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Olowo S, Iramiot JS, Ssenyonga LV. Knowledge of diabetic foot complication, self-care beliefs and practices among patients attending a tertiary hospital in Eastern Uganda. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Amir AA, Khader SA, El Chami Z, Bahlas SM, Bakir M, Arifeen S. Management of neuropathic pain in patients with diabetic peripheral neuropathy and low back pain in Saudi Arabia: Evidence and gaps. J Family Community Med 2021; 28:155-163. [PMID: 34703375 PMCID: PMC8496701 DOI: 10.4103/jfcm.jfcm_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/10/2021] [Accepted: 07/23/2021] [Indexed: 11/04/2022] Open
Abstract
We report existing evidence and gaps in neuropathic pain management in Saudi Arabia, the prevalence and patient management stages in diabetic peripheral neuropathy (DPN) and low back pain (LBP) with a neuropathic component. A semi-systematic approach was adopted to identify data on neuropathic pain. A structured search was conducted through MEDLINE, Embase, and BIOSIS databases to identify articles published in English between January 2010 and December 2019. Unstructured search was conducted through various sources including Google Scholar and Saudi Arabia's Ministry of Health website. Studies including populations ≥18 years and neuropathic pain were included; data gaps were supplemented with anecdotal data from local experts. Weighted or simple means were calculated for overall data; synthesized evidence was represented as an evidence gap map. Of 37 articles retrieved from structured search, none were eligible for final analyses. Thirteen articles from unstructured search and two anecdotal data sources were included for final analyses. The majority of articles included were of cross-sectional design (n = 10) in diabetes patients. The mean (range; number of articles) DPN prevalence was estimated as 33.6% (5.6%-65.3%; n = 8). Data on DPN patient management stages were limited; synthesized evidence indicated that 37.2% (0.41%-80.0%; n = 3) of patients had DPN awareness, 17.8% (n = 1) underwent screening, 22.4% (18.4%-65.3%; n = 2) had DPN diagnosis, and 45.1% (0.0%-62.7%; n = 2) received treatment for pain management. Data on LBP with neuropathic component were scarce (prevalence, 41.0% [n = 1]; diagnosis, 54.7% [n = 1]). Data are limited, so more studies are needed to accurately estimate the prevalence and stages of patient management for neuropathic pain in the country.
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Affiliation(s)
- Ashraf A Amir
- Department of Family Medicine, International Medical Center Hospital, Salam Home Health Care (Geriatric Care), Riyadh, Saudi Arabia
| | - Said A Khader
- Department of Diabetes and Endocrine, Dr. Suliaman Alhabib Medical Group, Riyadh, Saudi Arabia
| | - Ziad El Chami
- Advanced Neuro- Musculoskeletal Care Center, Dr. Samir Abbas Hospital, Riyadh, Saudi Arabia
| | | | | | - Shams Arifeen
- Africa and Middle East Clusters, Upjohn Pfizer Africa and Middle East, Dubai, UAE
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Manickum P, Mashamba-Thompson T, Naidoo R, Ramklass S, Madiba T. Knowledge and practice of diabetic foot care - A scoping review. Diabetes Metab Syndr 2021; 15:783-793. [PMID: 33838615 DOI: 10.1016/j.dsx.2021.03.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/07/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS This review aims to systematically map global evidence on foot-care knowledge and practices in relation to diabetes mellitus (DM) and identify areas that need further research. METHODS Database searches were undertaken using Google Scholar, Medline (PubMed), Academic Search Complete (EBSCOhost), and Medline (EBSCOhost). Studies were initially sought by title and focused on knowledge of diabetic foot ulcer burden. The framework by Arksey and O'Malley and the PRISMA-SCR guidelines were used to guide the methodology. The themes explored were principles of foot-care knowledge and practice and these were reported using content analysis. The mixed-methods appraisal tool (MMAT) was employed to appraise the quality of the primary studies. RESULTS Fifty-eight studies published between 2008 and 2018 met the inclusion criteria. Participants in various studies had varying degrees of foot-care knowledge and practice, including foot inspection, foot hygiene, glycaemic control, and foot protection. Many people had knowledge of the various aspects of foot care but fewer practiced proper foot care. The MMAT showed the majority of the articles to be of high quality. CONCLUSIONS Level of foot-care knowledge and practice varied in the studies. A need for intervention on foot care was highlighted.
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Affiliation(s)
- Prabashni Manickum
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | | | - Rasmika Naidoo
- Department of Occupational Therapy, Addington Hospital, KwaZulu-Natal, South Africa
| | - Serela Ramklass
- School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thandinkosi Madiba
- Gastrointestinal Cancer Research Group, Department of General Surgery, University of KwaZulu-Natal, Durban, South Africa
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Alqahtani MAA, Al Othman AO, Alqahtani AM, AlQahtani AMA, Asiri FAM, Mesfer AM, Alshehri SD, Al-Fifi SH. Effect of COVID-19 on control of T1DM patients in Aseer region of Saudi Arabia. J Family Med Prim Care 2021; 10:1737-1740. [PMID: 34123921 PMCID: PMC8144754 DOI: 10.4103/jfmpc.jfmpc_2333_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/24/2020] [Accepted: 12/26/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The novel corona virus disease, also known as COVID-19, has emerged as a major health concern globally. Its association with comorbid condition has increased its mortality. Diabetes mellitus (DM) is associated with increased risk of infection in comparison to general population. This risk is higher in type 1 DM that type 2 DM. METHODS A cross sectional study was done in T1DM patients in whom a structured questionnaire was administered after lockdown. Data regarding social demographical variables, Information regarding sugar levels, psychological effects, changes in weight, exercise habits and other variables were included in the validated, electronic questionnaire. Ethic approval was obtained from the Diabetic center Abha, study duration was from January-2020 to October-2020. RESULTS Out of 143 total patients (46.9%) were males while 53.1% were females. Mean ± S.D of age was obtained 29.6 ± 1.8. [Figure 1] depicted that 23% of the respondents were effected psychologically. [Figure 2] depicted that 80.4% used insulin as a treatment. [Figure 3] depicted that 8% of the respondents make an emergency visit to the health care centers for high rise in diabetes during lockdown. CONCLUSION COVID-19 and the lockdown affected the management of T1DM. It resulted in changes in lifestyle, compliance to medication, and psychological impact on the participant.
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Affiliation(s)
| | | | | | | | | | | | - Sahar Dahman Alshehri
- Pediatric Endocrinologist, King Faisal Medical City, Abha, Saudi Arabia
- Professor of Pediatrics and Pediatric Endocrinology, Department of Pediatrics, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Suliman H. Al-Fifi
- Pediatric Endocrinologist, King Faisal Medical City, Abha, Saudi Arabia
- Professor of Pediatrics and Pediatric Endocrinology, Department of Pediatrics, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Alshareef R, Al Zahrani A, Alzahrani A, Ghandoura L. Impact of the COVID-19 lockdown on diabetes patients in Jeddah, Saudi Arabia. Diabetes Metab Syndr 2020; 14:1583-1587. [PMID: 32947759 PMCID: PMC7422800 DOI: 10.1016/j.dsx.2020.07.051] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/26/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022]
Abstract
AIMS To explore the impact of the coronavirus disease lockdown on diabetes patients living in Jeddah, Saudi Arabia, in terms of their compliance with medication intake and lifestyle habits, and quality of life. METHODS In this cross-sectional, qualitative prospective study, a questionnaire was administered over the telephone to diabetes patients who had attended National Guard primary care centers in Jeddah, Saudi Arabia. The survey included questions on demographic data, type of diabetes, medications used, comorbidities, medication compliance, and daily habits before and after the lockdown, and those assessing patients' psychological parameters during the past month by using the Kessler Psychological Distress Scale (K10). Data analysis was performed using SPSS program version 26. RESULTS Totally, 394 patients participated. All of them had type 2 diabetes, and 37.6% had only one comorbidity. Antidiabetic monotherapy was used in 76.4% of the patients, while combination therapy was used in 23.6%. The compliance score before the lockdown was significantly higher (18.49 ± 3.05) than that after it (17.40 ± 3.25) (p-value <0.001). The average psychological assessment score was 9.78 ± 4.14 (range 8-35). Male participants and smokers had a significantly better psychological status than female participants (p-value = 0.002) and non-smokers (p value < 0.001), respectively. CONCLUSIONS The patients' levels of compliance with medications and healthy lifestyle habits were significantly reduced after the lockdown. These findings highlight the need for healthcare professionals to encourage diabetes patients to adhere to healthy lifestyle habits and use telemedicine during lockdowns to ensure optimal blood glucose control and reduce the incidence of complications.
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Affiliation(s)
- Reem Alshareef
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia.
| | - Abdullah Al Zahrani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
| | - Alhussain Alzahrani
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
| | - Lama Ghandoura
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
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Al-Busaidi IS, Abdulhadi NN, Coppell KJ. Development and Pilot Testing of a Diabetes Foot Care and Complications Questionnaire for Adults with Diabetes in Oman: The Diabetic Foot Disease and Foot Care Questionnaire. Oman Med J 2020; 35:e146. [PMID: 32733697 PMCID: PMC7372393 DOI: 10.5001/omj.2020.65] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Objectives Diabetic foot disease causes substantial morbidity and mortality, but it can be prevented. Our study examined the frequency of diabetes-related foot problems and foot self-care practices, as reported by consecutive patients attending primary and secondary diabetes services in Muscat, Oman. Methods A cross-sectional survey utilizing a newly developed and pre-tested questionnaire was conducted at eight primary health care centers and one polyclinic (secondary care) in A'Seeb, Muscat. A convenience sample of 353 consecutive Omanis, aged 20 years and above, diagnosed with diabetes were invited to participate in this study. We collected data on clinico-demographic characteristics, patient-reported foot complications, and foot self-care practices. Results Of the 350 patients who agreed to participate (mean diabetes duration 7.9±7.4 years, response rate: 99.2%), 62.3% were female, 57.4% were unemployed, more than half were illiterate (52.9%), and around three-quarters (71.4%) were unsure of the type of diabetes they had. More than half (55.1%) reported having at least one or more sensory peripheral neuropathy symptoms, almost half (49.1%) reported one or more peripheral vascular disease symptoms in the previous month, and 12.5% a history of foot ulceration. Reported foot self-care practices were overall suboptimal; 54.7% did not examine the bottom of their feet each day. Conclusions Although self-reported diabetes-related foot complications were common in this population, foot self-care practices were inadequate. These findings suggest a need for the provision of regular foot care education to patients with diabetes. Future research should explore barriers to recommended foot self-care practices.
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Affiliation(s)
- Ibrahim S Al-Busaidi
- Department of Medicine, Edgar Diabetes and Obesity Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.,Department of General Medicine, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
| | - Nadia N Abdulhadi
- Directorate General of Planning and Studies, Ministry of Health, Muscat, Oman
| | - Kirsten J Coppell
- Department of Medicine, Edgar Diabetes and Obesity Research, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Al Ayed M, Ababneh M, Alwin Robert A, Al Misfer N, Cruz M, Austria HC, Al Dawish M. Factors Associated With Health-Related Quality of Life in Patients With Diabetic Foot Ulcer: A Cross-Sectional Study From Saudi Arabia. Cureus 2020; 12:e8658. [PMID: 32699658 PMCID: PMC7370698 DOI: 10.7759/cureus.8658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background and objective Diabetic foot ulcers (DFU) have been shown to have a high impact on the patients' perceived health-related quality of life (HRQOL). The aim of this study was to estimate the HRQOL and its related risk factors in patients with foot ulcers associated with type 2 diabetes mellitus (T2DM). Methods This cross-sectional study was performed on 81 patients with DFU, from January 2019 to July 2019 at the Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia. The study population was purposively and conveniently chosen based on patients' availability during their regular and customary outpatient clinic visits. Using the Arabic version of the Short-Form 36-Item Survey (SF-36), these patients were interviewed and their HRQOL scores were was assessed. The SF-36 covered eight aspects of health such as physical functioning, body pain, limitations in the roles induced by physical health problems, limitations in the roles caused by personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. Results It was evident that age, gender, education, occupation, smoking, duration of diabetes, hypertension, dyslipidemia, body mass index (BMI), and the number of diabetes-associated complications, hypertension, and dyslipidemia significantly affected the patients' physical functions. The physical health of the patient was strongly influenced by gender, education, occupation, income, BMI, and the number of complications. The emotional health of the patient was affected by dyslipidemia, deformity, prior amputations, as well as BMI and glycosylated hemoglobin (HbA1c). The social standing of the patient was influenced by age, income, education, and occupation. The degree of pain experienced by the patient varied with age and the number of complications, as well as notable differences in their general health. The factors of age, education, occupation, income, and the number of diabetic complications induced several health changes in varying degrees. The patients with DFU revealed overall lower HRQOL relating to all the eight aspects of the SF-36. Conclusion The patients with DFU in Saudi Arabia generally revealed lower HRQOL. However, prospective and large-scale studies are required in the future to support these findings.
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Affiliation(s)
- Mousab Al Ayed
- Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, SAU
| | - Mutasem Ababneh
- Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, SAU
| | | | - Nasser Al Misfer
- Department of Physical Therapy, Prince Sultan Military Medical City, Riyadh, SAU
| | - Maria Cruz
- Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, SAU
| | - Hesiel C Austria
- Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, SAU
| | - Mohamed Al Dawish
- Department of Endocrinology and Diabetes, Prince Sultan Military Medical City, Riyadh, SAU
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Sukartini T, Theresia Dee TM, Probowati R, Arifin H. Behaviour model for diabetic ulcer prevention. J Diabetes Metab Disord 2020; 19:135-143. [PMID: 32550163 DOI: 10.1007/s40200-019-00484-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 12/27/2019] [Indexed: 01/27/2023]
Abstract
Purpose Diabetic ulcers are one of the complications that often occur in patients with DM. The aim is to develop a behaviour model for diabetic ulcer prevention by integrating Lawrance Green Theory and the Theory of Planned Behaviour. Methods An explanative observational design was used with a cross-sectional approach. The population consisted of DM patients who had underwent treatment at the internal medicine clinic of Sidoarjo District Hospital. The sample size of 133 respondents was obtained through purposive sampling. The data analysis used Partial Least Square. Results Predisposing factors (knowledge), supporting factors (availability of health facilities and accessibility of health resources) and driving factors (the role of health workers and family support) significantly influence the main factors (attitudes toward behaviour, subjective norms and perceptions of self-control) with a statistical T value>1.96. The main factor influences intention (T = 48.650) and intention influences behaviour (T = 4.891). Conclusion Intention is influenced by the attitudes toward behaviour, subjective norms and self-control perceptions. Good intentions can increase the preventive behaviour related to diabetic ulcers. Increasing the diabetic ulcer prevention behaviour can be done by providing regular education to both the patients and their families about diabetic ulcers and their prevention through the appropriate management of DM, lifestyle modification and regular foot care that requires active involvement from the family and health care workers.
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Affiliation(s)
- Tintin Sukartini
- Department of Fundamental, Medical-Surgical and Critical Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | | | - Ririn Probowati
- Sekolah Tinggi Ilmu Kesehatan Pemkab Jombang, Jombang, Indonesia
| | - Hidayat Arifin
- Master's of Nursing Study Program, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
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Ahmed SA, Badi S, Tahir H, Ahmed MH, Almobarak AO. Knowledge and practice of diabetic foot care in Sudan: A cross sectional survey. Diabetes Metab Syndr 2019; 13:2431-2435. [PMID: 31405655 DOI: 10.1016/j.dsx.2019.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Diabetes in Sudan is real health challenge for health authorities especially optimum glycemic control and complications in particular diabetic septic foot. This is study aimed to assess knowledge of individuals with diabetes about self-foot care. METHODS This is descriptive cross sectional, health facility-based study conducted in diabetes center in Khartoum, Sudan. The study recruited 150 individuals with diabetes. Data was collected using a standardized pretested questionnaire. RESULTS Among the participants 64.7% were females and 35.3% were males, 36% of the participants were between the age of 51-60 years old. Good glycemic control (HbA1c) were achieved by 41.3% only. The participants who had good knowledge about diabetic foot self-care were 46.7%, poor knowledge 29.3% and moderate knowledge 24%. Good self-practice toward diabetic foot self-care was reported by 42.6%, moderate by 36.7% and poor practice by 20.7%. The awareness and practices significantly correlated with an increase in ages (≥51 years), higher level of education, medium income, unemployment, longer duration of diabetes > 10years, family history, controlled diabetes mellitus and education about diabetes complications and diabetic foot care (P value < 0.05). CONCLUSIONS Only (46.7%) of participants address good awareness and practices about self-foot care. Accordingly, there is a great need to provide continuous health education to the patients about diabetic foot self-care and this knowledge-application gap must be narrowed down.
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Affiliation(s)
- Safa Abdullah Ahmed
- Public and Tropical Health Program, Graduate College, University of Medical Sciences and Technology, Khartoum, Sudan
| | - Safaa Badi
- Department of Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan
| | - Hanan Tahir
- Public and Tropical Health Program, Graduate College, University of Medical Sciences and Technology, Khartoum, Sudan
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eagelstone, Milton Keynes, Buckinghamshire, UK.
| | - Ahmed Omer Almobarak
- Department of Pathology, Faculty of Medicine, University of Medical Sciences and Technology, P.O. Box12810, Khartoum, Sudan
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Meklav K, Flis V, Stričević J, Sruk V. Diabetično stopalo kot zaplet sladkorne bolezni. OBZORNIK ZDRAVSTVENE NEGE 2018. [DOI: 10.14528/snr.2018.52.3.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Diabetično stopalo je skupina sindromov, pri katerih nevropatija, ishemija in infekcija pripeljejo do destrukcije tkiva, končna posledica je zbolevnost, lahko pa tudi amputacija. Namen raziskave je bil ugotoviti pogostost pojava diabetičnega stopala pri pacientih s sladkorno boleznijo.Metode: V raziskavi je bila uporabljena raziskava mešanih metod. Tehnika zbiranja podatkov je bilo anketiranje 60 pacientov s sladkorno boleznijo in delno strukturiran intervju z dvema medicinskima sestrama, ki delata v diabetološki ambulanti. Kvantitativni podatki so bili analizirani z opisno in bivariatno statistiko. Kvalitativni podatki so bili analizirani s pomočjo metode analize vsebine.Rezultati: Ugotovili smo, da amputacija noge ni pogost zaplet diabetičnega stopala (U = 4,4, p = 0,217) in da ne moremo trditi, da je diabetično stopalo pogostejše pri moških kot pri ženskah (U = 0,6, p = 0,417), ter da so pacienti zelo dobro poučeni glede nege stopal in pravilne obutve.Diskusija in zaključek: Najpomembnejša informacija o zdravstveni vzgoji pri diabetičnem stopalu za paciente je, da so o tem zapletu ozaveščeni pisno in ustno. Diabetično stopalo za paciente najpogosteje prinese spremembo v kakovosti življenja. Možnost za nadaljevanje raziskave bi bila izvedba enake raziskave na večjem številu pacientov.
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Abstract
Diabetes is associated with various complications and reduced quality of life. Of the many complications, some are life-threatening. Among these, foot complications remain an important concern. The major foot complications include foot ulceration, cellulitis, abscess, wet gangrene, dry gangrene, and necrotizing fasciitis, with different pathophysiological concepts behind each of them. Gangrene occurs due to reduced blood supply in the body tissues that leads to necrosis. This condition may arise because of an injury, infection, or other health conditions, majorly diabetes. Gangrene is classified as dry, wet, and gas gangrene. In case of wet and gas gangrene, surgical amputation is usually performed to prevent the spread of infection to other tissues. In dry gangrene, due to the presence of clear demarcation, autoamputation is preferred in certain parts of the globe. The present review aims to analyze the mode of dry gangrene management in diabetic patients based on previous evidence and plans to highlight various management strategies available for dry gangrene and the advantages/disadvantages of different treatments with special consideration to autoamputation.
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Affiliation(s)
- Abdullah Al Wahbi
- Division of Vascular Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Escárcega-Galaz AA, Cruz-Mercado JLDL, López-Cervantes J, Sánchez-Machado DI, Brito-Zurita OR, Ornelas-Aguirre JM. Chitosan treatment for skin ulcers associated with diabetes. Saudi J Biol Sci 2017; 25:130-135. [PMID: 29379369 PMCID: PMC5775090 DOI: 10.1016/j.sjbs.2017.03.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 03/10/2017] [Accepted: 03/29/2017] [Indexed: 11/30/2022] Open
Abstract
Infections, ulcerations, gangrene and, in severe cases, extremity amputation, are common complications among diabetic subjects. Various biomaterials have been utilized for the treatment of these lesions. Chitosan is an amino sugar with a low risk of toxicity and immune response. In this study, we evaluated chitosan topical gel and film treatments for subjects with diabetic ulcerations and wounds associated with diabetes mellitus. In a pre-experimental design, we described the result of chitosan gel and film treatment for wounds and skin ulcers among patients with long-standing diabetes mellitus. We studied 8 diabetic patients with wounds and skin ulcers (long duration and Wagner degree 1–2). Initially, most lesions had some degree of infection, tissue damage and ulceration. At the end of the treatment (topical chitosan) period, the infections were cured. All patients experienced a significant improvement in the initial injury and developed granulation tissue and a healthy skin cover. This report represents one of the few published clinical experience regarding the chitosan for the treatment of skin lesions among diabetic subjects. These results are relevant and promising for the treatment of this disease.
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Affiliation(s)
- Ana Aglahe Escárcega-Galaz
- Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, Mexico
| | - José Luis De La Cruz-Mercado
- Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades No. 2, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Ciudad Obregón, Sonora, Mexico
| | - Jaime López-Cervantes
- Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, Mexico
| | - Dalia Isabel Sánchez-Machado
- Departamento de Biotecnología y Ciencias Alimentarias, Instituto Tecnológico de Sonora, Ciudad Obregón, Sonora, Mexico
| | - Olga Rosa Brito-Zurita
- Unidad de Investigación en Epidemiología Clínica, Hospital de Especialidades No. 2, Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social, Ciudad Obregón, Sonora, Mexico
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