Wound Care Treatments for Patients with Diabetes
Posted on Wed, Oct 28, 2009 @ 02:25 PM
People with diabetes are especially prone to foot problems, so it's important to take good care of your feet and inspect them frequently. According to The National Institute of Diabetes and Digestive and Kidney Diseases, diabetic foot lesions are responsible for more hospitalizations than any other complication of diabetes. Among patients with diabetes, 15% develop a foot ulcer, and 12-24% of individuals with a foot ulcer require amputation.
A compounding pharmacy has the ability to work with your medical provider and custom make medications specifically for diabetic wounds and wound management. Medications can be compounded into topical formulations that may improve wound healing, reduce side effects, and minimize treatment costs. The following are some medications that a compounding pharmacist and your medical provider may consider utilizing when treating certain diabetic wounds.
Phenytoin
- Promotes granulation (tissue proliferation) in a healing wound
- Inhibits formation of collagenase, thereby, increasing collagen synthesis
- Decreases exudates, alleviates pain, exerts an antimicrobial effect, counteracts inflammation
- Proven effective in treatment of decubitus ulcers, traumatic wounds, diabetic and burn ulcers
- Used topically as solution, gel, cream, at concentrations of 1% - 10%
Nifedipine
- Inhibition of calcium influx into smooth muscles decreases vascular tone, thereby, increasing blood flow and vascularization of treated area.
- Used topically at 5 - 20% concentrations
Misoprostol
- Synthetic prostaglandin used primarily to protect gastric mucosa by replacing endogenous prostaglandins depleted by medications such as NSAIDs. Drug's mechanism of action aids in the acceleration of wound healing.
- Used topically at very low concentrations
Pentoxifylline
- Phosphodiesterase inhibitor used to reduce blood viscosity and improve circulation. Enhances vascular permeability resulting in increased blood flow and oxygen delivery to wound site. Improves functions of red and white blood cells and platelets.
- Used topically at concentrations of 5% to 15%.
Gentamicin / Clindamycin / Polymyxin B
- Gentamicin - most active against aerobic gram-negative rods, but it is also used in combination with other antibiotics to treat Staphylococcus aureus and certain species of streptococcus.
- Clindamycin - anti-anaerobic activity, either bacteriostatic or bactericidal, depending on its concentration at the site of action and on the specific susceptibility of the organism being treated.
- Polymyxin B - spectrum of activity is limited to gram-negative bacteria, bactericidal against most gram-negative bacilli; however, some Proteus and Serratia species may be resistant. Polymyxin B has no in vitro activity against gram-positive organisms or fungi.
Metronidazole
- Antibacterial and antiprotozoal agent with effective coverage against many anaerobic organisms
- Used topically, also provides control of wound odor.
If you suffer from diabetes and notice any changes in the appearance of your feet make sure to consult with your medical provider to diagnose the issue, and ask him/her to contact a compounding pharmacy that specializes in wound care.