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Maiya GA, Nataraj M, K G, Hande M, Rodrigues GS, Shenoy R, Prasad SS. KADAM topical warm oxygen therapy device for diabetic foot ulcer-a novel approach. J Diabetes Metab Disord 2023; 22:507-514. [PMID: 37255791 PMCID: PMC10225447 DOI: 10.1007/s40200-022-01172-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/12/2022] [Indexed: 06/01/2023]
Abstract
Purpose Diabetic foot ulcer (DFU) is a significant healthcare burden demanding prompt attention. In the past decade, newer technologies such as topical oxygen therapy have grown increasingly popular. The purpose of the study was to determine effect of KADAM-a topical warm oxygen therapy (TWOT) medical device in healing of DFU. Methods The KADAM medical device developed by Yostra Labs Pvt Ltd, delivered pure oxygen between 93 ± 3% concentration at an optimal temperature range of 39-42º Celsius to DFU wound site. Results A total of 40 diabetic foot ulcer individuals, aged over 18 years were included in the study. Individuals with the Grade 1 DFU were 34 (85%), grade 2 were 5 (12.5%) and grade 3 were 1 (2.5%). The changes in initial area and final area for the various diabetic foot ulcer grades were as follows: 0.32 [0.12, 0.96] (< 0.001) for grade 1 ulcer, 0.76 [0.54, 1.17] (P = 0.013) for grade 2 ulcer and 1.26 for grade 3 ulcer. The percentage reduction in wound size achieved for the grade 1 & 2 DFU were 100%, and grade 3 was 75%. Conclusion Topical warm oxygen therapy serves as an adjunctive modality to facilitate diabetic foot ulcer healing in the clinical practice.
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Affiliation(s)
- G. Arun Maiya
- Department of Physiotherapy, Centre for Diabetic Foot Care & Research (CDFCR), Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, 576104 Karnataka India
| | - Megha Nataraj
- Department of Physiotherapy, Centre for Diabetic Foot Care & Research (CDFCR), Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, 576104 Karnataka India
| | - Gagana K
- Department of Physiotherapy, Centre for Diabetic Foot Care & Research (CDFCR), Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, 576104 Karnataka India
| | - Manjunatha Hande
- Department of Medicine, Kasturba Medical College-Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104 Karnataka India
| | - Gabriel Sunil Rodrigues
- Department of Surgery, Kasturba Medical College-Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104 Karnataka India
| | - Rajgopal Shenoy
- Department of Surgery, Kasturba Medical College-Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104 Karnataka India
| | - Shiva S. Prasad
- Department of Surgery, Kasturba Medical College-Manipal, Manipal Academy of Higher Education (MAHE), Manipal, 576104 Karnataka India
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Benskin LL. Evidence for Polymeric Membrane Dressings as a Unique Dressing Subcategory, Using Pressure Ulcers as an Example. Adv Wound Care (New Rochelle) 2018; 7:419-426. [PMID: 30595968 PMCID: PMC6306668 DOI: 10.1089/wound.2018.0822] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/07/2018] [Indexed: 11/12/2022] Open
Abstract
Objective: Wound management recommendations usually group dressings by base substrate material or reimbursement codes, even when functional differences are vast (e.g., honey-containing alginates, super-absorbent hydrogels). Polymeric membrane dressings (PMDs) diverge dramatically from conventional foam dressings in functional attributes, indications, and patient results, providing an opportunity to demonstrate the evidence for categorizing dressings based upon functional differences. Approach: A search of ALL published literature describing the use of PMDs, with no date or language limits, was conducted. Documents simply listing a PMD brand name (e.g., PolyMem) as one of many "foam" dressings were eliminated. The subset of evidence evaluating PMDs for tissue damage resulting from pressure (pressure ulcers, pressure injuries, henceforth: PUs) was summarized. Results: Studies of PMDs, primarily from independent clinician-researchers, have accumulated into a significant evidence base over the past 30 years. PMDs actively cleanse and debride wounds, balance moisture, relieve pain, and limit inflammation: all functions not shared by conventional foams. Innovation: This article supports a paradigm shift for wound management guidance materials to embrace a more evidence-based, patient-centered method of classifying products. The results presented here, using PMDs for PUs as an example, show that functional attributes, indications, and patient results are not always dictated by dressing substrates. Rather than being comparable with conventional foam dressings, PMDs have substantially enhanced functions and results. Conclusion: These results strongly support the author's assertion that evidence-based wound management requires guidelines and recommendations that categorize advanced dressings based upon how they function in real-life settings, rather than upon their base substrate.
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Affiliation(s)
- Linda L. Benskin
- Independent Nurse Researcher, for Wound Care in Rural Areas of Tropical Developing Countries, and Clinical Research & Education Liaison, Charity Liaison for Ferris Mfg. Corp., Austin, Texas
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Jia J, Wei C, Chen S, Li F, Tang Y, Qin W, Zhao L, Jin H, Xu H, Wang F, Zhou A, Zuo X, Wu L, Han Y, Han Y, Huang L, Wang Q, Li D, Chu C, Shi L, Gong M, Du Y, Zhang J, Zhang J, Zhou C, Lv J, Lv Y, Xie H, Ji Y, Li F, Yu E, Luo B, Wang Y, Yang S, Qu Q, Guo Q, Liang F, Zhang J, Tan L, Shen L, Zhang K, Zhang J, Peng D, Tang M, Lv P, Fang B, Chu L, Jia L, Gauthier S. The cost of Alzheimer's disease in China and re-estimation of costs worldwide. Alzheimers Dement 2018; 14:483-491. [PMID: 29433981 DOI: 10.1016/j.jalz.2017.12.006] [Citation(s) in RCA: 377] [Impact Index Per Article: 62.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 11/06/2017] [Accepted: 12/07/2017] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The socioeconomic costs of Alzheimer's disease (AD) in China and its impact on global economic burden remain uncertain. METHODS We collected data from 3098 patients with AD in 81 representative centers across China and estimated AD costs for individual patient and total patients in China in 2015. Based on this data, we re-estimated the worldwide costs of AD. RESULTS The annual socioeconomic cost per patient was US $19,144.36, and total costs were US $167.74 billion in 2015. The annual total costs are predicted to reach US $507.49 billion in 2030 and US $1.89 trillion in 2050. Based on our results, the global estimates of costs for dementia were US $957.56 billion in 2015, and will be US $2.54 trillion in 2030, and US $9.12 trillion in 2050, much more than the predictions by the World Alzheimer Report 2015. DISCUSSION China bears a heavy burden of AD costs, which greatly change the estimates of AD cost worldwide.
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Affiliation(s)
- Jianping Jia
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China; Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China; Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China; National Clinical Research Center for Geriatric Disorders, Beijing, China.
| | - Cuibai Wei
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
| | - Shuoqi Chen
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Fangyu Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Yi Tang
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Wei Qin
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Lina Zhao
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Hongmei Jin
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Hui Xu
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Fen Wang
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Aihong Zhou
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Xiumei Zuo
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Liyong Wu
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Yue Han
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Liyuan Huang
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Qi Wang
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Dan Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Changbiao Chu
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Lu Shi
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Min Gong
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Jiewen Zhang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chunkui Zhou
- Department of Neurology, The First Teaching Hospital of Jilin University, Changchun, China
| | - Jihui Lv
- Dementia Unit, Beijing Geriatric Hospital, Beijing, China
| | - Yang Lv
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haiqun Xie
- Department of Neurology, Affiliated Foshan Hospital of Sun Yat-sen University, Foshan, China
| | - Yong Ji
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Fang Li
- Department of Gerontology, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Enyan Yu
- Department of Psychiatry, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Benyan Luo
- Department of Neurology, The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Yanjiang Wang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Shanshan Yang
- Department of Neurology, Daqing Oilfield General Hospital, Daqing, China
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qihao Guo
- Department of Neurology and Institute of Neurology, Huashan Hospital Fudan University, Shanghai, China
| | - Furu Liang
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Jintao Zhang
- Department of Neurology, The 88th Hospital of PLA, Taian, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital Central South University, Changsha, China
| | - Kunnan Zhang
- Department of Neurology, People's Hospital of Jiangxi Province, Nanchang, China
| | - Jinbiao Zhang
- Department of Neurology, Weihai Municipal Hospital, Weihai, China
| | - Dantao Peng
- Department of Neurology, Center for Geriatric Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Muni Tang
- Department of Geriatric Psychiatric, Guangzhou Huiai Hospital, Guangzhou, China
| | - Peiyuan Lv
- Department of Neurology, Hebei General Hospital, Shijiazhuang, China
| | - Boyan Fang
- Department of Neurology, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing, China
| | - Lan Chu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Longfei Jia
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA
| | - Serge Gauthier
- McGill Centre for Studies in Aging, McGill University, Montreal, Canada.
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Skrinjar E, Duschek N, Bayer GS, Assadian O, Koulas S, Hirsch K, Basic J, Assadian A. Randomized controlled trial comparing the combination of a polymeric membrane dressing plus negative pressure wound therapy against negative pressure wound therapy alone: The WICVAC study. Wound Repair Regen 2016; 24:928-935. [PMID: 27313054 DOI: 10.1111/wrr.12457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 06/12/2016] [Indexed: 02/04/2023]
Abstract
Negative pressure wound therapy (NPWT) is the treatment of choice for chronic wounds; yet, it is associated with considerable workload. Prompted by its nonadhesive and wound-healing properties, this study investigated the effect of an additional polymeric membrane interface dressing (PMD; PolyMem WIC) in NPWT. From October 2011 to April 2013, 60 consecutive patients with chronic leg wounds or surgical site infections after revascularization of lower extremities were randomly allocated to either treatment with conventional NPWT (control arm) or NPWT with an additional PMD (intervention arm). The primary outcome was wound healing achieved within 30 days, the secondary endpoints included: number of days between dressing changes, wound-related pain, cost efficiency, and occurrence of adverse events (ClinTrials.gov Identifier: NCT02399722). Forty-seven patients completed follow-up. No difference in wound healing was observed (p > 0.05) between both study arms. The additional PMD allowed significantly longer wearing times (days) between dressing changes (intervention: 8.8 ± 0.5, control: 4.8 ± 0.2; p < 0.001). Pain was slightly higher in patients randomized to NPWT alone (VAS score: 4.8 ± 2.9) compared to NPWT + PMD (VAS score: 3.0 ± 2.9, p = 0.063). No wound infections were observed. Costs were reduced by 34% per patient in the intervention arm. These results suggest that the combination of NPWT and an additional interface PMD is a safe and economic method for the treatment of chronic wounds, which requires significantly fewer dressing changes for a comparable wound healing.
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Affiliation(s)
- Edda Skrinjar
- Department of Vascular and Endovascular Surgery, Wilhelminenhospital, Vienna, Austria.
| | - Nikolaus Duschek
- Department of Dermatology and Venerology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Vaud, Switzerland
| | - Gottfried S Bayer
- Department of Vascular and Endovascular Surgery, Wilhelminenhospital, Vienna, Austria
| | - Ojan Assadian
- Institute for Skin Integrity and Infection Prevention, School of Human & Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Spyridon Koulas
- Department of Vascular and Endovascular Surgery, Wilhelminenhospital, Vienna, Austria
| | - Kornelia Hirsch
- Department of Vascular and Endovascular Surgery, Wilhelminenhospital, Vienna, Austria
| | - Jelena Basic
- Department of Vascular and Endovascular Surgery, Wilhelminenhospital, Vienna, Austria
| | - Afshin Assadian
- Department of Vascular and Endovascular Surgery, Wilhelminenhospital, Vienna, Austria
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Tsang KK, Kwong EWY, Woo KY, To TSS, Chung JWY, Wong TKS. The Anti-Inflammatory and Antibacterial Action of Nanocrystalline Silver and Manuka Honey on the Molecular Alternation of Diabetic Foot Ulcer: A Comprehensive Literature Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:218283. [PMID: 26290672 PMCID: PMC4531195 DOI: 10.1155/2015/218283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 07/10/2015] [Accepted: 07/14/2015] [Indexed: 01/09/2023]
Abstract
Honey and silver have been used since ancient times for treating wounds. Their widespread clinical application has attracted attention in light of the increasing prevalence of antibiotic-resistant bacteria. While there have been a number of studies exploring the anti-inflammatory and antibacterial effects of manuka honey and nanocrystalline silver, their advantages and limitations with regard to the treatment of chronic wounds remain a subject of debate. The aim of this paper is to examine the evidence on the use of nanocrystalline silver and manuka honey for treating diabetic foot ulcers through a critical and comprehensive review of in vitro studies, animal studies, and in vivo studies. The findings from the in vitro and animal studies suggest that both agents have effective antibacterial actions. Their anti-inflammatory action and related impact on wound healing are unclear. Besides, there is no evidence to suggest that any topical agent is more effective for use in treating diabetic foot ulcer. Overall, high-quality, clinical human studies supported by findings from the molecular science on the use of manuka honey or nanocrystalline silver are lacking. There is a need for rigorously designed human clinical studies on the subject to fill this knowledge gap and guide clinical practice.
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Affiliation(s)
- Ka-Kit Tsang
- O&T Department, Queen Elizabeth Hospital, Hong Kong
- Department of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | | | - Kevin Y. Woo
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Tony Shing-Shun To
- Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong
| | - Joanne Wai-Yee Chung
- The Faculty of Liberal Arts and Social Sciences, The Hong Kong Institute of Education, Hong Kong
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