References
Management of diabetic foot ulcers using topical probiotics in a soybean-based concentrate: a multicentre study
Abstract
Objective:
Diabetic foot ulcer (DFU) is a common complication in people with diabetes. Standard management includes strict glycaemic management, control of the infection, revascularisation, debridement, mechanical offloading and foot care education. This study aimed to evaluate the efficacy of using topical probiotics in a soybean-based concentrate in the management of DFUs
Method:
A retrospective, multicentre evaluation of patients with diabetes with non-infected DFUs between October 2020 and October 2021, and who were treated with twice daily topical application of probiotics in a soybean-based concentrate as an adjunct to standard wound care.
Results:
A total of 22 patients were enrolled into this study, including 16 males and six females, with a mean age of 61 years (range: 31–89 years). Defect size ranged from 1–33.5cm2 (mean: 7.2cm2). The mean number of days until complete healing was 51 (range: 21–112 days). Of the patients, 83% showed complete healing at the end of 16 weeks, 72% showed complete healing at 12 weeks, 56% at eight weeks, and 22% at four weeks. The wounds showed an average decrease in size of 0.59cm2 (9%) per week, calculated using generalised estimating equation.
Conclusion:
This findings of this study provide a new perspective on the therapeutic potential of probiotics as an effective form of management in patients with small, hard-to-heal (chronic) DFUs.
Diabetic foot ulcer (DFU) is a common complication in people with diabetes worldwide. Approximately 34% of all patients with diabetes will develop some form of lower extremity ulcer and, of these, an estimated 12% will ultimately require lower limb amputation.1
Standard management of DFUs includes: strict glycaemic management; infection control, both locally and systemically; revascularisation of the ischaemic limb; debridement; mechanical offloading; and foot care education.2 Currently, there is a wide range of advanced wound care therapies available for the management of DFUs and all are effective to a certain degree.3,4
The majority of us are unaware of the beneficial role of probiotics when administered topically in the management of wounds. Numerous reports show that oral administration of probiotics plays a beneficial role in managing diabetes, respiratory tract infections, gastrointestinal disorders, urogenital infections, certain skin inflammatory diseases, and hard-to-heal (chronic) wounds.5–12 There are now emerging reports of the beneficial effects of using probiotics topically in the management of wounds.5,13–16 Soy protein has been shown to be beneficial to wound healing by increasing dermal extracellular matrix (ECM) synthesis and stimulating re-epithelialisation. It has bioactive peptides similar to ECM proteins present in human tissues. These ECM-mimetic peptides can promote cell adhesion, proliferation and migration, critical for supporting wound healing.17,18 However, the application of topical probiotics in a soybean concentrate for advanced wound care has not been well described.
Register now to continue reading
Thank you for visiting Journal of Wound Care's World Union of Wound Healing Supplement and reading some of our peer-reviewed resources for healthcare professionals. To read more, please register today.