diabetestalk.net

Diabetes And Surgical Wound Healing

Conditions & Treatments

Conditions & Treatments

What is a non-healing wound? A non-healing or chronic wound is defined as a wound that does not improve after four weeks or does not heal in eight weeks. These include: Diabetic foot ulcers* Venous-related ulcerations Non-healing surgical wounds Pressure ulcers Wounds related to metabolic disease Wounds that repeatedly break down *If you have diabetes, any sore or tender spot on the foot warrants immediate attention from a physician, regardless of how long the wound has been present. Inova Wound Healing physicians have expertise in treating diabetes-related foot wounds. Learn more Why should I be concerned about a wound that is not healing? Infection is the greatest risk from non-healing wounds. Each of us is exposed every day to common bacteria such as staphylococcus and pseudomonas. These bacteria are present on our skin and in the environment around us. They don't present a problem when we are healthy and wound free. But an open wound increases the risk for infection, which can lead to serious conditions, even the loss of a limb. Symptoms of an infected wound A qualified physician who deals with non-healing wounds is your best resource for questions about potential infection from a wound that is not healing properly. Symptoms that may indicate an infection include: Increasing pain Redness and warmth around the wound "Oozing" from the wound An odor coming from the wound Common places for non-healing wounds Feet, ankles, heels and calves For people unable to walk, common places include hips, thighs and buttocks Diagnosis and treatment Our physicians and staff use one or more of the following diagnostic treatment options to tailor a program just for you: Laboratory evaluation Vascular studies Nuclear medicine Radiology exams Skin or tissue grafting Medications and dress Continue reading >>

Diabetic Wound Healing Through Nutrition And Glycemic Control

Diabetic Wound Healing Through Nutrition And Glycemic Control

Diabetes has quickly become one of the most complex health challenges of the 21st century. In 2010, a total of 10.9 million US residents ages 65 years and older were reported to be living with diabetes.1 Currently, it is the seventh-leading cause of death in the US, totaling 4.6 million deaths in 2011 (with healthcare expenditures reaching more than $471 billion.)2 A condition that increases one’s risk for heart disease and stroke, diabetes is also the leading cause of kidney failure, new cases of blindness among adults, and non-traumatic lower-limb amputations. Approximately 15% of individuals who live with diabetes develop a foot ulcer, and 84% of this population will end up with lower-leg amputations.3 Several factors can disrupt wound healing. Without proper nutrition, a normal wound can rapidly become a chronic, infected wound. However, it is possible for wound care providers to reduce the huge economic burden and life-threatening complications of diabetes by implementing timely, easy-to-use interventions. Comprehensive diet and nutrition management have been shown to promote optimal glycemic control and facilitate wound prevention and healing. As such, all healthcare professionals should know how to adequately manage blood glucose levels to support wound healing in patients living with diabetes. This article explains how uncontrolled blood sugar impairs wound healing and offers practical nutrition recommendations and guidelines that promote healing, as well as simple suggestions to prevent further complications and comorbidities. Effect of Diabetes Diabetes often causes slow-healing wounds that can worsen rapidly — with elevated blood glucose levels serving as the initial barrier to healing. Thus, achieving optimal glycemic control is imperative. Hyperglycemia Continue reading >>

Wound Care

Wound Care

A wound is a break in the skin or tissues that may be caused by an accident, injury, surgery, disease or several other factors, and often involves bleeding, redness, swelling, pain, tenderness and other symptoms. They may occur nearly anywhere on the body. While many wounds can be treated at home by simply cleaning and bandaging the wound, more severe wounds may require professional care. Many patients with skin ulcers, burns and other types of wounds face difficulty with the healing process for these troubling wounds, especially if the patient is diabetic. There are several different treatment options available for wounds resistant to conventional therapies. Some of these may include creams, ointments, synthetic skin grafts and other therapies that promote natural healing within the skin to avoid wound complications. We are proud to offer patients many advanced solutions to their wound healing problems. It is important for wounds to remain clean and free of debris and bacteria in order to properly heal and prevent infection, so proper dressings that are changed on a regular basis are essential. We provide a clean, moist environment that is conducive to healing for most wounds and helps lead toward a quick and efficient recovery, while keeping cosmetic concerns in mind as well. Your doctor will determine which type of wound care is best for you after an initial evaluation of your wound size, location and severity. Diabetic Wound Management People with diabetes are at high risk for developing problems with their feet. Ulcers and other wounds commonly form on the bottom of the foot and can easily become infected or lead to other serious complications. Ulcers may develop as a result of poor circulation, lack of feeling in the feet, irritation or trauma. Once a wound has be Continue reading >>

How To Care For Cuts And Scratches If You Have Diabetes

How To Care For Cuts And Scratches If You Have Diabetes

If you have diabetes, you may want to be a little more cautious about taking care of simple cuts, scratches, scrapes and bruises. In fact, skin care of any kind is important to your health. Bruises are the simplest to address. As long as the skin is not broken, you really don’t need to do much of anything, except keep an eye on the area. “A bruise is a bruise and will act like a bruise and go through the different changes in color over time,” says dermatologist Christine Poblete-Lopez, MD. “So being diabetic does not necessarily mean it will lengthen the way a bruise will resolve or not.” If you have any type of laceration, however, you should keep a keen watch for infections because diabetics are more prone to developing infections, according to Dr. Poblete-Lopez. The signs of infection to look for around the cut are redness, warmth, tenderness and pus drainage. “If you have any of those signs, you definitely need to bring it to the attention of your doctor, because you may need oral antibiotics,” she says. A diabetes specialist’s approach There are some differences of opinion among diabetes experts and dermatologists when it comes to healing wounds, so we will take a look at both. When cleaning out a cut, for example, diabetes specialist Leann Olansky, MD, says to wash the cut with soap and water and then add an over-the-counter topical antibiotic such as Neosporin® or a prescription ointment such as Bactroban® to help prevent bacteria from entering into your subcutaneous tissue. The next step for Dr. Olansky is to cover the cut with a bandage to keep it moist so that it will heal faster. “I don’t think there’s any advantage to keeping it open to the air,” Dr. Olansky says. “If the edge of a laceration gets dry, those cells dry, and you’r Continue reading >>

Compromised Wound Healing In Ischemic Type 2 Diabetic Rats

Compromised Wound Healing In Ischemic Type 2 Diabetic Rats

Abstract Ischemia is one of the main epidemic factors and characteristics of diabetic chronic wounds, and exerts a profound effect on wound healing. To explore the mechanism of and the cure for diabetic impaired wound healing, we established a type 2 diabetic rat model. We used an 8weeks high fat diet (HFD) feeding regimen followed by multiple injections of streptozotocin (STZ) at a dose of 10mg/kg to induce Wister rat to develop type 2 diabetes. Metabolic characteristics were assessed at the 5th week after the STZ injections to confirm the establishment of diabetes mellitus on the rodent model. A bipedicle flap, with length to width ratio 1.5, was performed on the back of the rat to make the flap area ischemic. Closure of excisional wounds on this bipedicle flap and related physiological and pathological changes were studied using histological, immunohistochemical, real time PCR and protein immunoblot approaches. Our results demonstrated that a combination of HFD feeding and a low dose of STZ is capable of inducing the rats to develop type 2 diabetes with noticeable insulin resistance, persistent hyperglycemia, moderate degree of insulinemia, as well as high serum cholesterol and high triglyceride levels. The excision wounds on the ischemic double pedicle flap showed deteriorative healing features comparing with non-ischemic diabetic wounds, including: delayed healing, exorbitant wound inflammatory response, excessive and prolonged ROS production and excessive production of MMPs. Our study suggested that HFD feeding combined with STZ injection could induce type 2 diabetes in rat. Our ischemic diabetic wound model is suitable for the investigation of human diabetic related wound repair; especically for diabetic chronic wounds. Figures Citation: Yang P, Pei Q, Yu T, Chan Continue reading >>

Decrease Of Collagen Deposition In Wound Repair In Type 1 Diabetes Independent Of Glycemic Control

Decrease Of Collagen Deposition In Wound Repair In Type 1 Diabetes Independent Of Glycemic Control

Hypothesis Type 1 and type 2 diabetes mellitus and glycemic control influence wound healing in humans. Design Experimental study using a human wound-healing model. Setting Collaboration among a multidisciplinary wound-healing department, department of medicine, and research laboratories. Patients, Control Subjects, and Methods In 34 patients with type 1 (insulin-dependent) and 25 with type 2 (non–insulin-dependent) diabetes and 5 nondiabetic control subjects matched with the type 2 diabetic patients, wound-healing capacity was determined as subcutaneous accumulation of collagen measured as hydroxyproline. Two expanded polytetrafluoroethylene tubes were implanted and removed 10 days later. The hydroxyproline level was determined by means of high-performance liquid chromatography; the collagenase activity, by using a radiolabeled collagen substrate. Proliferation of fibroblasts cultured from the wounds was studied in patient groups. Results The deposition of hydroxyproline decreased by 40% (P = .03) in type 1 compared with type 2 diabetes (median, 0.70 vs 1.16 nmol/mg; interquartile range, 0.48-1.04 vs 0.56-1.63 nmol/mg), which in turn did not differ significantly from that of controls (median, 1.35 nmol/mg; interquartile range, 0.72-1.88 nmol/mg). The decreased collagen deposition in type 1 diabetes was not caused by increased collagenase activity. The deposition of hydroxyproline did not correlate significantly (rs = 0.07; P = .63) with glycosylated hemoglobin levels in either diabetic group. Fibroblast growth was also decreased in type 1 compared with type 2 diabetic patients and controls. Conclusions Collagen deposition in acute wounds is impaired in type 1 diabetes, possibly due to a decreased fibroblast proliferation. In type 2 diabetes, collagen deposition is nor Continue reading >>

Diabetes And Its Effects On Wound Healing

Diabetes And Its Effects On Wound Healing

Abstract This article discusses the reasons why wounds in people with diabetes take longer to heal and are more susceptible to complications. The physiology of the wound healing process, and how this is affected by diabetes, is outlined. The article also explains why wounds in patients with diabetes are more prone to infection and discusses preventive measures. Discover the world's research 14+ million members 100+ million publications 700k+ research projects Join for free Download Continue reading >>

Unique Surgical Wound Care Concerns For Diabetics

Unique Surgical Wound Care Concerns For Diabetics

Diabetics have higher risks of wound healing complications following surgery. If you have diabetes, you are well aware of the importance of maintaining control of your blood sugar levels to prevent serious health problems. The same is true when it comes to surgical wound care. When you undergo surgery, because you have diabetes, you are at a much higher risk of having complications or developing a wound infection. Uncontrolled blood sugar levels can cause serious and even life-threatening complications, making safe and effective wound care practices crucial following surgery. Post-Surgery Risks Surgical procedures normally carry with them a risk of wound infection, excessive bleeding, or tissue damage. When you undergo surgery while also dealing with diabetes, your chances of developing complications is significantly higher. Researchers have found that those with high blood sugar levels before or after surgery run a higher risk of having their wounds reopen through dehiscence, which is a common cause of infections. If you experience stress due to your surgery or have difficulty controlling your blood sugar levels, your body can become even more resistant to insulin, produce lower amounts of insulin, and absorb lower amounts of glucose. These issues can become contributing factors to your ability to recover. The biggest concerns associated with surgical wound care for people with diabetes include the following: Wound Healing – Wounds tend to require more time to heal in those with diabetes. This can be due to nerve damage, poor blood circulation, or a compromised immune system. These effects make it harder for post-surgical wounds to heal effectively, so it is imperative you follow your physician’s surgical wound care instructions. Wound Infection – Surgical incisi Continue reading >>

Impairment Of Wound Healing In Patients With Type 2 Diabetes Mellitus Influences Circulating Microrna Patterns Via Inflammatory Cytokines

Impairment Of Wound Healing In Patients With Type 2 Diabetes Mellitus Influences Circulating Microrna Patterns Via Inflammatory Cytokines

Abstract Objective—MicroRNAs (miRNA/miR) are stably present in body fluids and are increasingly explored as disease biomarkers. Here, we investigated influence of impaired wound healing on the plasma miRNA signature and their functional importance in patients with type 2 diabetes mellitus. Approach and Results—miRNA array profiling identified 41 miRNAs significantly deregulated in diabetic controls when compared with patients with diabetes mellitus–associated peripheral arterial disease and chronic wounds. Quantitative real-time polymerase chain reaction validation confirmed decrease in circulating miR-191 and miR-200b levels in type 2 diabetic versus healthy controls. This was reverted in diabetic subjects with associated peripheral arterial disease and chronic wounds, who also exhibited higher circulating C-reactive protein and proinflammatory cytokine levels compared with diabetic controls. miR-191 and miR-200b were significantly correlated with C-reactive protein or cytokine levels in patients with diabetes mellitus. Indeed, proinflammatory stress increased endothelial- or platelet-derived secretion of miR-191 or miR-200b. In addition, dermal cells took up endothelial-derived miR-191 leading to downregulation of the miR-191 target zonula occludens-1. Altered miR-191 expression influenced angiogenesis and migratory capacities of diabetic dermal endothelial cells or fibroblasts, respectively, partly via its target zonula occludens-1. Conclusions—This study reports that (1) inflammation underlying nonhealing wounds in patients with type 2 diabetes mellitus influences plasma miRNA concentrations and (2) miR-191 modulates cellular migration and angiogenesis via paracrine regulation of zonula occludens-1 to delay the tissue repair process. Introduction Diabetes me Continue reading >>

Atlanticare Wound Healing Center

Atlanticare Wound Healing Center

At any given time, almost six million Americans suffer from chronic, non-healing wounds. Many are associated with complications from diabetes and vascular disorders. Non-healing wounds also occur in surgical wounds, pressure sores and traumatic wounds. The AtlantiCare Wound Healing Center uses the most up-to-date approaches to wound healing and remains current in the latest scientific advances in wound care. The AtlantiCare Wound Healing Center is a hospital-based outpatient service. Please select from the links below to learn about our program: An Experienced Team Patients referred to the Wound Healing Center program benefit from a comprehensive interdisciplinary approach. Integrating a team of wound care professionals increases the level of care, improves patients compliance and clinical outcomes. We Specialize in Healing Chronic Wounds: If you're suffering from a non-healing wound, you're not alone. Every year, chronic wounds, caused by diabetes, poor circulation or other conditions, keeps millions of Americans just like you from doing things they love to do. The AtlantiCare Wound Healing Center can help you get your life back. Our unique multidisciplinary team specially trained doctors and nurses treat more of these wounds than anyone else. Many patients find wounds that have resisted healing after months and even years of traditional treatment can be treated. It's all we do. In fact, for most patients, the AtlantiCare Wound Healing Center program leaves them completely healed in just a few weeks. Who Needs Wound Care? The AtlantiCare Wound Healing Center can help patients with all chronic wounds, including: Diabetic Wounds Venous Stasis ulcers Pressure ulcers Arterial insufficiency ulcers Burns Osteomyelitis Soft tissue radionecrosis and osteoradionecrosis from eff Continue reading >>

Post-op Concerns For People With Type 2 Diabetes

Post-op Concerns For People With Type 2 Diabetes

People with Type 2 diabetes have to worry about more than the normal risks and complications after an operation. Risks associated with diabetes and surgery are increased dependent on age, diabetes treatment regimen, level of control, existing complications or illness, malnutrition, length of time with diabetes, and general physical fitness. Post-Op Concerns The physical and mental stress of surgery can cause undesirable changes in hormone levels. These changes lead to increased insulin resistance, lowered insulin secretion, and lessened glucose uptake into cells. These increase the risk for hyperglycemia in a person with diabetes. The following list of concerns illustrates the importance of having glucose levels in control prior to an operation: : High or low glucose levels can cause post-operative complications, with high glucose levels topping the list. High levels increase the likelihood and severity of other complications. It is important to have glucose levels in good control prior to surgery. Dehydration: The patient may have high urinary output if diabetes is under poor control with increased risk of osmotic diuresis. This can increase risk for other complications. Hyperglycemic hyperosmolar syndrome (HHS): This is a situation where the patient has high glucose levels, dehydration, and decreased consciousness. It is of great concern following certain surgical procedures such as cardiac bypass surgery where it is associated with 42% mortality. (DKA): Surgery and/or other complications can increase levels of stress hormones, making insulin less effective. If insulin cannot help the body burn glucose for energy, the body will burn fat instead. Toxic acid byproducts called ketones build up in the blood and can become life-threatening. Dehydration can accompany and so Continue reading >>

Wound Healing: What Every Diabetic Should Know

Wound Healing: What Every Diabetic Should Know

At the St. Vincent’s Center for Wound Healing we see patients with all types of non-healing wounds, wounds that would not heal normally due to diabetes, poor circulation or other comorbid conditions. Diabetics are at the highest risk for developing a non-healing wound due to the loss of sensation in their feet and the impact that diabetes has on the blood vessels supplying the feet and lower legs. When to Seek Treatment: Talk to your doctor if you experience any of these symptoms: Wound that hasn’t healed in 30 days (commonly experienced by people with diabetes). Sore with increasing pain, redness or swelling, foul odor, or a change in color. Surgical wound that has become infected. It is estimated that 2 million people with diabetes will develop a wound of their lower limb this year. It is important that patients with diabetes check their feet regularly and see a podiatrist for routine foot care. However, if a person discovers they have a wound they need to seek an appointment with the Center for Wound Healing as soon as possible. Delayed treatment is a serious concern that can lead to infection requiring hospitalization or possible amputation. A 56 year old male diabetic patient entered the wound healing center last summer; he was concerned about a callused area that would drain some blood onto his sock while he was at work. He was evaluated by one of our Wound Physicians, he was sent for an x-ray which revealed a pocket of infection in his foot. Through early identification and an aggressive treatment plan that included a special walking boot and daily hyperbaric treatments the patient healed and was able to return to work. The Wound Healing Center set the patient up with a local podiatrist for ongoing foot care and referred him back to his Primary Care Physician Continue reading >>

Wound Healing And Diabetes Mellitus☆

Wound Healing And Diabetes Mellitus☆

Advertisements on this site do not constitute a guarantee or endorsement by the journal, Association, or publisher of the quality or value of such product or of the claims made for it by its manufacturer. Continue reading >>

Surgical Wound

Surgical Wound

A surgical wound is a cut or incision in the skin that is usually made by a scalpel during surgery. A surgical wound can also be the result of a drain placed during surgery. Surgical wounds vary greatly in size. They are usually closed with sutures, but are sometimes left open to heal. Surgical wounds can be classified into one of four categories. These categories depend on how contaminated or clean the wound is, the risk of infection, and where the wound is located on the body. Class I: These are considered clean wounds. They show no signs of infection or inflammation. They often involve the eye, skin, or vascular system. Class II: These wounds are considered clean-contaminated. Although the wound may not show signs of infection, it is at an increased risk of becoming infected because of its location. For example, surgical wounds in the gastrointestinal tract may be at a high risk of becoming infected. Class III: A surgical wound in which an outside object has come into contact with the skin has a high risk of infection and is considered a contaminated wound. For example, a gunshot wound may contaminate the skin around where the surgical repair occurs. Class IV: This class of wound is considered dirty-contaminated. These include wounds that have been exposed to fecal material. Surgical wounds are created when a surgeon makes an incision or cut with a surgical instrument called a scalpel. A wide variety of medical circumstances require surgery. The size of a wound depends on the type of procedure and location on the body. Any surgical procedure will create a surgical wound. The likelihood of a wound infection after surgery is between 1 and 3 percent. Risk factors for developing a surgical wound infection include having other medical issues, such as diabetes or a weakene Continue reading >>

Diabetic Wound Care

Diabetic Wound Care

What is a Diabetic Foot Ulcer? A diabetic foot ulcer is an open sore or wound that occurs in approximately 15 percent of patients with diabetes and is commonly located on the bottom of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ulcer-related complication. Diabetes is the leading cause of non-traumatic lower extremity amputations in the United States, and approximately 14-24 percent of patients with diabetes who develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Research has shown, however, that development of a foot ulcer is preventable. Causes Anyone who has diabetes can develop a foot ulcer. Native Americans, African Americans, Hispanics, and older men are more likely to develop ulcers. People who use insulin are at higher risk of developing a foot ulcer, as are patients with diabetes-related kidney, eye, and heart disease. Being overweight and using alcohol and tobacco also play a role in the development of foot ulcers. Ulcers form due to a combination of factors, such as lack of feeling in the foot, poor circulation, foot deformities, irritation (such as friction or pressure), and trauma, as well as duration of diabetes. Patients who have diabetes for many years can develop neuropathy, a reduced or complete lack of ability to feel pain in the feet due to nerve damage caused by elevated blood glucose levels over time. The nerve damage often can occur without pain, and one may not even be aware of the problem. Your podiatrist can test feet for neuropathy with a simple, painless tool called a monofilament. Vascular disease can complicate a foot ulcer, reducing the body's ability to heal and increasing the risk for an infection. Elevations in blo Continue reading >>

More in diabetes