Tomislav Bulum 1,2,* , Tamara Poljiˇcanin 3 , Anica Badanjak 4 , Jelena Držiˇc 4 and Željko Metelko 4
1 Clinical Hospital Merkur, University Clinic for Diabetes, Endocrinology, and Metabolic Diseases Vuk Vrhovac, Dugi dol 4a, 10000 Zagreb, Croatia
2 School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
3 Zagreb County Health Center, Ljudevita Gaja 37, 10430 Samobor, Croatia
4 Polyclinic for Physical Medicine and Rehabilitation with Physical Therapy, Vascular Surgery, Neurology, Endocrinology, and Diabetology, Kalinovica 3, 10000 Zagreb, Croatia
* Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。
Abstract: (1) Background: Diabetes-related foot ulcers (DFUs) are a severe complication of diabetes mellitus (DM), with a five-year mortality rate of around 40%. Our study aimed to explore the effects of transcutaneous application of carbon dioxide (CO2 therapy) on DFU healing and recurrence rate, as well as diabetic polyneuropathy. (2) Methods: Adults with at least one chronic DFU were invited to undergo 20 50-min-long CO2 therapies within 4 weeks. After the completion of the last CO2 therapy, the effect of the therapies on wound healing and diabetic polyneuropathy was assessed, and 1 year later, we evaluated the incidence rate of DFU recurrence. (3) Results: Thirty-five subjects with DM and forty DFUs (ischemic: 15, neuropathic: 8, neuroischemic: 17) participated in our trial. After 4 weeks, 67.5% of all DFUs healed, whereas the reduction of the surface area of the unhealed wounds (74.0% ± 22.3%) was statistically significant. The restoration of protective sensations was also statistically significant. All unhealed wounds received standard care and healed within 2 additional weeks. The recurrence rate after 1 year was 17.5%. None of the patients required antibiotic treatment, hospitalization, or amputation. (4) Conclusion: CO2 therapy is a promising therapeutic intervention for treating DFUs and improving diabetic polyneuropathy.
Keywords: diabetic foot; diabetes-related foot ulcer; CO2 therapy; transcutaneous CO2 application; wound healing; distal symmetrical polyneuropathy; loss of protective sensation
Serhan Sakarya, MD1 ; Necati Gunay, MS2 ; Meltem Karakulak, MS3 ; Barcin Ozturk, MD1 ; Bulent Ertugrul, MD1
Abstract: Introduction. Chronic wounds and the infections associated with them are responsible for a considerable escalation in morbidity and the cost of health care. Infection and cellular activation and the relation between cells are 2 critical factors in wound healing. Since chronic wounds offer ideal conditions for infection and biofilm production, good wound care strategies are critical for wound healing. Topical antiseptics in chronic wounds remain in widespread use today. These antiseptics are successful in microbial eradication, but their cytotoxcity is a controversial issue in wound healing. Objective. The aim of this study was to investigate the effect of stabilized hypochlorous acid solution (HOCl) on killing rate, biofilm formation, antimicrobial activity within biofilm against frequently isolated microorganisms and migration rate of wounded fibroblasts and keratinocytes. Materials and Methods. Minimal bactericidal concentration of stabilized HOCl solution for all standard microorganisms was 1/64 dilution and for clinical isolates it ranged from 1/32 to 1/64 dilutions Results. All microorganisms were killed within 0 minutes and accurate killing time was 12 seconds. The effective dose for biofilm impairment for standard microorganisms and clinical isolates ranged from 1/32 to 1/16. Microbicidal effects within the biofilm and antibiofilm concentration was the same for each microorganism. Conclusion. The stabilized HOCl solution had dose-dependent favorable effects on fibroblast and keratinocyte migration compared to povidone iodine and media alone. These features lead to a stabilized HOCl solution as an ideal wound care agent.
Key words: hypochlorous acid, biofilm, wound healing, fibroblast, keratinocyte
This article is excerpted from the 《Frontiers in Toxicology》 by Wound World
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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