophages were observed, while the under-expression of M1 macrophages was noted. In addition, the activation markers of macrophages exhibited a correlation with the indicated Th1/Th2 cytokines. MDT interventions have the potential to modulate macrophage activity, thereby aiding in the healing of diabetic foot wounds.

Identification of potential immunologic resilience in the healing process of diabetic foot ulcers.

Diabetic foot ulcers (DFUs) are one of the most common and challenging complications of diabetes, yet our understanding of their pathogenesis remains limited. We collected gene expression data of DFU patients from public databases. Bioinformatics tools were applied for systematic analysis, including the identification of differentially expressed genes (DEGs), weighted gene co-expression network analysis (WGCNA) and enrichment analysis. We further used single-cell RNA sequencing to identify the distribution of different cell populations in DFU. Finally, key results were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and flow cytometry. We identified 217 DEGs between ulcerated and healthy skin, and 37 DEGs between healing ulcers and ulcers. WGCNA revealed that the cyan module had the highest positive correlation with healthy skin and negative correlation with ulcers. The black module had the highest negative correlation with healthy skin and positive correlation with ulcers. Enrichment analysis showed that the genes in the cyan module were mainly associated with complement and coagulation cascades, while the genes in the black module were mainly associated with the IL-17 signalling pathway. In addition, CD8 T cells were significantly lower in ulcers than in healthy and healing ulcers. By comparing marker genes of CD8 T cells, we identified key genes in the cyan and black modules and validated their expression using RT-qPCR. The proportion of CD8 T cells was increased in healing ulcers. Flow cytometry detected increased levels of CD8 T, B and natural killer cells in healing ulcers. CD8 T cells and related key genes play an important role in the healing process of DFU. The results of this study provide a new perspective for understanding the pathogenesis and treatment of DFU.

Evaluation of factors affecting the healing process of venous ulcers: A 12-week longitudinal study.

The process of healing venous ulcers is complex and influenced by many factors. By identifying the risk factors that influence a slower healing process, it is possible to predict impending delays and plan an individualised care plan. We analysed our database of patients with venous ulcers and identified clinical and demographic factors that delay the healing process. The research analysed the medical records of 754 patients with VLUs at Chronic Wound Treatment Unit of the University Hospital treated between 2001 and 2019. In study, the majority (64.3%) were women, the mean age was 65.7 years. The median duration of Chronic Venous Insufficiency was 24 years, 52% patients had had the disease >20 years, and 296 (39.3%) had experienced ulceration >12 months. Most of the patients (85.8%) had comorbidities, 84% were obese. At 12-week follow-up, 432 of the 754 ulcers had healed. Identified independent predictors of slower ulcer healing rates: wound area greater than 8.25 cm2 , location of the ulceration other than the medial ankle area, underlying disease >20 years, the presence of multiple comorbidities, depth of the ulcer, the presence of an unpleasant smell and alert pathogens. The presence of redness resulted in faster healing of VLUc. Many factors influence the healing process of venous ulceration. The results of the study can help in planning patient care and implementing appropriate early strategies to promote healing.

The protective effect of small black soybean (Vigna Mungo L.) polysaccharide on acetic acid-induced gastric ulcer in SD rats and its impact on gut microbiota and metabolites

Small black soybean (Vigna Mungo L.) is a kind of medicinal and edible plant with many potential health benefits for the human body. In this study, we investigated the potential anti-gastric ulcer effect of Vigna Mungo L. polysaccharides (VMP) using an acetic acid-induced gastric ulcer model in SD rats. The impact of VMP on the levels of antioxidant factors and growth factors in gastric tissue homogenate, serum metabolites, short-chain fatty acids (SCFAs) and gut microbiota in SD rats were analyzed. The results revealed that VMP exhibited a beneficial role in facilitating the healing process of gastric ulcers, specifically by reducing the area of gastric ulcers, increasing the levels of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF), and improving oxidative stress status. Additionally, VMP modulated 20 potential serum biomarkers associated with gastric ulcers, thereby exerting a significant impact on multiple crucial metabolic pathways. Notably, VMP notably increased the levels of SCFAs, including acetic acid, propionic acid, i-butyric acid, n-butyric acid, i-valeric acid, n-valeric acid, in the colonic contents of rats with gastric ulcers. Furthermore, VMP effectively ameliorated gut microbiota dysbiosis in gastric ulcer rats by reducing the relative abundance of Firmicutes, Lachnospiraceae_NK4A136_group, Quinella and Lactobacillus, while increasing the relative abundance of Bacteroidota, Bacteroides, Oscillospiraceae_UCG-005, Muribaculaceae, Parasutterella and Ruminococcus. Correlation analysis showed that the relative abundance of Parasutterella and Lachnospiraceae_NK4A136_group were closely related to the changes of SCFAs and serum metabolites. These findings provide potential groundwork for the development of health products aimed at preventing and treating gastric ulcers.

XB130 inhibits healing of diabetic skin ulcers through the PI3K/Akt signalling pathway.

Diabetic skin ulcers, a significant global healthcare burden, are mainly caused by the inhibition of cell proliferation and impaired angiogenesis. XB130 is an adaptor protein that regulates cell proliferation and migration. However, the role of XB130 in the development of diabetic skin ulcers remains unclear. To investigate whether XB130 can regulate the inhibition of proliferation and vascular damage induced by high glucose. Additionally, we aim to determine whether XB130 is involved in the healing process of diabetic skin ulcers, along with its molecular mechanisms. We conducted RNA-sequencing analysis to identify the key genes involved in diabetic skin ulcers. We investigated the effects of XB130 on wound healing using histological analyses. In addition, we used reverse transcription-quantitative polymerase chain reaction, Western blot, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining, immunofluorescence, wound healing, and tubule formation experiments to investigate their effects on cellular processes in human umbilical vein endothelial cells (HUVECs) stimulated with high glucose. Finally, we performed functional analysis to elucidate the molecular mechanisms underlying diabetic skin ulcers. RNA-sequencing analysis showed that the expression of XB130 was up-regulated in the tissues of diabetic skin ulcers. Knockdown of XB130 promoted the healing of skin wounds in mice, leading to an accelerated wound healing process and shortened wound healing time. At the cellular level, knockdown of XB130 alleviated high glucose-induced inhibition of cell proliferation and angiogenic impairment in HUVECs. Inhibition of the PI3K/Akt pathway removed the proliferative effects and endothelial protection mediated by XB130. The findings of this study indicated that the expression of XB130 is up-regulated in high glucose-stimulated diabetic skin ulcers and HUVECs. Knockdown of XB130 promotes cell proliferation and angiogenesis via the PI3K/Akt signalling pathway, which accelerates the healing of diabetic skin ulcers.

Effectiveness of Modern Dressing on Healing Diabetic Foot Ulcer: A Literature Review

Background: Diabetes mellitus is a group of heterogeneous disorders that have indications in the form of increased content of high blood sugar levels. WHO also confirmed DM to be the 7th trigger of death. IDF (International Diabet Federation) data estimates from survey results after North America in 2017 the 3rd place was occupied by Southeast Asia and people with diabetes mellitus with a percentage of 8.5% at the age of 20-29 years in North Africa. One of the treatments for patients with diabetes mellitus can be wound care using Modern Dressing with the Moist Wound Healing method. Methods: The method used in this wound treatment is the Modern Dressing technique with the Moist Wound Healing method. This procedure can clinically grow tissue 30-50%, increase collagen synthesis by 50%, and the rate of re-epithelialization with moist conditions is 2-5 times faster and can reduce the amount of fluid from above the wound surface. Results: evaluation shows that Modern Dressing wound care with the Moist Wound Healing method is in fact able to maintain moist conditions in the wound, reduce inflammation in the wound so that it can improve and accelerate the healing process of diabetic ulcers. Conclusion: The results showed that the Modern Dressing technique with the Moist Wound Healing method was able to improve the healing process of diabetic ulcers. The results also showed that there were significant changes between modern and conventional dressings. The modern dressing group had a much better development than the conventional dressing. The application of the Moist Wound Healing method in patients with diabetic ulcers can provide a much faster wound recovery reaction.

Evaluation of clinical, histology, TNF-α, and collagen expressions on oral ulcer in rats after treatment with areca nut and chrysanthemum oral gel

Background: Areca nut (Areca catechu Linn.) is the seed of the fruit of the oriental palm that is commonly used among Southeast Asian communities. Chrysanthemum (Dendrathema grandiflora) is a flowering plant originating from East Asia and dominantly grows in China. Both of these plants have strong antioxidant activities. To investigate the mechanism of their wound healing activities, we prepared areca nut and chrysanthemum polyethylene oral gel and performed several in vivo assays using Sprague–Dawley rats. Methods: Sprague–Dawley rats were divided into six groups: Negative control group (rats with base gel treatment), positive control group (rats treated with triamcinolone acetonide), F1 (treatment with 20% areca nut:80% chrysanthemum), F2 (treatment with 50% areca nut:50% chrysanthemum), F3 (treatment with 80% areca nut:20% chrysanthemum), and normal group (without ulcer and treatment). Traumatic ulcers were performed on the buccal mucosa of all experimental animals that received topical oral gel and triamcinolone acetonide twice a day for seven days. The clinical and histological characteristics were analyzed and scored. Results: During the six days, the ulcerated area receded linearly over time and was completely cicatrized in F2, F3, and the positive control group (Dependent t-test, p&lt;0.05). There were significant increases in body weight in F2 and positive control groups. There were no significant differences between groups in histology examination (Kruskal Wallis test, p&lt;0.05). The moderate score of TNF-α levels was seen in F2 and positive control groups (ANOVA/Tukey test, p&lt;0.05). In the collagenases assay, a high concentration of areca nut (F3) induced the abundance of collagen during the ulcer healing process. Conclusions: The combination of areca nut and chrysanthemum extract in the oral gel can optimize the healing of traumatic oral ulcers in Sprague-Dawley rats through the increase of TNF-α and collagen deposition.

Characteristics of Nutrition Intake in Diabetic Ulcer Patients at Hospital dr. Slamet Garut

Diabetes mellitus can lead to the development of ulcers on the extremities, which are typically caused by peripheral nerve disorders, infections, and blood flow disorders. Managing diabetes requires adhering to proper nutritional intake, including the frequency and duration of meals, as well as the types of foods consumed. In this study, we aimed to examine the nutritional intake characteristics of outpatients with diabetic ulcers at Dr. Slamet Garut, including their eating frequency, meal duration, and food choices. We used a quantitative descriptive research design and selected a sample of 49 diabetic ulcer patients through purposive sampling. Data was collected using a validated and reliable questionnaire. The results of our study indicated that the majority of patients (57.1%) did not eat frequently, had short meal durations (51.0%), and consumed low-calorie foods (61.2%). Diet planning is a major component of success in treating diabetic ulcers. The accuracy and regularity of the patient in setting the amount, type and schedule of meals aims to control glucose levels so that blood flow to the ulcer area becomes smooth and the ulcer healing process will run well. Overall, nutritional intake in patients with diabetic ulcers is largely inadequate during the wound healing process.