Diabetic Extremity Lower Ulcers
Conditions
Keywords
methylene blue, Photodynamics Therapy
Brief summary
The investigators designed this prospective, randomized control study to confirm the efficacy and safety of methylene blue - mediated photodynamic therapy for diabetic lower limb ulcer and to explore its mechanism.
Detailed description
OBJECTIVE- Infection is associated with poor healing of diabetic lower limb ulcer. Diabetic lower limb ulcer are often lower extremity vascular stenosis or occlusion, poor blood supply, making local ulcer local antibacterial drugs difficult to effectively reach and distribution, resulting in systemic antibacterial efficacy is limited, and easy to induce bacterial resistance at the same time . In recent years, the incidence of clinical multidrug-resistant bacteria increased, increasing the difficulty and cost of treatment. The current study attempts to identify whether the photodynamic therapy (PDT) would kill the surface of ulcer bacteria and promote ulcer healing, and explore the mechanism of methylene blue-mediated photodynamic therapy for diabetic lower limb ulcer RESEARCH DESIGN AND METHODS-This study evaluated six clinical indicators： diabetic foot ulcer area reduction rate, inflammation control rate, Local bacterial load, the dose and use time of antibiotics, adverse reaction rate, bacterial biofilm,local neutrophil extracellular traps. The efficacy and safety of PDT could be confirmed if the clinical indicators of PDT group is better than the control group. In this study, three methods were used to investigate the mechanism of -methylene blue mediated photodynamic therapy for diabetic lower limb ulcer: a comparison of the bacterial load, bacterial biofilm,local neutrophil extracellular traps of the ulcer immediately pre-treatment and immediately,1-week ,2 week,1 momth post-treatment ; EXPECTED RESULTS-The investigators will expect that methylene blue-mediated photodynamic therapy could kill bacteria on the surface of diabetic lower limb ulcer and accelerate wound healing.
Interventions
COMBINATION_PRODUCTmethylene blue
Continue treatment after 5mins suspension if the patient feels that the local temperature is too high to stand
COMBINATION_PRODUCTPhoton therapy instrument
Continue treatment after 5mins suspension if the patient feels that the local temperature is too high to stand
Sponsors
Chongqing Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* 1\. Understand the whole test process, voluntary and signed informed consent form. * 2\. Men and women aged 18 to 80 years old. * 3\. Diagnosed with diabetic lower limb ulcer. * 4\. Ulcer duration\> 1 month of wagner grade Ⅱ, Ⅲ subjects. * 5\. An ulcer area ≤100 cm² or of linear dimension ≤ 10 cm.
Exclusion criteria
* 1\. Diagnosis of systemic infection or any concomitant infection that would require treatment with an additional antimicrobial agent. * 2\. Pregnant or lactating women. * 3\. Wagner grade Ⅰ, Ⅳ, Ⅴ subjects. * 4\. Patients with a peripheral vascular disease require immediate revascularization, and/or an ankle brachial systolic blood pressure (SBP) index\<0.5 in the infected limb. * 5\. Patients with inappropriate health to participate as determined by the principal investigators. * 6\. Patients in the hepatitis A, hepatitis B, AIDS, tuberculosis and other infectious diseases of the active period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline （Ulcer area）in the diabetic lower limb ulcer at day 7 | Baseline and day 7 | Changes of ulcer area before and after treatment |
| Change from baseline (immediately before the first treatment) in the bacterial load of the ulcer at one hour (immediately after the first treatment) | Baseline and (immediately after the first treatment)，day 7,14,21,28 | Changes of local bacterial load before and after treatment |
| Change from baseline(bacterial biofilm） | Baseline and day 7,14,21,28 | Changes of local bacterial biofilm before and after treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| A comparison of local NET neutrophil extracellular traps before the first treatment and after the tenth treatment | Baseline and day 7,14,21,28 | Fluorescence intensity and area of local NET |
| The dose of antibiotics | 7 days during treatment | Dosage of antibiotics during treatment |
| Inflammation control rate | 7 days during treatment | Duration of inflammation |
| The time of antibiotics | 7 days during treatment | Antibiotic use time during treatment |
| Adverse events | 7 days during treatment | including pain,redness, and swelling |
Countries
China
Contacts
Primary ContactQingfeng Cheng, PhD
Outcome results
None listed