Adjunctive therapies in diabetic foot ulcers

NewsBot · Jan 27, 2016

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A systematic review and meta-analysis of adjunctive therapies in diabetic foot ulcers
Tarig Elraiyah, MBBS, Apostolos Tsapas, MD, PhD, Gabriela Prutsky, MD, Juan Pablo Domecq, MD, Rim Hasan, MD, Belal Firwana, MD, Mohammed Nabhan, MD, Larry Prokop, MLS, Anil Hingorani, MD, Paul L. Claus, MD, Lawrence W. Steinkraus, MD, Mohammad Hassan Murad, MD, MPH
Journal of Vascular Surgery; February 2016Volume 63, Issue 2, Supplement, Pages 46S?58S.e2

Background
Multiple adjunctive therapies have been proposed to accelerate wound healing in patients with diabetes and foot ulcers. The aim of this systematic review is to summarize the best available evidence supporting the use of hyperbaric oxygen therapy (HBOT), arterial pump devices, and pharmacologic agents (pentoxifylline, cilostazol, and iloprost) in this setting.

Methods
We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus through October 2011. Pairs of independent reviewers selected studies and extracted data. Predefined outcomes of interest were complete wound healing and amputation.

Results
We identified 18 interventional studies; of which 9 were randomized, enrolling 1526 patients. The risk of bias in the included studies was moderate. In multiple randomized trials, the addition of HBOT to conventional therapy (wound care and offloading) was associated with increased healing rate (Peto odds ratio, 14.25; 95% confidence interval, 7.08-28.68) and reduced major amputation rate (odds ratio, 0.30; 95% confidence interval, 0.10-0.89), compared with conventional therapy alone. In one small trial, arterial pump devices had a favorable effect on complete healing compared with HBOT and in another small trial compared with placebo devices. Neither iloprost nor pentoxifylline had a significant effect on amputation rate compared with conventional therapy. No comparative studies were identified for cilostazol in diabetic foot ulcers.

Conclusions
There is low- to moderate-quality evidence supporting the use of HBOT as an adjunctive therapy to enhance diabetic foot ulcer healing and potentially prevent amputation. However, there are only sparse data regarding the efficacy of arterial pump devices and pharmacologic interventions.
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NewsBot · Oct 3, 2022

Cilostazol-induced Acute Kidney Injury in A Patient With Diabetic Foot Ulcer: A Case Report and Review of Literature
Shahrzad Shahidi, Elham Kabiri Naeini, Sadegh Mazaheri-Tehrani
Iran J Kidney Dis. 2022 Sep;16(5):311-314.

Introduction: Cilostazol is an antiplatelet agent, that has been recently used as an adjunctive therapy in the management of diabetic foot ulcers. Headache, diarrhea, palpitations, and edema are reported as common side effects.

Case presentation: A 53-year-old woman was admitted to hospital, with decreased urine output and increased serum creatinine level. She had taken Cilostazol for the first time, for only one day, so the diagnosis of acute kidney injury, probably drug-induced acute interstitial nephritis, due to Cilostazol use, was made. Her kidney function did not improve despite Cilostazol discontinuation and therefore, empirical corticosteroid therapy was initiated. Her urine output increased and her serum creatinine level significantly decreased, on the third day of treatment. She was discharged with acceptable kidney function. Follow-up visits showed gradual normalization of serum creatinine in the next 62 days.
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NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Nail drilling as adjunctive treatment for toenail onychomycosis

Granulocyte-colony stimulating factors as adjunctive therapy for diabetic foot infections

Use of proven (albeit *illegal*) therapies in elite athletes

Injection therapies for plantar fasciitis

Chronic plantar fasciitis is mediated by local hemodynamics: Implications for emerging therapies

Use of unproven therapies in elite athletes

Improving Orthotic Results via Manual Therapies

Share This Page

Use of proven (albeit illegal) therapies in elite athletes