Virgin coconut oil and diabetic wound healing: histopathological and biochemical analysis

Delayed wound healing (the diabetic ulcer) is one of the major complications of diabetes mellitus (DM), which has shown an increasing trend over previous decades to affect almost 15% of diabetic patients. Virgin coconut oil (VCO) is a natural oil rich in vitamins and antioxidants and possesses antimicrobial and antiviral activities. In the current study, we evaluated the effects of topical application of VCO on wound healing in diabetes-induced Sprague-Dawley rats. A total of 72 animals were divided into 4 groups: i.e. (I) non-diabetic nontreated (NN), (II) diabetic non-treated (DN), (III) diabetic treated with VCO (VCO), and (IV) diabetic treated with silver sulfadiazine cream (SS). Wounds were inflicted on all groups using punch biopsy needles, and the animals were treated for 14 days. Wound closure rate (WCR) was measured on day 5, 10, and 14. Histological analysis was performed on day 7 and 14. Total protein content and superoxide dismutase (SOD) activity were measured on day 1, 7, and 14. WCR in VCO group was higher on all days compared to DN. Histological analysis revealed that VCO promoted re-epithelialization and increased collagen content of wound tissue. Total protein content in VCO group was higher on day 7 and 14 compared to both DN and SS groups. VCO showed insignificant effects on SOD levels. In summary, VCO was found to be better than silver sulfadiazine cream in the healing of diabetic wounds via promoting reepithelialization and collagen synthesize as well as increasing WCR and total protein content

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Successful topical hemotherapy with a new occlusive dressing for an intractable ulcer on the toe.

Topical hemotherapy is a method of applying heparinized venous blood directly onto the surface of an ulcer, which is covered with an occlusive hydrocolloidal dressing. It is often effective on chronic ulcers with thick necrosis, because some proteinases and growth factors in plasma are probably involved in the digestion of necrotic tissues and the acceleration of granulation and epithelization. We treated a patient with an intractable ulcer on the toe caused by a peripheral circulatory disturbance due to her systemic sclerosis. As conventional topical hemotherapy cannot be applied to ulcers on the round tip of a toe, we made a device for occlusive dressing of topical hemotherapy which could successfully improve the previously refractory ulcer.

Diabetic foot problems in India: an overview and potential simple approaches in a developing country.

India has the highest number of people with diabetes in the world. Diabetic foot care is one of the most ignored aspects of diabetes care in India. Due to social, religious, and economic compulsions, many people walk barefoot. Poverty and illiteracy lead to usage of inappropriate foot wear and late presentation of foot lesions. Many nonphysicians are interfering in the treatment of diseases, including diabetes. Patients also try home remedies before visiting their physicians. We believe that rational improvisation is the key to success when working with diabetic foot patients in developing countries. We have developed several improvised techniques/approaches for diabetes care in general and specifically for foot care. Our techniques/approaches are based on four principles: 1) they are simple, 2) no special training is needed, 3) they are affordable, and 4) they are effective. Only simple and affordable methods are successful in the developing world.

Treatment of pododermatitis in the guinea pig.

Pododermatitis is a painful inflammation of the footpads. This column describes appropriate treatment for pododermatitis in guinea pigs.

The use of maggot therapy in the treatment of a malignant foot wound.

Mrs T presented with a necrotic wound to her right foot secondary to malignant adenocarcinoma. Maggot therapy was used to successfully debride the wound, which had failed to respond to conventional treatment. The maggot therapy removed the necrotic tissue and appeared to initiate the process of granulation, which allowed the wound to be dressed with conventional materials and progress towards healing.

Electrotherapy reverses inframalleolar ischemia: a retrospective, observational study.

OBJECTIVE: To determine if high-voltage pulsed current (HVPC) augments ischemic wound healing and increases periwound perfusion. DESIGN: A 5-year, retrospective, observational study was conducted on successive patients with ischemic wounds who were poor candidates for revascularization. INTERVENTION: HVPC was applied directly to wounds at greater than 100 volts, 100 pulses per second, 1 hour per day. In addition to HVPC, patients received standard care for ischemic wounds at the study facility. Ischemic wounds for which HVPC was not clinically indicated or not available received standard care alone. MAIN OUTCOME MEASURES: Wound area measured by planimetry, wound appearance observed by digital imaging techniques, and microcirculation monitored by transcutaneous oxygen (TcPo(2)) levels. RESULTS: The group that received HVPC plus standard care showed smaller wound areas from weeks 20 though 52 after the start of treatment compared with the group that received standard care alone (P <.05; Mann-Whitney test). One year after the start of treatment, 90% of HVPC-treated wounds were healed, compared with 29% of the wounds that received only standard care (P <.05; Fisher exact test). For the HVPC group, maximum periwound TcPo(2) improved during electrotherapy (6 +/- 8 mm Hg [standard deviation; SD] at baseline improved to 26 +/- 20 SD, during HVPC, P <.05; Wilcoxon signed rank test). CONCLUSION: The results of this retrospective trial demonstrate that HVPC plus standard care improved the healing rate of high-risk ischemic wounds. A direct relationship was shown between improved healing rates and increased periwound perfusion. A prospective randomized controlled trial is needed to further support these observational, preliminary findings.

[Structural and functional evaluation of combined local application of miliacylum and laser irradiation in the treatment of trophic ulcers]. / Strukturno-funktsional'naia ostenka vozdeistviia sochetannogo mestnogo primeneniia miliatsila i lazernogo izlucheniia pri lechenii troficheskikh iazv.

In 54 patients, suffering from trophic ulcers of lower extremities of different origin, the efficiency of local application of miliacylum and laser irradiation in combined in the treatment, was evaluated. As the result of clinical, histological, histochemical and histoautoradiographic studies, it was established that the process of trophic wound healing was more favorable in patients receiving a combined treatment by miliacylum and laser irradiation in comparison with that when only miliacylum or 1% dioxidine solution and oleum Hippophae were used. When the combination of miliacylum and laser irradiation was applied, the treatment periods were reduced 1.3 and 2 times, respectively, as compared to those ones when miliacylum or dioxidine and oleum Hippophae were used.