WCET Journal - Chinese Edition

Background Recurrent foot ulcers in people with Diabetes Mellitus (DM) represent a significant clinical challenge, with rates that can reach between 28% and 42% in the first year, and 69% in five years.

Aim This study conceptualises the recurrence of foot ulcers in individuals with DM and the incidence between the concepts.

Methods A scoping review was conducted according to the Joanna Briggs Institute (JBI) guidelines. Eight databases were searched (LILACS, Medline, BDENF, SciELO, PubMed, Web of Science, Science Direct, and Embase), 2976 studies were identified. Of these, 2939 did not meet the inclusion criteria or were duplicates, resulting in 37 studies included in the research.

Results A narrative description revealed a lack of consensus in defining diabetic foot ulcer recurrence (DFUR), with significant variations among the analysed studies and variations in incidence rates reported by the different classifications of diabetic foot ulcer recurrence concept in the studies. Within one, three, and five years following complete healing of the initial ulcer, DFUR1 showed incidence rates ranging from 24.1% to 42.4%, DFUR2 from 40% to 60.5%, and DFUR3 from 32.4% to 70%.

Future Directions Currently, there is great heterogeneity in the concept of what constitutes a recurrence. The DFUR standard represents a significant change for the field of scientific research, facilitating the communication and understanding of preventive strategies and therapeutic measures effective in reducing DFUR.

Conclusion The results reinforce the need to standardise concepts for effective prevention and treatment strategies .associated with developing a recurrence.

Aims To report the outcome of using Bioelectric Dressings (BED) in reducing bioburden and enhancing the healing of a chronic Venous Leg Ulcer (VLU).

Methods A case report of a patient with a recalcitrant VLU over the right anterior ankle, recurring three times since August 2023, presented to the outpatient wound clinic. The most recent recurrence of the VLU, measuring 7.1cm x 5.5cm (39.05cm²) post-surgery, was treated with nanocrystalline silver dressing and two-layer compression bandaging (40 mmHg) for 32 days, reducing the size to 22.55cm² (57.8%). The treatment was then switched to BED with compression bandaging, achieving further reduction to 16.5cm² (42.2%) in 21 days, successfully healing the wound.

Results The VLU has taken in total of 53 days to heal. The wound healing rate was 1.8% per day, while treated with nanocrystalline silver dressing as the primary dressing in the first 32 days. Then the primary dressing was switched to BED, the wound healing rate was 2% per day, in the subsequent 21 days of treatment. The VLU site was fully healed, leaving residual hyperpigmentation and hyperkeratosis at the anterior ankle.

Conclusion BED has shown some promise in accelerating epithelialisation and transitioning wounds from the inflammatory to the proliferative phase.

There are many hydrocolloid skin barriers (HSBs) available to ostomy patients, making it difficult to determine the differences among ostomy products and offerings. The materials that are used to formulate the HSB is one perspective to classify different HSB types. Here, I classify HSBs, (traditional, infused, insoluble), based on their materials. Specifically, I focus on the use of the super absorbent polymer (SAP) in the HSB, by measuring fluid management and durability properties. This was conducted by comparing three different HSB products from two different companies. The results show the differences in performance for two different types of SAP, soluble and insoluble (iSAP). I further show how formulating with an iSAP can be optimised with an additional property, such as pH balancing, to create an HSB formulation defined as an iSAP+.

Objective This case study summarises nurses’ experiences in managing a case of severely infected wounds from bilateral extensive Wagner Scale Grade 4 diabetic foot ulcers (DFU) in conjunction with multidisciplinary team cooperation (MDT).

Methods MDT consultation was conducted to establish a clear diagnosis and focus on systemic comprehensive treatment. The treatment plan was adjusted over time according to the results of the wound cultures and antibiotic tests to effectively control the infection. Lipid hydrocolloid foam dressings and negative pressure wound treatment were applied based on evidence to effectively manage the exudate.

Results The patient’s left foot healed in 59 days and the right foot healed in 38 days. In the following three years, Wechat follow-up was conducted and the patient did not develop recurrent DFUs or infections in either foot.

Conclusion MDT cooperation in determining the differential diagnosis, developing a clear treatment plan comprehensive treatment of Grade 4 severe infected diabetic foot ulcers can accelerate wound healing, relieve the patient pain and reduce the financial burden to the patient and their family.