scholarly journals Growth factors in the treatment of diabetic foot syndrome

2019 ◽  
Vol 22 (4) ◽  
pp. 377-383
Author(s):  
Elena Y. Komelyagina ◽  
Michail B. Antsiferov
Keyword(s):  
Growth Factors ◽  
Growth Factor ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Diabetic Foot Syndrome ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Level Of Evidence

Growth factors play a key role in wound healing, deficiency of which leads to delayed healing. Various growth factors are used in the treatment of chronic wounds, including diabetic foot ulcers. The purpose of this review was to analyse the literature data on the effectiveness of epidermal growth factor, platelet-rich plasma and platelet growth factor in patients with diabetic foot syndrome. The effect of treatment with these growth factors on healing of diabetic foot ulcers and healing time were analysed. Published studies, mostly with low level of evidence, demonstrate a positive effect of various growth factors on the healing process of diabetic foot ulcers. Currently, there is no conclusion on the advantages of growth factor therapy. Further studies with a high level of evidence are needed to justify their use in routine clinical practice.

scholarly journals The Role of Recombinant Proteins and Growth Factors in the Management of Diabetic Foot Ulcers: A Systematic Review of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-18 ◽  
Author(s):  
Elahe Mahdipour ◽  
Amirhossein Sahebkar
Keyword(s):  
Systematic Review ◽  
Growth Factors ◽  
Growth Factor ◽  
Recombinant Proteins ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Diabetic Foot Ulcers ◽  
Randomized Controlled

Background. Recombinant proteins and growth factors are emerging therapies for diabetic foot ulcers. Despite several clinical reports, there has been no comprehensive and systematic assessment of the totality of clinical evidence on the efficacy and safety of recombinant proteins and growth factors in diabetic foot ulcers. We tried to address this gap through an updated systematic review of randomized controlled trials (RCTs). Methods. PubMed, the Cochrane Library, Scopus, Embase, and Google Scholar databases were searched, and RCTs on the efficacy of recombinant proteins and growth factors in the treatment of cutaneous wounds in diabetic patients were selected. The literature search and assessment were performed by two independent reviewers. Methodological quality of studies was appraised using the Jadad scale. Results. We identified 26 RCTs involving diabetic patients with ulcer that evaluated the effectiveness of platelet-derived growth factor, epidermal growth factor, fibroblast growth factor, granulocyte colony-stimulating factor, vascular endothelial growth factor, erythropoietin, transforming growth factor, talactoferrin, and rusalatide acetate. The main primary outcome was complete healing though different indices were employed to define this such as wound closure, granulation tissue formation, or complete reepithelialization. Few studies had a follow-up period to report any recurrence and amputation rate. No adverse effect was reported due to the intervention. Conclusion. Overall, there is a greater agreement on the effectiveness of EGF to enhance the healing of diabetic ulcers. Nevertheless, extant evidence is lacking for other agents since few trials have been conducted for most of the growth factors and available studies are heterogeneous in their methodologies.

scholarly journals A clinical study of platelet rich plasma versus conventional dressing in management of diabetic foot ulcers

2018 ◽  
Vol 5 (10) ◽  
pp. 3210 ◽  
Author(s):  
Nithyaraj Prakasam ◽  
Prabakar M.S. ◽  
Reshma S. ◽  
Loganathan K. ◽  
Senguttuvan K.
Keyword(s):  
Wound Healing ◽  
Tissue Regeneration ◽  
Diabetic Foot ◽  
Tamil Nadu ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Group A ◽  
Group B

Background: Diabetic foot ulcers continue to pose significant global issue despite the advances made in the management of diabetes. It causes major foot complications if they are not addressed properly. It needs multidisciplinary approach for its care. While several advancements has taken place in wound care management, platelet rich plasma and stem cell therapy promises to offer a new hope in its management, aiding in cellular and tissue regeneration. The purpose of the present study was to compare Platelet-Rich Plasma versus conventional dressing in the management of diabetic foot ulcers.Methods: This prospective study was focused on 20 diabetic foot ulcers, carried out in a surgical unit of ACS Medical College and Hospital, Chennai, Tamil Nadu, from January 2018 to June 2018. Patients were divided into two groups; Group A received conventional ordinary dressing (N=10, 50%) and Group B received PRP dressing (N = 10, 50%). The mean follow-up period was 8 weeks.Results: The estimated time of wound healing was 8 weeks and healing was found to be more effective for patients in group B compared to patients in group A; the PRP group was found to be more effective in wound healing with fewer complications, less infection, exudates and pain.Conclusions: There have been considerable advances in the use of PRP in therapeutic processes in recent years in tissue regeneration therapy. PRP is a powerful tool for the treatment of chronic wounds and very promising for diabetic foot wounds; PRP enables healing, and reduces amputation rates, infection and exudates.

scholarly journals Safety and efficacy of platelet rich plasma in the management of diabetic foot ulcer

2021 ◽  
Author(s):  
Raju Rani ◽  
Kathirvel Priyanka
Keyword(s):  
Diabetic Foot ◽  
Tamil Nadu ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Wound Care ◽  
Foot Ulcer ◽  
Mean Value ◽  
Wound Contraction ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Background: Diabetic foot ulcers continue to pose a significant global issue despite the advances made in the management of diabetes. It causes major foot complications if they are not addressed properly. While several advancements have taken place in wound care management, platelet-rich plasma (PRP) promises to offer new hope in its management, aiding in cellular and tissue regeneration. Hence the present study was carried out to determine the safety and effectiveness of PRP in the management of diabetic foot ulcers in comparison to conventional dressing.Methods: This prospective study was focused on 50 diabetic foot ulcers, carried out in a surgical unit of Onsite Hospital, Chennai, Tamil Nadu from November 2018 to November 2019. Patients were divided into two groups group A received conventional ordinary dressing (n=25, 50%) and group B received PRP dressing (n=25, 50%). The mean follow up period was 6 weeks.Results: The present study observed that participants receiving PRP showed better wound contraction of 33.74% than the group receiving only conventional treatment with a mean wound contraction of was 12.82%. In addition, the duration required for wound contraction in the PRP group was short (mean value 4.488 cm) compared to the conventional dressing group (mean value 6.188 cm). The PRP group was found to be more effective in wound healing with fewer complications, less infection, exudates and pain.Conclusions: PRP is a powerful tool for the treatment of chronic wounds and very promising for diabetic foot wounds and it enables healing and reduces amputation rates, infection and exudates.

scholarly journals Wound Fluid Matrix Metalloproteinase-9 as a Potential Predictive Marker for the Poor Healing Outcome in Diabetic Foot Ulcers

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Punyanuch Jindatanmanusan ◽  
Sivat Luanraksa ◽  
Tanit Boonsiri ◽  
Thirayost Nimmanon ◽  
Pasra Arnutti
Keyword(s):  
Wound Healing ◽  
G Protein ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Fluid ◽  
The Poor ◽  
Wound Size

Background and Objective. Evidence for the roles of matrix metalloproteinases-9 (MMP-9) in the healing process of diabetic foot ulcers has remained unclear. We therefore aimed to demonstrate the relationship of MMP-9 with the wound healing process and determine its potential usefulness in predicting the wound healing outcome. Methods. Twenty-two patients with diabetic foot ulcer were recruited. The wound size was determined, and the wound fluid was collected for the measurement of MMP-9 levels using an ELISA during the 12-week follow-up period regularly. The patients were categorized as good healers and poor healers when the wound area reduction was ≥ 50% and < 50% at week 4 when compared to the initial wound size at week 0. Results. Median wound fluid MMP-9 levels in the poor healer group were shown to be significantly higher than those in the good healer group (1.03 pg/µg protein vs. 0.06 pg/µg protein, p = 0.001), and the levels fluctuated throughout the 12-week follow-up period. In contrast to the poor healer group, the MMP-9 levels were demonstrated to be constantly low throughout the follow-up period in the good healer group. ROC analysis showed that the MMP-9 level of 0.38 pg/µg protein was able to predict the wound healing outcome with the sensitivity of 81.8%, the specificity of 64.6%, and the area under the curve of 0.901 (CI 0.78-1.03, p = 0.001). Conclusion. These findings suggested that determination of wound fluid MMP-9 levels might become a promising biomarker predicting wound healing outcomes and a novel potential therapeutic target for diabetic foot ulcers.

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