Ulcer Patients Research Articles

A comparison of myeloid-derived suppressor cell populations in patients with ulcerated vs non-ulcerated melanoma receiving immune checkpoint blockade.

Myeloid-derived suppressor cells (MDSCs) are expanded in cancer patients, have an intrinsic immunosuppressive function, and thus may play a role in resistance to immunotherapy. Ulceration of the melanoma primary is associated with more aggressive disease and is an independent prognostic factor for melanoma-specific survival. However, the underlying factors contributing to this more aggressive phenotype are not completely understood. The current study aims to correlate changes in circulating MDSC during immunotherapy in patients with ulcerated vs non-ulcerated melanoma primary tumors. Longitudinal changes in levels of circulating MDSCs were analyzed via flow cytometry in melanoma patients receiving immune checkpoint inhibitors (ICIs) and stratified by ulceration status. Following the initiation of therapy, the percentage of total MDSCs increased significantly in patients with both ulcerated (P = 0.003) and non-ulcerated (P < 0.001) tumors. When MDSCs were stratified by subset, the proportion of granulocytic MDSC (PMN-MDSC) decreased in patients with non-ulcerated tumors (P = 0.023), while the proportion remained stable in patients with ulcerated tumors (P = 0.121). The reduction in the proportion PMN-MDSC in non-ulcerated patients coincided with a statistically significant increase in the proportion of CD14+/CD15+ MDSC (P = 0.008), resulting in a greater proportion of CD14+/CD15+ MDSC in non-ulcerated patients as compared to ulcerated melanoma patients following two infusions of ICIs (27.3 ± 19.2% vs 16.1 ± 19.2%; P = 0.008). The trajectories of the MDSC populations described here provide insight into the altered tumor microenvironment in ulcerated melanoma and highlight key changes in a cell population that could contribute to immunotherapy resistance.

Differential effects of clary sage (Salvia sclarea L.) oil and linalyl acetate on depression levels in diabetic foot ulcer patients with T2DM: a randomized blinded controlled trial

BackgroundDiabetic foot ulcer (DFU) is a significant global health concern due to its substantial burden on individuals and healthcare systems. In addition to its physical impact, DFU has emotional effects on patients. This study analyzed the effects of inhaling clary sage (CS; Salvia sclarea L.) or linalyl acetate (LA) on depression and psychological factors in patients with DFU.MethodsThis study, performed at the Diabetic Wound Center, enrolled DFU patients, categorized as having mild or moderate to severe depression based on visual analog scale (VAS) for depression scores. Patients were randomized to inhalation of 5% CS oil, 5% LA or almond oil (control) by natural breathing. Blood pressure, heart rate, Depression-VAS, Anxiety-VAS, and Stress-VAS were measured before and after inhalation.ResultsThis study enrolled 72 patients with DFU, including 43 with mild and 29 with moderate to severe depression. Of the 43 patients with mild depression, 14, 14, and 15 were randomized to inhalation of CS, LA, and almond oil, respectively. Of the 29 patients with moderate to severe depression, 9, 11, and 9 were randomized to inhalation of CS, LA, and almond oil, respectively. Compared with inhalation of almond oil, inhalation of CS oil significantly reduced stress (p &amp;lt; 0.05) and (p &amp;lt; 0.01) in patients with mild depression, whereas inhalation of LA significantly reduced anxiety-VAS (p &amp;lt; 0.05) and depression-VAS (p &amp;lt; 0.05) in patients with moderate to severe depression.ConclusionInhalation of CS oil may have the potential to alleviate stress and anxiety in DFU patients with mild depression, whereas inhalation of LA may have the potential to alleviate anxiety and depression in DFU patients with moderate to severe depression. These findings suggest that adjunct therapy in DFU patients should be individualized according to the degree of depression.Clinical trial registrationhttp://cris.nih.go.kr/, identifier KCT0009722.

Comparison Of Wound Healing Process Between Hepar Sulph With Aloe Vera Wound Care Dressing Treatment Among Diabetic Foot Ulcers : A Pilot Study

This pilot study examines the effectiveness of Hepar Sulph and Aloe Vera in diabetic foot ulcer management. Key findings indicate superior outcomes with Hepar Sulph in wound size reduction and closure time. Implications for alternative wound care strategies are discussed. Diabetic foot ulcers (DFUs) pose a significant challenge in diabetic patient management. This pilot study aims to compare the effectiveness of Hepar Sulph and Aloe Vera in promoting wound healing among diabetic foot ulcer patients. A total of 60 participants were divided into three groups: 20 in the control group treated with normal saline (NaCl), 20 in the Aloe Vera group, and 20 in the Hepar Sulph group. The study found that both Hepar Sulph and Aloe Vera were effective in wound healing, with Hepar Sulph demonstrating superior results. This study highlights the potential of Hepar Sulph as a more effective treatment option for DFUs compared to Aloe Vera.

Will controlled monitoring of biochemical profile help in better prognosis of diabetic foot ulcer?

Diabetes Mellitus affects more than 400 million people worldwide and that number is growing rapidly. India is the country with largest number of diabetic patients in the world. Diabetic foot ulcer is one of the common causes of hospital admissions among diabetics in India.This study was aimed at creating a database on biochemical profile of diabetic foot ulcer patients and to see if they can be used to detect and prevent progressing complications and also to monitor treatment progress. A cross sectional study was conducted amongst 50 diabetic foot ulcer patients, biochemical parameters such as HbA1c, S. urea, S. creatinine, S. electrolytes, S. protein, S. albumin, S. SGPT, S. acetone, S. cholesterol, S. triglycerides and S. HDL were estimated from the time of hospital admission and in successive follow up. The population study group age was between 40 to 65 years with 60 percent being males. Among 50 patients there was a relative and gradual increase in values of HbA1c, Creatinine, Cholesterol and Triglycerides. whereas there is a decrease in values observed in parameters like Protein, Albumin and Sodium. Novel diagnostics are able to rapidly detect some of the most dangerous consequences of diabetic foot ulcer and can help to guide therapy. Therefore, preventive and evidence -based guidelines should be followed for diabetic wound management. Diabetic foot ulceration is a major health problem along with wound healing. Its management must also focus on identifying and correction of these biochemical changes and other contributing factors.

Pre-operative Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios as Predictors of Morbidity and Mortality in Diabetic Foot Infection Amputation Patients

Background: Diabetic foot infection is a complication of uncontrolled diabetes. Some cases require amputation to avoid the spread of infection; however, this can also lead to poor outcomes. Inflammatory markers, such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), have been explored as predictors of outcomes following amputation; however, only a few published studies are available. Objective: The study aimed to determine the diagnostic value of pre-operative neutrophil-lymphocyte and platelet-lymphocyte ratios in predicting in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation in a tertiary government hospital. Methodology: This retrospective cohort study included a total of 535 diabetic foot ulcer patients who underwent amputation at a tertiary government hospital. Data was collected via medical chart review. Complete blood count (CBC) parameters closest to the time of amputation were obtained to calculate the neutrophil-lymphocyte and platelet-lymphocyte ratios. Stata software was used for data processing and analysis. Results: Only 10.28% of patients experienced in-hospital morbidity and/or mortality. Based on Youden’s index, the optimal cutoff points of neutrophil-lymphocyte and platelet-lymphocyte ratios were 7.27 and 32.40, respectively. Both markers showed 98% sensitivity in predicting the outcome. Specificity was 99% for the neutrophil-lymphocyte ratio and 93% for the platelet-lymphocyte ratio. Accuracy parameters remained high when morbidity and mortality were analyzed separately, and subgroup analyses by major and minor amputations were performed. Conclusion: Neutrophil-lymphocyte and platelet-lymphocyte ratios accurately predict in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation. The low cost and wide availability of a CBC make NLR and PLR valuable options in low-resource settings. Future studies should explore these markers' utility in predicting long-term outcomes after amputation.

Effective of Health Education Program in Knowledge, Attitudes and Practice of Diabetic Septic Foot Patients to Prevent Foot Ulcers at King Fahd General Hospital Jeddah, Kingdom of Saudi Arabia (2018 to 2021)

Diabetes is the most common chronic disease worldwide. Although many serious complications can affect the individual with diabetes, foot problems take the greatest. This is an interventional quasi-experimental hospital-based study was conduct in King Fahd General Hospital in Jeddah, king of Saudi Arabia aimed at assessing the effective of health education program in knowledge, attitudes and practice of diabetic septic foot patient to prevent foot ulcer. Sixty diabetic ulcers patients were participating in this study during the period of the study from July 2018 to July 2021. The data was collected by using a questionnaire. The data was analyzed by using statistical package for social sciences (SPSS). The study results evident that the percentage of knowledge regarding diabetic septic foot patient to prevent foot ulcer for all items of diabetic septic foot care, were improved after the training program. The results of study regarding knowledge of patients to cause of diabetic foot ulcers were highly increased in percentages in post-intervention compared to pre-intervention. The results regarding education of risk factors of diabetic patients were increased in percentage in post-intervention compared to pre-intervention in education program for correct questions, but for incorrect it decreased also same results were presented in surgical management. The study concluded that there was significant improvement in patients’ knowledge attitude and practice regarding diabetic septic foot care after the education program. So the study recommended that continuing education program for diabetic septic foot patients is very important, learning facilities (books, Journals) about diabetic septic foot care should be available at hospitals

Validation of questionnaire on knowledge, attitude, practice of peptic ulcer patients to design pharmacist consultation model

Validation of questionnaire on knowledge, attitude, practice of peptic ulcer patients to design pharmacist consultation model

A novel and alternative treatment method for moderate diabetic foot ulcer: tibial periosteal distraction

ObjectiveResearchers have proposed a novel surgical treatment for moderate diabetic foot ulcer: tibial periosteal distraction (TPD) which could improve affected limb microcirculation. We aimed to describe the method and therapeutic effects of this technique.MethodsWe provided a technical guide to perform TPD surgery for the treatment of moderate diabetic foot ulcer of who had been treated in our department. The demographic information had been collected at the time of their admission. The patients were followed up at 3, 6, and 12 months after the operation with the ulcer area, skin temperature of the medial malleolus, transcutaneous oxygen pressure of the medial malleolus, ankle brachial index, dorsalis pedis artery pulsation, 12 item short form survey quality of life scale score, and visual analogue scale.ResultsA total of 35 patients with type 2 diabetes were included in this study, including 19 males and 16 females, with an average age of 62.49 ± 10.34 years and a maximum age of 87 years. The ulcers of all patients were cured, and the average healing time of ulcers was 8.09 ± 2.28 weeks, with no associated complications. The microcirculation indexes of the affected foot were significantly improved (p < 0.05). Three cases showed new vessels regeneration in the affected limbs according to their computed tomography angiography (CTA) results.ConclusionTPD surgery technique is a simple procedure that significantly increases the efficacy and reduces the complications of moderate diabetic foot ulcer patients, which could accelerate the formation of collateral circulation.

Evaluation of Practice and Awareness of the Safety Profile of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) among Dental Practitioners: A Cross-Sectional Study

Non-steroidal anti-inflammatory drugs (NSAIDs) are the common medications used by dental practitioners to relieve dental pain and control post-operative signs of inflammation. NSAIDs, irrespective of their benefits, have a lot of hazards because of misuse and faulty prescriptions by dentists. The aim of this study is to evaluate the current use of NSAIDs during dental practice and to evaluate the association of the level of education and years of experience of dental practitioners with the awareness of the safety profile of NSAIDs. This observational cross-sectional study was conducted in Benghazi city between August and October 2024. The sample size is composed of 341 dentists. Participants were selected randomly from approximately every dental clinic in Benghazi. The questionnaire is composed of sections including assessment of drug use and drug-precautionary awareness. It is structured with checklist answers and was formulated in English. It is filled by the dentists during a visit to their dental clinics on the basis of an interview. The Statistics Package for Social Science Version 21 (SPSS) software was used for transferring and analysis of data. The results showed that the females accounted for the majority (60.7%). General practitioners represented 67.7% of the participants. About 61.0% of the dentists had clinical experience of less than 10 years. Ibuprofen and Ketoprofen were the most prescribed NSAIDs, 67.2% and 51.6, respectively. More than fifty percent (55.4%) of the participants used to prescribe NSAIDs for less than three days. Postoperative pain and dental pain were the most common clinical indications that NSAIDs were prescribed, 71.3% and 59.5%, respectively. Pregnancy was the most cited to be contraindicated (58.9%). Awareness of avoiding NSAIDs in the case of peptic ulcer patient was associated with years of experience of the dentists (P=0.030). Participants agreed that nausea was the most side effects (45.2%). Awareness of the interaction between NSAIDs and warfarin was associated with the level of education (P=0.006). The outcomes of the study have revealed less comprehension regarding scientific background knowledge of NSAIDs. There was little effect of level of education and years of experience on the awareness of the safety profile of NSAIDs during dental practice. Therefore, a lot of efforts should be focused on improving the knowledge for making proper therapeutic decisions and minimizing the risk of serious adverse effects on the patients who attend dental clinics.

Suppression of TRIM72-mediated endoplasmic reticulum stress facilitates FOXM1 promotion of diabetic ulcer healing.

Foot ulcers are amongst the most prevalent complications of diabetes, known for their delayed healing process. Recent research indicates that the transcription factor forkhead box M1 (FOXM1) plays a role in promoting diabetic ulcer repair. However, the precise mechanisms underlying FOXM1 functions in this context remain unclear. This study aimed to clarify the role of tripartite motif-containing protein 72 (TRIM72)-mediated endoplasmic reticulum stress in FOXM1 promotive effects. Immunohistochemistry revealed that FOXM1 expression was significantly reduced in the lesion tissues of diabetic foot ulcer patients. In vitro experiments revealed a decrease in FOXM1 expression in cultured dermal fibroblasts under high glucose conditions. Activating FOXM1 with a plasmid accelerated the proliferation, migration, and differentiation of dermal fibroblasts and mitigated endoplasmic reticulum stress under high glucose conditions. Additionally, ChIP and luciferase reporter gene assays confirmed that FOXM1 suppressed TRIM72 expression transcriptionally by binding to its promoter. Furthermore, high glucose induced ubiquitination of adenosine 5'-monophosphate-activated protein kinase alpha (AMPKα), whilst inactivation of AMPKα signalling reversed the aforementioned effects of FOXM1 on cells. Finally, the FOXM1-overexpressing plasmid was transfected in vivo, which promoted wound healing in a murine diabetic ulcer model. In conclusion, FOXM1 reduces endoplasmic reticulum stress by inhibiting TRIM72-mediated AMPKα ubiquitination, thereby accelerating the healing of diabetic ulcers.

Comparison of high-pressure compression stockings and compression bandages for ulcer treatment in venous ulcer patients.

This study aims to compare the effectiveness of compression bandages and compression stockings in the treatment of venous ulcers following venous ulcer surgery. A total of 170 patients who underwent venous ulcer surgery were included in this retrospective study. Patients were divided into two groups: the first group used compression bandages, and the second group used compression stockings. In all patients, a sterile cotton dressing from the venous ulcer care kit was first applied directly over the open ulcer to protect the wound bed. Both groups were followed for 3months. Demographic and clinical characteristics such as age, gender, smoking status, hypertension, peripheral arterial disease (PAD), and diabetes mellitus (DM) were recorded. Primary endpoints included changes in ulcer size, calf circumference, NPRS pain scores, and VCSS scores. Measurements were taken before treatment, at 1week, at 1month, and at 3months. The data were statistically analyzed using appropriate methods. The results showed that the compression bandage group had a more significant reduction in ulcer size compared to the compression stocking group. The ulcer size in the bandage group decreased from 16.5 ± 2.2cm2 to 7.9 ± 5.1cm2 after 3months, while in the stocking group, it reduced from 16.1 ± 1.8cm2 to 9.6 ± 3.1cm2 (p < .001). Additionally, the calf circumference showed a greater reduction in the bandage group, from 41.3 ± 1.9cm to 35.3 ± 2.9cm, compared to the stocking group, which showed a reduction from 40.7 ± 1.8cm to 38.1 ± 2.4cm (p < .001). NPRS pain scores also decreased more significantly in the bandage group, with scores dropping from 8.0 ± 1.1 to 2.9 ± 2.8, while the stocking group saw a decrease from 7.9 ± 1.2 to 5.4 ± 2.4 (p < .001). VCSS scores improved in both groups, but the bandage group showed a more marked improvement from 19.6 ± 5.1 to 5.2 ± 8.3 compared to the stocking group, which improved from 18.0 ± 5.1 to 7.1 ± 4.7 (p < .001). The findings suggest that compression bandages may be more effective than compression stockings in the post-surgical treatment of venous ulcers, particularly in terms of reducing ulcer size, calf circumference, and pain, as well as improving VCSS scores. These results support the continued use of compression bandages as a primary treatment modality for venous ulcers following surgery.

Family Support As A Determinant Of Foot Care Compliance In Recurrent Diabetic Foot Wounds

As many as 15-25% of Diabetes Mellitus (DM) patients have the potential to experience diabetic foot ulcers and the rate of recurrence or recurrence of diabetic ulcers is 50% to 70% over 5 years. A quarter of patients with Diabetes Mellitus have the potential to develop diabetic foot sores or diabetic ulcers and more than half to 70% have a recurrence of diabetes mellitus over 5 years. Recurrent diabetic ulcers have various impacts such as reduced quality of life, economic burden, and psychological, and social effects, even if not treated properly, they can lead to infection, amputation, and even death. The study aimed to analyze the relationship between family support and foot care compliance with the incidence of recurrent diabetic ulcers. The study design was a cross-sectional study, with a sample size of 50 diabetic ulcer patients and the family support measurement instrument was the Hensaring Diabetes Family Support Scale (HDFSS). The results of statistical analysis using the chi-square test obtained p value = 0.013. Patients who adhere to foot care experience recurrent wounds (12%) and those who do not comply with foot care experience recurrent wounds (34%). Statistical analysis using the chi-square test obtained p value = 0.039. It can be concluded that family support and compliance with foot care are related to the incidence of recurrent diabetic foot injuries, so it is recommended to comply with foot care and provide support for DM patients to prevent recurrent foot injuries.

Audit of co-morbidity patterns and 5-year survival among patients presenting to a rapid access leg ulcer service.

Background: While leg ulceration is common, data regarding long-term is limited. Historical data indicate that approximately 50% of leg ulcer patients die within 5years of presentation. However, little is known regarding survival outcomes in contemporary patient populations. This retrospective study aimed to assess 5-year survival in patients attending a vascular leg ulcer clinic. Objectives: To evaluate 5-year survival among patients with leg ulcers and to analyse the effect of ulcer aetiology and patient co-morbidities on survival. Methods: Over 30months (2016 to 2018), 119 new patients were assessed at the leg ulcer clinic and followed over 5years. Baseline co-morbidities, ulcer type, interventions performed, and 5-year survival were recorded. Survival was calculated using Kaplan-Meier curves. Co-morbid burden and survival were compared between venous and arterial/mixed patients. Results: Overall 5-year survival was 74%. Venous patients fared better than arterial/mixed patients (5-year mortality 16/88 vs 15/31; p < .01 log-rank test). Arterial/mixed patients had a greater burden of co-morbidities. In multivariate regression modelling, the presence of three or more co-morbidities at presentation was the only significant predictor of mortality. Conclusions: Overall, 5-year survival for leg ulcer patients has improved compared to historical data but remains static for arterial/mixed patients.

To Evaluate Anti-Ulcer Activity of Nux Vomica for the Treatment of Gastric Ulcer

This study aimed to determine the anti-ulcer activity of Nux Vomica for the Treatment of Gastric Ulcer. Present study was clinical study with simple randomized single blind drug evaluation method. As per study design and methodology all patients were treated with homoeopathic treatment only. Hence control study or comparison with modern medicine is out of framework of the present study. To evaluate curative efficacy of Nux Vomica and to show that is better than modern line of treatment in Gastric ulcer it has been used for comparison. After this research work it has been seen that lot many gastric ulcer patient got cured and healed by Nux Vomica. The conclusion is that patient compliance, trust economic status is indeed an important strategy in the used of any medicine system benefits with correct dose. Homeopathy and Allopathic medicines continue potentially impacting on the attainment of 'health' as a society in its entirety. No doubt, in cases of short and long time treatments of illness both medicine systems have their own importance and earlier have done more than the miracles and have proven life saving for everybody.

Sequencing of messenger RNA in the healing process of diabetes foot ulcer.

Transcriptome analysis of skin wound tissues from diabetic foot ulcer (DFU) patients to assess changes in the microenvironment during wound healing is performed by messenger RNA (mRNA) sequencing. All 5 patients with initial DFU area ≥ 3 cm2 were selected for wound specimen collection at two time points of 0% and 50% wound healing. A total of 10 skin wound samples were obtained for mRNA sequencing. According to the sequencing results, quantitative polymerase chain reaction (qPCR) validation was performed on 12 relevant genes related to angiogenesis, fibroblast proliferation, and wound inflammation. All patients received electrospun poly (L-lactide-co-caprolactone) and formulated porcine fibrinogen (PLCL/Fg) dressing for DFU treatment. The mRNA sequencing results of DFU skin specimens showed that compared to the 0% and 50% wound healing time points, there were 4347 differentially expressed genes, including 2827 upregulated genes and 1520 downregulated genes. Enrichment analysis of the differentially expressed genes using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) revealed that the upregulated genes were mainly associated with biological processes such as cell adhesion, adhesion junctions, epidermal development, and skin barrier formation. The qPCR analysis results indicated that the increased expression of fibroblast growth factor, vascular endothelial growth factor, and CD200 gene was related to DFU healing. The healing process of DFU wounds involves the interaction of multiple factors, especially in inflammation control, angiogenesis, and fibroblast proliferation.

A comparative study of efficacy of platelet rich fibrin and conventional saline dressing in chronic non-healing ulcers: A randomized controlled trial in a tertiary care centre, Chengalpattu, Tamil Nadu

Non-healing ulcers pose a significant risk for deformities and platelet-rich fibrin (PRF) emerges as a promising treatment modality with feasible, easy, cost-effective day care therapy for chronic non-healing ulcers, exhibiting notable improvement in these chronic conditions. This study aims at demonstrating the efficacy of PRF (platelet rich fibrin) dressing in chronic non- healing ulcers.A prospective study with Forty patients of chronic non-healing ulcer aged more than 18 years are recruited, treated with PRF dressing and normal saline dressing. PRF dressing is repeated every week for 4 weeks and for normal saline dressing it is done every alternate days for the same period. Photographs were taken before treatment and at every subsequent session and sizes are measured in baseline (1) and 2,3,4 weeks. Each patient was followed up after four weeks from the last visit.In this study, excellent improvement was seen in 57% of total ulcers, 15% have showed moderate improvement. PRF dressing have shown significant improvement with &amp;#62;75% improvement in the size of the ulcer in visit 3 where as normal saline have shown only 34% improvement in 3 visit. Depth of the ulcer improved to 100% and 35% in visit 3 for PRF and normal saline dressing respectively.This study have found that PRF dressing has shown significant reduction in the overall size of the ulcer and quality of life with minimal visits and without any adverse events.

Association between sarcopenia and the foot-ankle function in type 2 diabetic foot ulcer

BackgroundThe diabetic foot (DF) ulcer is the severe complication of type 2 diabetes mellitus (T2DM). Sarcopenia is characterized as the loss of muscle mass and strength, resulting in the increased risk of fracture and physical disability. Sarcopenia may affect the foot-ankle function in DF ulcer patients, compromise the quality of life.ObjectiveThe aim was to clarify the effect of sarcopenia on foot-ankle function in patients with DF ulcer.MethodsIn total of 108 T2DM patients with DF ulcer were enrolled. Based on the examination of muscle mass by dual energy X-ray absorptiometry (DXA) and grip strength and 5x sit-to-stand test, the DF patients were divided into sarcopenia and non-sarcopenia groups. The severity of DF ulcer was evaluated by Wagner classification. The foot-ankle function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score.ResultsDF patients with sarcopenia showed advanced age, lower BMI, longer duration of T2DM, and more severe Wagner classification, reduced appendicular skeletal muscle mass index (ASMI), grip strength, transcutaneous oxygenpressure (TcPO2) and prolonged time of 5X sit-to-stand test. The stratified comparison analysis indicated that severity of sarcopenia and DF ulcer, reduced TcPO2, and grip strength were aggravated with the impaired foot-ankle function (P < 0.05). Multivariate Logistic analysis showed that age, TcPO2, and severe sarcopenia were risk factors deteriorating the foot-ankle function.ConclusionThe sarcopenia is a key risk factor of decreasing foot-ankle function in patients with DF ulcer. Thus, the prevention of muscle mass and strength loss could be considered as part of comprehensive therapy for DF ulcer.

Multiple Decubitus Ulcers in Dm type II Patients with Autologous Plasma-Rich Platelet therapy : A Case Report

Background:Multiple decubitus ulcers are a condition of injury that appears on several parts of the body’s skin due to pressure for a long time without any change in position. This condition usually occurs in someone with limited movement, for example, due to experiencing certain disease conditions that require the person to rest in bed for a long time, especially patients in the Intensive Care Unit (ICU) or after ICU care with chronic diseases and limited movement. Case Presentation: This case report assesses the success of multiple cases of decubitus ulcers in patients with type II diabetes mellitus with Autologous Plasma Rich Platelet therapy. Case report: Autologous PRP therapy is given by intralesional injection; debridement is done every three days and assessed every one week. Patients are also subjected to blood sugar control, blood pressure control, blood correction, and albumin to speed up the wound healing process in multiple decubitus ulcers. Conclusion:the conclusion of this case report with additional management in the form of intralesional injection of autologous PRP performed on multiple decubitus ulcer patients with Diabetes Mellitus, which is rich in growth hormone, will greatly help the wound healing process.

KECEMASAN PADA PASIEN DENGAN LUKA KAKI DIABETIK

The prevalence of diabetes continues to increase from year to year in 2021. There were 90 million cases and 5.5% are predicted to have diabetic foot ulcers, and it is predicted that it will increase by 68% in 2045 with 152 million patients. This study was conducted to determine whether there was a relationship between duration of diabetes and age on the level of anxiety in patients with diabetic foot ulcers at the Kitamura clinic in Pontianak. This type of research is descriptive analytic with a cross sectional approach. The sample used in this study were 60 respondents with diabetic foot ulcers who received treatment at the Kitamura Pancasila Pontianak Clinic, the instruments used in this study were the Anxiety Inventory (S-AI) Form questionnaire to measure anxiety levels and observation sheets for respondent demographic data. The results of the Spearman Ranks test obtained with the results of significance (2-tailed) or p value = 0.005 there is a relationship between the length of time suffering from DM with anxiety levels in diabetic foot ulcers patients and there is no relationship between age and anxiety levels in diabetic foot ulcers patients with p-value 0.064. Conclusion, there was no relationship between age and anxiety level and there was a relationship between duration of DM and anxiety level in patients with DM.

Wireless matrix metalloproteinase-9 sensing by smart wound dressing with controlled antibacterial nanoparticles release toward chronic wound management

Chronic wounds cause serious health and economic burdens on patients and society. Herein, a wireless and flexible smart wound dressing was developed for matrix metalloproteinase-9 (MMP-9) monitoring and antimicrobial treatment toward chronic wound management. The highly sensitive radio frequency MMP-9 sensor was realized based on a bioresponsive hydrogel with the bioactive peptide sequences. Taking advantage of the flexible inductive-capacitive (LC) circuit and bioresponsive hydrogel, the wireless and wearable smart wound dressing offered an efficient strategy for in-situ wound analysis. Besides, the controlled release of silver nanoparticles (AgNPs) from the degradable hydrogel exhibited significant antimicrobial efficacy against typical bacteria in wound infection including Escherichia coli and Staphylococcus aureus. The analysis of MMP-9 in wound exudate from diabetic foot ulcer (DFU) patients demonstrated good accuracy cross-validated with gold-standard fluorescent measurements, providing great potential for personalized wound management.