A Novel Potential Treatment for Diabetic Foot Ulcers and Non-Healing Ulcers - Case Series


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Abstract

Introduction::Appropriate care and treatment of a wound is the need of the hour whether it is an infected or a non-infected wound. If wound healing is delayed for some reason, it leads to serious complications and further increases the hospital stay and cost of treatment. Herein, we describe a novel antimicrobial wound dressing formulation (VG111), with an objective to generate the preliminary data showing the distinct advantages in various types of wounds.

Method::This case series involved the treatment of acute cases of wounds or chronic wounds that did not respond well to conventional wound healing treatments with VG111 in patients with different etiologies. Thirteen cases of patients that included patients with diabetes, pressure ulcers, burns, trauma, and others treated with VG111 showed rapid wound healing in all the cases even obviating the need for a graft when complete skin regeneration occurred.

Result::This was illustrated by clearing of the wound infections, reduction/disappearance of the exudate, appearance of intense granulation, epithelialization, and anti-biofilm activity followed by complete wound closure. This VG111 precludes the need for systemic antimicrobial agents in localized infections and therefore, this single agent is an attempt to address the limitations and the drawbacks of the available products.

Conclusion::Despite patients belonging to the old age group and having comorbidities like diabetes, still VG111 showed effective rapid wound healing, and that too without any scar formation in hardto- heal, infected, and non-infected wounds.

About the authors

Sarabpreet Singh

Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education and Research

Email: info@benthamscience.net

Arun Kumar Aggarwal

Radiation oncology, Aadhar Hospital

Email: info@benthamscience.net

Rajendra Gudisa

Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research

Email: info@benthamscience.net

Priyam Batra

Department of Medical Microbiology, All India Institute of Medical Sciences

Email: info@benthamscience.net

Nitesh Kumar Rathi

Department of Orthopaedics, Saveetha Institute of Medical and Technical Sciences

Email: info@benthamscience.net

Vibha Madan

, Miri Piri Hospital

Email: info@benthamscience.net

Vipul Thakur

Department of General Surgery, Post Graduate Institute of Medical Education and Research

Email: info@benthamscience.net

Harish Sharma

General Surgery, Aadhar Hospital

Email: info@benthamscience.net

Rajesh Kumar

Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research

Email: info@benthamscience.net

Siddhant Khare

Department of General Surgery, Post Graduate Institute of Medical Education and Research

Email: info@benthamscience.net

Lipika Singhal

Department of Microbiology, Government Medical College and Hospital

Email: info@benthamscience.net

Rama Chaudhry

Department of Medical Microbiology, All India Institute of Medical Sciences

Email: info@benthamscience.net

Neeraj Arora

Department of Microbiology, Civil Hospital

Email: info@benthamscience.net

Hardeep Singh

Department of General Surgery, Civil Hospital

Email: info@benthamscience.net

Jasjeet Kaur

, CMO, MT SAKET Hospital and Physiotherapy College

Email: info@benthamscience.net

Ashish Sharma

Department of Renal Transplant Surgery, Post Graduate Institute of Medical Education and Research

Email: info@benthamscience.net

Ganesh Dakhale

Department of Pharmacology, All India Institute of Medical Sciences (AIIMS)

Email: info@benthamscience.net

Vijay Sharma

Department of Orthopedics, Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS)

Email: info@benthamscience.net

Vikas Gautam

Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research

Author for correspondence.
Email: info@benthamscience.net

References

  1. Bhattacharya S, Mishra RK. Pressure ulcers: Current understanding and newer modalities of treatment. Indian J Plast Surg 2015; 48(1): 004-16. doi: 10.4103/0970-0358.155260 PMID: 25991879
  2. Dumville JC, Lipsky BA, Hoey C, Cruciani M, Fiscon M, Xia J. Topical antimicrobial agents for treating foot ulcers in people with diabetes Cochrane Database Syst Rev 2017; (6): doi: 10.1002/14651858.CD011038.pub2
  3. Okur ME, Karantas ID. Şenyiğit Z, Üstündağ Okur N, Siafaka PI Recent trends on wound management: New therapeutic choices based on polymeric carriers Asian Journal of Pharmaceutical Sciences 2020; 15(6): 661-84. doi: 10.1016/j.ajps.2019.11.008 PMID: 33363624
  4. Yazarlu O, Iranshahi M, Kashani HRK, et al. Perspective on the application of medicinal plants and natural products in wound healing: A mechanistic review. Pharmacol Res 2021; 174: 105841. doi: 10.1016/j.phrs.2021.105841 PMID: 34419563
  5. Diabetes Atlas IDF. 2021. Available from: https://diabetesatlas.org/atlas/tenth-edition/ (Accessed on 2022 Sep 28)
  6. Rastogi A, Bhansali A. Diabetic foot infection: An indian scenario. J Foot Ankle Surg 3(2): 71-9.
  7. Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med 2017; 376(24): 2367-75. doi: 10.1056/NEJMra1615439 PMID: 28614678
  8. Everett E, Mathioudakis N. Update on management of diabetic foot ulcers. Ann N Y Acad Sci 2018; 153(1): 1411. doi: 10.1111/nyas.13569
  9. Walsh JW, Hoffstad OJ, Sullivan MO, Margolis DJ. Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom. Diabet Med 2016; 33(11): 1493-8. doi: 10.1111/dme.13054 PMID: 26666583
  10. Prompers L, Schaper N, Apelqvist J, et al. Prediction of outcome in individuals with diabetic foot ulcers: Focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study. Diabetologia 2008; 51(5): 747-55. doi: 10.1007/s00125-008-0940-0 PMID: 18297261
  11. Zaidi SRH, Sharma S. Pressure Ulcer Integumentary. Phys Ther 2022; 61-84.https://www.ncbi.nlm.nih.gov/books/NBK553107/
  12. Gosain A, DiPietro LA. Aging and wound healing. World J Surg 2004; 28(3): 321-6. doi: 10.1007/s00268-003-7397-6 PMID: 14961191
  13. Anderson K, Hamm RL. Factors that impair wound healing. J Am Coll Clin Wound Spec 2012; 4(4): 84.
  14. Hansson C. Interactive Wound Dressings Drugs & Aging 2012; 11(4): 271-84.https://link.springer.com/article/10.2165/00002512-199711040-00003
  15. Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World J Diabetes 2015; 6(1): 37-53. doi: 10.4239/wjd.v6.i1.37 PMID: 25685277
  16. Moura LIF, Dias AMA, Carvalho E, de Sousa HC. Recent advances on the development of wound dressings for diabetic foot ulcer treatment—A review. Acta Biomater 2013; 9(7): 7093-114. doi: 10.1016/j.actbio.2013.03.033 PMID: 23542233
  17. Melamed E, Kiambi P, Okoth D, Honigber I, Tamir E, Borkow G. Healing of chronic wounds by copper oxide-impregnated wound dressings—case series. Medicina 2021; 57(3): 296. doi: 10.3390/medicina57030296 PMID: 33809898
  18. Summa M, Russo D, Penna I, et al. A biocompatible sodium alginate/povidone iodine film enhances wound healing. Eur J Pharm Biopharm 2018; 122: 17-24. doi: 10.1016/j.ejpb.2017.10.004 PMID: 29017952
  19. Qian LW, Fourcaudot AB, Leung KP. Silver sulfadiazine retards wound healing and increases hypertrophic scarring in a rabbit ear excisional wound model. J Burn Care Res 2017; 38(1): e418-22. doi: 10.1097/BCR.0000000000000406 PMID: 28009700
  20. Gautam L, Malik YS, Panwar H, et al. Defying the odds: Natural product formulation leads to restoration of methicillin sensitivity in Methicillin-resistant S. aureus. Poster presented at the 2023 European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). April 15-18, 2023; Copenhagen, Denmark. 2023.
  21. Gautam L, Sningh KA, Kaushik S, et al. A Novel Formulation (VG111) Demonstrating Clinical Evidence of Anti-Pathogenic Activity and Accelerated Wound Healing in Humans and Companion Animals. Available at SSRN: https://ssrn.com/abstract=4251312 doi: 10.2139/ssrn.4251312
  22. Darvishi S, Tavakoli S, Kharaziha M, Girault HH, Kaminski CF, Mela I. Advances in the sensing and treatment of wound biofilms. Angew Chem Int Ed 2022; 61(13): e202112218. doi: 10.1002/anie.202112218 PMID: 34806284
  23. Gautam V. The antibiofilm effect of a natural product formulation on P. aeruginosa intact biofilm: Meeting the horizon of antibiofilm therapeutics. 2023 European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). April 15-18, 2023; Copenhagen, Denmark.
  24. Sutar NG, Sutar U, Sharma Y, Shaikh I, Kshirsagar S. Phytochemical investigation and pharmacological screening of leaves of Achyranthus aspera Linn. as analgesic and antipyretic. undefined 2016.
  25. Leavitt T, Hu MS, Marshall CD, Barnes LA, Lorenz HP, Longaker MT. Scarless wound healing: Finding the right cells and signals. Cell Tissue Res 2016; 365(3): 483-93. doi: 10.1007/s00441-016-2424-8 PMID: 27256396
  26. Best practice guidelines Wound management in diabetic foot ulcers - Wounds International. Available from: https://www. woundsinternational.com/resources/details/best-practice-guidelines-wound-management-diabetic-foot-ulcers (Accessed on 2022 Sep 28)
  27. Lipsky BA, Berendt AR, Cornia PB, et al. infectious diseases society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clinical Infect Dious Diseases 2012; 54(12)https://www.idsociety.org/practice-guideline/diabetic-foot-infections/
  28. Ahmed AA, Mooar PA, Kleiner M, Torg JS, Miyamoto CT. Hypertensive patients show delayed wound healing following total hip arthroplasty. PLoS One 2011; 6(8): e23224.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0023224 doi: 10.1371/journal.pone.0023224 PMID: 21853091
  29. Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care 2015; 4(9): 560. doi: 10.1089/wound.2015.0635
  30. Gautam L. Natural product formulation leads to restoration of methicillin sensitivity in Methicillin-resistant S. aureus. 2023 European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). Copenhagen, Denmark. April 15-18, 2023;
  31. Depypere M, Morgenstern M, Kuehl R, et al. Pathogenesis and management of fracture-related infection Clin Microbiol Infect 2020; 26(5): 572-8.https://pubmed.ncbi.nlm.nih.gov/31446152/ doi: 10.1016/j.cmi.2019.08.006 PMID: 31446152
  32. Morgenstern M, Vallejo A, McNally MA, et al. The effect of local antibiotic prophylaxis when treating open limb fractures: A systematic review and meta-analysis. Bone Joint Res 2018; 7(7): 447. doi: 10.1302/2046-3758.77.BJR-2018-0043.R1
  33. Ibrahim N. Wound healing properties of selected natural products. Int J Environ Res Public Health 2018; 15(11)
  34. Ning S, Zang J, Zhang B, Feng X, Qiu F. Botanical drugs in traditional chinese medicine with wound healing properties. Front Pharmacol 2022; 13. doi: 10.3389/fphar.2022.885484

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