جستجوی مقالات مرتبط با کلیدواژه « زخم دیابتی » در نشریات گروه « پزشکی »

A diabetic wound is a long-term diabetes complication increasing the risk of mortality and amputation-related disability and decreasing the quality of life. Due to incorrect and incomplete use of standard therapies, complementary therapeutic strategies, including elevation of wound nitric oxide (NO) level by using NO donors, precursors, and inducers, have received attention in in vitro studies, animal experiments, and clinical trials. Here, we aimed to review the potential clinical applications of NO in accelerating wound healing in diabetes. Exogenous NO in the gaseous form or as acidified nitrite-containing ointments, NO-containing sprays, and NO-containing hydrogels has been applied in wound healing. Although limited clinical trials have been conducted to assess the efficiency of NO in accelerating diabetic wound healing, 56-100% effectiveness was reported for NO-based treatments compared to standard care. The known physiological functions of NO in wound healing include increasing the local blood flow, inducing angiogenesis, collagen synthesis, re-epithelization, wound closure, and anti-inflammatory effects via enforcing immune responses, and promoting potent broad-spectrum antibacterial effects. Considering the limited existing evidence, clinical trials with predefined effect sizes, i.e., wound area reduction, wound healing rate, and length of hospital stay, are required to confirm the efficiency of NO-based therapies compared to standard treatment.

Diabetes is the most common endocrine disease, which has an increasing prevalence in the world and is the most important cause of non-traumatic limb amputation. Amputation is one of the problems that arise in these patients. Based on this, the present study was conducted with the aim of determining and comparing glycosylated hemoglobin between two groups with and without lower limb amputation in patients with diabetic ulcers referred to Shahid Beheshti Hospital in Qom.

This study was a case-control Study, the research population was patients with diabetic ulcers referred to Shahid Beheshti Hospital in Qom in 2018-2019. A total of 262 patients (127 in the group of diabetic patients with amputation and 135 in the group of diabetic patients without amputation) were examined. Finally, all the clinical and paraclinical information of the patients were extracted from the patients' files and were analyzed between the two groups.

There was no significant difference between gender, age and duration of hospitalization in the two groups (P > 0.005) and the two groups were homogeneous, but there was a significant difference between body mass index, hemoglobin A1C and fasting blood sugar in the two groups (P < 0.005) and was higher in the group of patients with diabetes with amputation.

According to our findings, there is a statistically significant difference in blood sugar and hemoglobin A1C as well as body mass index between the two groups with and without amputation. In this regard, it is necessary for patients not only to eat a balanced diet and correct their lifestyle according to the disease, but also to do proper sports.

Stem cells have a pivotal role in wounds healing; however, the mechanism of the healing effect of these cells is not still clear. The present study was carried out to investigate the effect of fibroblast cells on diabetic wound healing and skin thickness and elasticity in male rats. This research was done in Javid Biotechnology Laboratory in 2021.

In the present experimental laboratory study, fibroblast cells were isolated from the foreskin. Totally, 12 streptozotocin-induced diabetic male Wistar rats were divided into control (normal saline-treated) and fibroblast-treated rats. Wounds with a diameter of 0.8 cm were created via a biopsy puncture in the back of the mice. On days 7, 14, and 21 after treatment, the wound healing was evaluated via morphological observation, sonography, and elasticity assessment. Data were analyzed using one-way analysis of variance.

The healing rate and skin thickness and elasticity significantly increased in fibroblast cells treated group compared with control group. Compared with day 7, on days 14 and 21 after treatment, we observed significant increase in wound area skin gross elasticity (R2), recovery after deformation (R7) (p=0.008<0.01 and p=0.0007<0.001, respectively), and net elasticity (R5) (p=0.0008<0.001and p=0.009<0.01, respectively).

The results of the present study showed that foreskin derived fibroblast cells can accelerate diabetic wound healing by increasing the skin thickness and elasticity.

Many studies have shown that placenta derivatives can play a role in wound healing; however, the exact role of the placenta extracellular matrix in skin wound healing is unclear. Accordingly, the present study investigated the effects of placental extracellular matrix on diabetic wound healing in an animal model.

In this experimental-laboratory study, human placenta was decellularized and extracellular matrix was prepared. Streptozotocin induced diabetic male Wistar rats were divided into two groups: control group (n=9) and group treated with placental extracellular matrix (n=9). Wounds with a diameter of 0.8 cm were created in the back of rats. On days 0, 7, 14 and 21 the wound area was measured using ImageJ software. Two-way repeated-measures ANOVA was used to compare wound area between groups.

Wound area significantly decreased on the 14th and 21st days after treatment compared to the first day of experiment in control and treatment groups. Unlike the treatment group, the wound area was not significantly different 7 days after treatment compared to the first day of experiment in control group. There was more reduction in wound area on day 21 in treatment group than the group treated with acellular placenta.

The extracellular matrix has a significant role in accelerating the healing process of skin wounds in diabetic cases in an animal model. The findings of this study can be applied to the treatment plan of skin wounds in diabetic patients.

One of the common complications of diabetes is impairment of wound healing. The aim of the present study was to investigate the synergistic effect of hyperbaric oxygen (HBO) therapy and decellularized human amniotic membrane (dHAM) in healing of full-thickness diabetic wounds in rats.

In this experimental study, 60 diabetic male rats were randomly divided into four groups (n=15) as follows: untreated diabetic wound, wound treated with HBO, wound treated with dHAM, and wound treated with HBO+dHAM. Sampling was performed after 7, 14, and 21 days following wounding. Assessments included wound closure rate, histological (collagen density) and stereological examinations, expression of genes involved in repair and angiogenesis (TGF-β and VEGF), inflammatory genes (TNF-α and IL-1β), and wound tissue biomechanical properties.

Combined use of dHAM and HBO significantly increased wound closure rate, new epidermis and dermis volume, fibroblast cell and blood vessel density, collagen density, repair and angiogenesis genes, and wound biomechanical properties compared with those in the diabetic group (P<0.05). Also, the expression level of inflammatory genes and neutrophil density significantly decreased in all treatment groups, especially in HBO+dHAM group compared with the diabetic group (P<0.05).

dHAM and HBO had a greater effect on the healing process of diabetic wounds when taken together than when each was taken separately.

Although many studies have been performed concerning the effects of adipose-derived mesenchymal stem cells on wound healing, the repairing effects of these cells are still controversial. In this context, the present study investigated the effect of spraying the adipose-derived mesenchymal stem cells suspension on diabetic wound healing and skin tissue collagen synthesis in an animal model.

In this experimental study, abdominal adipose tissue was obtained from patients referred for abdominoplasty. Mesenchymal cells were isolated from adipose tissue and identified by micoscoic examination and flow cytometry. Streptozotocin was used to induce diabetes in 10 male Wistar rats. Wounds with a diameter of 0.8 cm were created by a biopsy punch in the back of diabetic rats. Animals were divided into two groups: control (untreated) and treated with mesenchymal cell. After treatment, wound healing was assessed by photographic methods on days 7, 14 and 21 and the collagen synthesis was evaluated using Mason’s trichrome method.

Observational data showed that the wound healing rate was higher in the treatment group than control group. 21 days after treatment, the density of collagen fibers, the formation of tissue vessels and the collagen fibers arrangement had higher quality in the treatment group than the control group.

Spraying the adipose-derived mesenchymal stem cells in diabetic wound area can increase the collagen synthesis in the wound area and accelerate the healing of the diabetic wound. According to which, the use of these cells can be considered in cell therapy of wounds.

In recent years, there has been significant increase in the number of diabetic patients, the rate of hospitalization and non-traumatic lower limb amputation. The last two mentioned are known as the major complications of diabetes.  In addition to it, there has been a considerable tendency among the medical therapist in applying  apitherapy a branch of alternative medicine that deals with natural agents containing effective chemical compounds in this specialized field. Following what was explained we decided to reexamine the effects of Bee pollen as a natural support to promote the process of diabetic pressure ulcer healing.

This study is a one-blinded clinical trial study included 84 diabetic patients suffering from diabetic ulcers. These patients were referred to the wound clinics under supervision of Alborz University of medical sciences in Karaj. The study group was divided into two groups: experimental group (E.G), the patients who were given Bee pollen and control group (C.G.), those whom were given placebo .patient educated to solve one tea spoon powder in milk or water  three times a day and drink, preferably before meals. Equal care was provided to all patients by wound experts over a twelve week period of time. During this time the PUSH questionnaire was completed for each patient by wound experts twice weekly.

To match the research, we selected these two groups from similar demographic variables such as: age, gender, education, marital status, underlying disease, body mass index, fasting blood sugar, hemoglobin and the size of the wounds. Comparing the PUSH score at the end of sessions 6, 12, 18 resulted in lower scores in E.G., while at the last session of 24 the PUSH score in C.G. was reported lower than E.G.Yet, no significant difference between the two groups was founded.

In this study, Bee pollen as a nutritional supplement in diabetic ulcer healing stimulation has not been proved. Hence, more studies are needed.

Despite many studies carried out on the application of stem cells in the healing of diabetic wounds, the results are still challenging. The aim of the present study was to determine the effects of gelatin hydrogel containing adipose-derived mesenchymal stem cells on diabetic wound healing in animal model.

In the present experimental-laboratory study conducted in 2019, mesenchymal stem cells were isolated from human adipose tissue and at that point characterized. The gelatin hydrogel was made using the microbial transglutaminase enzyme. Diabetes was induced in Wistar male rats by injecting streptozotocin. Subsequently, 0.8 cm thick wounds appeared on the backs of the mice. Animals were divided into control groups (treated with normal saline) and treated group with hydrogels containing adipose tissue-derived mesenchymal stem cells. Wound healing was assessed on days 7, 14 and 21 days after treatment through wound imaging. Data were analyzed using t-test and one-way analysis of variance.

The wound area decreased significantly in rats treated with “hydrogel + mesenchymal stem cells” on post-treatment days 7, 14 and 21 compared to first day of treatment (P<0.01, 0.001 and P<0.001, respectively). Unlike control group, the wound area significantly decreased on day 14 compared with day 7 in treated group.

Conclusion

Mesenchymal stem cells transported by gelatin hydrogel to the wound site, cause faster healing of diabetic wounds, therefore, can be used as a dressing for diabetic wounds.

The number of patients suffering from diabetic ulcers has been increased in recent years and the current therapies have faced failure. This study aimed to investigate the effects of Wharton’s jelly stem cells (WJMSCs) on the diabetic wound in an animal mode.

During this laboratory experimental study carried out in Skin and Stem Cells Research Center from March 2021 to November 2021, WJMSCs were isolated and their differentiation capability to osteocytes and adipose cells was assessed using the colorimetric method, and the expression of specific markers was evaluated using flow cytometry. 12 male Wistar rats weighing 200 to 250 grams were purchased from the Pasteur Institute and kept in the animal room in standard condition. Streptozotocin was used to induce diabetes in male Wistar rats. Animals were divided to control (normal saline injection: n=6) and WJMSCs injection (n=6) groups. Wounds with 0.8 cm in diameter were made on the back of rats. After subdermal injection of normal saline and WJMSCs, wound healing was evaluated 7, 14 and 21 days using the photography method. Data were analyzed using a t-test and analysis of variance.

The results showed that the isolation process should be performed no later than a few hours after the cesarean section. Storing the sample for one day or more caused sample contamination leading to significant failure in cell proliferation and differentiation. WJMSCs were positive for specific mesenchymal stem cell markers (CD44, D73, CD90 and CD 105, and negative for CD45 and CD 34. They were capabale to differentiate into osteocytes and adipose cells and had a high viability rate (83.1%). Subdermal injection of WJMSCs in diabetic rats resulted in acceleration of diabetic wound healing compared with the control group.

Subdermal injection of WJMSCs can effectively accelerate diabetic wound healing. According to which, applying Wharton’s jelly stem cells can be considered in cell therapy particularly in the field of diabetic wound healing.

In recent years, the number of patients suffering from diabetic ulcers has increased and many studies have shown that stem cells can be effective in healing of skin ulcers. Common diabetic wound therapies face serious failures. The aim of this study was to evaluate the healing of diabetic wounds and collagen changes following injection of fibroblast cells in male rats.

In this experimental study, streptozotocin induced diabetic male Wistar rats (n=16) were divided into two groups: control and foreskin derived fibroblast treated group. Wounds with a diameter of 0.8 cm were created in the back of rats and after subdermal injection fibroblast cells, the wound was evaluated by photographic method and Mason’s trichrome staining on days 7 and 21. Data were analyzed using t-test and one-way analysis of variance.

The healing and collagen production rate significantly increased in fibroblast cells treated group 7 and 21 days after treatment compared with control group (P<0.01).

Subdermal injection of foreskin derived fibroblast cells causes more collagen production and fast healing of diabetic wound therefore can be applied in cell therapy.

The application of mesenchymal stem cells in the healing of chronic wounds is one of the most challenging issues in cell therapy. The present study investigated the efficacy of intradermal injection of umbilical cord Whartonchr('39')s Jelly-derived mesenchymal stem cells in diabetic wound healing using ultrasound imaging in an animal model.

During this experimental laboratory study that was performed in the Skin and Stem Cell Research Center, Tehran University of Medical Sciences between October 2017 and October 2016, mesenchymal stem cells were isolated from umbilical cord Whartonchr('39')s jelly of 10 neonates. The cells were passage. The differentiation potential of cells to osteocyte and adipose cells was evaluated. The expression of specific markers of mesenchymal stem cells was evaluated using flow cytometry. The viability and quality of cells were evaluated before transplantation. The diabetes model was developed by intraperitoneal injection of streptozotocin in 42 male Wistar rats. The animals were randomly divided into two groups: normal saline injection (control) and cell injection. Cell transplantation was performed intradermally. Skin thickness and density were assessed using ultrasound imaging on days 7, 14 and 21. Finally, the data were analyzed using a t-test and analysis of variance.

Injection of mesenchymal stem cells caused faster closing of the wound. The results of biometric measurement of wound skin in rats showed that skin thickness and density on days 7, 14 and 21 in the Wharton jelly mesenchymal stem cell injection group had a significant increase compared to the control group.

The results of cell analysis showed that the isolated cells are the same as mesenchymal stem cells. The cells were of the required health and quality. Intradermal injection of mesenchymal stem cells in diabetic wound area caused faster healing in diabetic rats, according to which, such stem cells can be considered in cell therapy, especially in the field of chronic wound healing.

Diabetes is as a chronic disorder, which produce lots of limitation in patients' activities and psychological quality. The aim of the present study was to investigate the efficacy of cognitive-behavioral therapy based on Lazarus's multimodal approach to psychological weakness and thoughts fusion among diabetic patients with wounds.

The present study was a semi-experimental (pre-test, post-test) with a control and experimental group. The statistical population of study consisted of 50 diabetic patients with wounds in Tabriz Sina Hospital, 24 patients with Purposive sampling selected and randomly divided into two experimental and control groups (each group was 12). The experimental group participated in group sessions for 8 sessions of 120 minutes, while the control group did not receive any intervention. Subjects in both experimental and control groups were assessed with the Minnesota Multiplier Questionnaire (MMPI) Questionnaire (Pt sub-scale) and Thought Fusion Inventory (TFI) before and after treatment. Data were analyzed by descriptive statistics (such as mean and standard deviation), ANCOVA and MANCOVA

Results indicated that there were significant differences in post-test mean scores of experimental and control groups and cognitive behavior therapy could significantly reduce psychological weakness (F=41/138, p=0.01) and increase thought fusion (F=9/306, P<0.007).

Cognitive behavioral therapy with changing maladaptive thought and helping to accept disease, resulted in behavior change in diabetic patients.

A wound is described as any laceration in normal anatomic structure and functional integrity of the skin. Chronic wounds don’t progress through the normal wound healing process in 3 months leaving open laceration of different degrees of severity. Diabetic wound healing is an insurmountable process due to the chronic nature of diabetic wounds. For these complications, this has been a challenge in the health care system. By the appearance of regenerative medicine, advisedly stem cell-based therapies and ingredients have been gained the focus of researchers and professionals as well. As there is no definite cure for diabetic wounds and forasmuch as the appearance of regenerative medicine and cell-based therapies there is a big hope to find a definite treatment for diabetic wounds. In this article novel therapies based on stem cells were observed.

Maggot therapy is mentioned in holy books. After the introduction of antibiotics to the market, a long period of delay occurred in using maggot therapy method. In recent years, due to resistance of infectious agents against antibiotics, there has been a good return to this method. In 1999, WHO confirmed this science and included it in its remedial policies. Maggot therapy was approved by FDA in 2004. Tissue engineering means development and change in experimental growth of cells in tissues or limbs, in order to substitute or heal the damaged part of the body. The main problem of serious wounds is the risk of infection, their depths and loss of tissue. Integrated use of maggot therapy and tissues engineering is a bridge between two ancient and modern methods which is very effective for curing diabetic wounds and bedsore. Due to high probability of success in this method, development and use of the above-mentioned method is highly recommended and it is necessary to use this method in our country widely.

Some native species of medicinal plants are abundantly found in Iran. High incidence of ulcers in diabetic patients necessitates research on herbal medicines with fewer side effects. This study was conducted to evaluate the histological variables of the Fumaria parviflora extract on the repair of ulcers in diabetic rats. The study was carried out in 48 adult male Wistar rats at 14-15 weeks of age, weighing 200 ± 10 gr. Diabetes was induced by injection of alloxan. The animals were randomly divided into 4 groups (n= 12), including negative control group (healthy without any treatment), positive control group (diabetic with no treatment), experimental group I (diabetic treated by eucerin cream), and experimental group II (diabetic treated by a cream containing 3% F. parviflora). Histopathological examination was done at the end of days 3, 7, 14, and 21. The size of the scars and tissue indices were measured in these groups. There was a significant difference between the experimental group II and other groups in the rate of recovery (P <0.001). Compared to experimental group I, the scores for some microscopic parameters were higher in experimental group II. According to current study, topical use of F. parviflora could diminish inflammation and accelerate wound healing. It was also found to be highly efficient in accelerating the transition from inflammatory to fibroblast hyperplasia phase. Therefore, F. parviflora as an efficient low-cost herbal medicine could be used in accelerating wound healing.

Background and Chronic non-healing diabetic wounds are a major medical challenge worldwide. Stem cell therapy has been developed as a new approach in the management of such wounds that need to be explored further. In the present study we aimed to evaluate the effects of adipose derived mesenchymal stem cells (ADSCs) on gene expression level of some important inflammatory factors involved in wound healing in diabetic animal model.
ADSCs were isolated from adipose tissue of mice and their stemness was identified in terms of specific cell surface markers (CD44, CD90, and CD34) and multi-lineage differentiation potentials. Then 106 stem cells were injected in dermis area around the wounds and the wound tissues were tested for the expression level of IL-8 and IL-10 genes and histopathological analysis at 3rd, 7th, 14th, and 21st days after treatment.
Expression level of IL-10 gene at days 3, 14 and 21 increased significantly (P The present study indicated that stem cells could improve the indicators of wound healing.

Background and Diabetes mellitus is a metabolic disorder with several complications, such as delayed wound healing. The aim of this study was to evaluate the efficacy of oral administration and topical application of hydroalcoholic extract of Melissa officinalis on cutaneous wound healing and serum biochemical changes in alloxan-induced diabetic rats.
In this experimental study thirty-six Wistar rats were randomly divided into three groups of control, diabetic control, and diabetic treatment. After anesthesia, full-thickness pieces of skin (25×25 mm) were removed from upper dorsal part of the rats. Subsequently, 24 h after the operation, the wounds of the diabetic group were locally treated with topical application of 5% cream and oral administration of Melissa officinalis extract (2500 mg/kg) was performed by gavage, daily for three weeks. The control and diabetic control groups received no treatment. The wound surface areas were measured using linear and photographic methods on days 4, 7, 14, and 21. Incisional biopsies were performed to evaluate the wound healing rate and for histopathologic examination. Finally, blood samples were taken to measure the serum glucose level and biochemical factors including triglycerides, total cholesterol, high-density lipoprotein, serum glutamic pyruvic transaminase, and serum glutamic oxaloacetic transaminase using standard methods.
According to the results, administration of Melissa officinalis extract significantly reduced glucose, total cholesterol, low-density lipoprotein, and creatine phosphokinase levels in the diabetic group (P As the findings indicated, oral and topical administrations of Melissa officinalis extract accelerated the wound healing process and may act as an cardioprotective agent.

Diabetic wound is a common complication of diabetes. The aim of this study was to evaluate the effects of topical application of Lotus corniculatus hydroalcoholic extract on cutaneous wound healing in diabetic rats induced by streptozocin (STZ) in comparison with Phenytoin ointment in rat.Methods and Materials: In this interventional experimental study, male Wistar rats (250±20 g) were divided randomly to normal and diabetic groups. Diabetes was induced by intraperitoneal injection of STZ (60 mg/kg). After anesthesia, full thickness skin of upper dorsal part of rats removed in 2cm2 area. 24 hours after operation, wound in each animal treated once daily with L. corniculatus hydroalcoholic extract (40%) or phenytoin ointment (1%) in normal and diabetic group. Control group received no treatment. Wound surface area measured until 24th postoperative days. The time required for complete healing was also recorded. The progress of wound healing in diabetic animals was slower than in normal animals, and also healing effect of L. corniculatus extract compared with controls and normal Phenytoin and diabetic test groups was significant (p<0.001). Topical application of L. corniculatus might be accelerate the wound healing after seven day and it was comparable to phenytoin cream in diabetes-related complications.

•Recent studies indicate that vacuum compression therapy (VCT) of the foot may offer benefits in patients with intermittent claudication through improving arterial and venous blood flow. Regarding this mechanism, we investigated the effectiveness of VCT in the treatment of diabetic leg and foot ulcers. In a clinical trial study, sixteen patients with diabetic foot ulcer received VCT plus routine management for 4 weeks and twelve controls received only routine treatments. The reduction in the size and depth of ulcer were compared between two groups after the study. The mean reduction of ulcer size after the study in VCT group was 1.26 1.37 cm², while in controls the size of ulcer was increased. 44. 89 cm² (P=.000). The depth of ulcer in VCT group was significantly decreased (4.0 1.5 mm) versus a slight increase (.3. 5 mm) in control group (P=. 000).•VCT can be used as an effective method in the treatment of diabetic leg and foot ulcers. Although it’s limits and contraindications should be kept in mind.