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Iodosorb* Abstract 10

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Iodosorb Cadexomer Matrix with Iodine

 

Male, 65 years old, with diabetic ulcers of the right foot.


M Marazzi, MD; MN Ordanini, MD; Y Uysal, MD; L Falcone, MD; V Rapisarda, MD.


Tissue Therapy Dept., Plastic Surgery & Burn Centre, Niguarda Hospital Milan (Italy)

 

Abstract

 

Introduction
The latest statistical estimates indicate the number of diabetes affected people worldwide to rise to 220 million people in 2010, 3 million of them being in Italy, and 15% of them developing ulcers during their life. Infection is on eof the major complication of diabetic foot ulcers and can lead to delayed healing and in the worst case to amputation. It therefore still represents a challenge for the clinician taking care of wound treatment and has to be faced by a multidisciplinary team of specialists and nurses.
Aim of this study is to present our experience in diabetic foot ulcers in the management of exudate and bacterial burden with cadexomer iodine.

 

The Patient
Male, 65 years old, with diabetic ulcers of the right foot (one plantar ulcer, not shown and a necrotic ulcer of the third finger (Fig. A). Daily application of Iodosorb powder (Fig. B). Conversion to dry necrosis in the to course of the treatment (Fig. C and D). Outcome (autoamputation) after 30 days (Fig. E).

 

Method
10 diabetic patients were admitted to our hospital ward with exuding foot ulcers, resulting positive at swabs cultures for Staphylococcus aureus and/or Pseudomonas aeruginosa and/or Proteus mirabilis. In 4 cases clinical signs of osteomyelitis were present and bone involvement confirmed by X-rays examination and scintigraphy. Local application of a slow release formulation of cadexomer iodine in powder was started, aiming at wound bed preparation in terms of infection and exudates control, and continued until positive outcome. Medication change was performed on average, depending on exudate level, every 2 days. Systemic antibiotic treatment with telcoplanin was associated in the acute phase.

 

Results
We treated 10 diabetic patients (40-87 yrs; 6M, 4F) with exuding foot ulcers of diabetic origin with Iodosorb powder. Patients achieved complete wound healing in 1 to 2 months (30-65 days) depending on wound depth and size (4-25 cm2). At treatment end the absence of infection was confirmed by swab culture. The product was also effective in the management of heavy exudates and odour control. No adverse events were reported in the treatment course.

 

Discussion
The safety and efficacy of cadexomer iodine powder in the management of infected diabetic foot ulcers was confirmed in this case collection. The product combines anti-infective and exudates-managing properties and is particularly useful in critical cases at high risk of infection and amputation.

 

Summary points:
Infection is one of the major complication of diabetic foot ulcers and can lead to delayed healing and in the worst case to amputation
Cadexomer Iodine is an effective and proved drug for the management of infected and exuding chronic ulcers
The anti-infective and exudates-managing properties of Cadexomer Iodine as well as the good tolerability were confirmed in our case series of diabetic patients with infected high risk foot ulcers.

 

Diabetic foot ulcer

Fig 1

 

Diabetic foot ulcer

Fig 2

 

Diabetic foot ulcer

Fig 3

 

Diabetic foot ulcer

Fig 4

 

Diabetic foot ulcer

Fig 5