Treatment of Diabetic Foot Ulcer in a 58-year-old Turkman Patient based on Iranian Traditional Medicine
AbstractIntroduction: Diabetic foot ulcer is among serious problems for diabetic patients and its treatment is very complicated and requires great care. Inappropriate responses to various medical and surgical treatments have made this complication problematic.Case Presentation: The patient was a 58-year-old man with diabetes for more than twenty five years and hospitalized with complaint of diabetic foot ulcers, uncontrolled blood sugar, and sepsis at Shohadaye Gonbad Kavus hospital in June 2015. The patient's foot ulcer did not respond to conventional treatments, and amputation order was made by his treating orthopedist. The patient referred to traditional medicine clinic for counselling. The patient had two wounds on the right foot in Zone 1 (Right 11 X and 1 XR) with a diameter of approximately 5 cm by 6 cm and Zone 2 (Right 9 Y and 6, 7, 10 X) with a diameter of approximately 12 cm by 5 cm which was equivalent to STAGE D/GRADE III according to clinical examination by traditional medicine physician based on the standards of Texas University Diabetic Wound Classification System, and equivalent to GRADE 4 based on the standards of Wagner Comprehensive System for Wound Diabetic Foot. The patient's health and nutrition was under control. Pharmaceutical measures in this patient were including the herbal medicines (including both uni- and multi-component medicines), and conventional antihyperglycemic drugs. The manual actions were including full back cupping every night until the end of therapy, massage therapy, and leech therapy inside and around the wound with 10 to 12 fine,medium and big leeches in 16 sessions every 2 to 4 days. The diabetic foot ulcer healed completely, the patient's physical and mental states improved, and his blood sugar was controlled after 60 days of treatmentConclusion: It seems that combining the modern and traditional medicine can treat most of the common diseases especially diabetic foot ulcer and it is essential to perform a wide range of assessments and studies in different diseases based on the Iranian effective medicine.
Levin ME. Pathogenesis and management of diabetic foot lesion. In: Levin ME, O'Neal LW, Bowker JH,editors. The Diabetic Foot. 5th ed. St. Louis:Mosby;1993. 17-60.
Wild S,Roglic G,Green A,Sicree R,King H.Global prevalence of diabetes.DiabetesCare 2004; 1047- 1053
Wieman TJ, Smiell JM, Su Y. Efficacy and Safety of Topical gel formulation of recombinantHuman platelet-Derived growth factor- BB (Beclapermin) in patients with chronicNeuropathicDiabetic ulcers.DiabetesCare 1998; 21: 822-7.
Larijani B, Afshari M, Bastan Hagh MH, Pajouhi M,Baradar Jalili R, Moadi M . Prevalence of lower limb amputation in patients with diabetic foot ulcer in Imam Khomeini and Shariati hospitals,1979-2001. J Med Council of Islamic of Iran 2005; 1: 29-25.Persion.
Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005; 12 (293):217-28.
RamachandranA. Specific problems of the diabetic foot in developing countries. DiabetesMetab Res Rev 2004;20 (Suppl 1):S19-22.
TheDiabetesControl andComplicationsTrialResearch Group. Lifetime benefits and costs of intensive therapy as practiced in the Diabetes Control and Complications Trial. JAMA1996; 276:1409-1415.
SaarWE, Lee TH, Berlet GC. The economic burden of diabetic foot and ankle disorders. Foot Ankle Int 2005; 26:27-31.
Reiber GE, Vileikyte L, Boyko EJ,et al. Pathways for incident lower-extremity ulcers in patientswith diabetes fromtwo settings.;DiabetesCare 1999;22:157-162.
Larijani B, Afshari M, Darvishzade F, Bastan Hagh MH, Pajouhi M, Baradar Jalili R, et al. Lower limb amputation in patientswith diabetic foot ulcer:A22 year review.MJIRC2006;8(3):21-24.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its-complitions. Part1: diagnosid and classification of diabetes mellitus,provisional report of WHO Consulation. Diabet Med 1998; 15(7):539-53
Wagner FW. Supplement: algorithms of foot care. In:LevinME,ONealLW, editors.The diabetic foot. 3rd ed.St.Louis,MO,CV:Mosby; 1983. 291-302.
OyiboSO, JudeEB,Tarawneh I,NguyenHC,Harkless LB,BoultonAJ.Acomparison of two diabetic foot ulcerclassification systems: theWagner and theUniversity ofTexas wound classification systems Diabetes Care 2001; 24:84-8.
Wieman TJ, Smiell JM, SuY. Efficacy and safety of a topical gel formulation of recombinant human plateletderived growth factor-BB(becaplermin) in patientswith chronic neuropathic diabetic ulcers. A phase III randomized placebo controlled double-blind study.DiabetesCare 1998;21(5):822-7.
McCulloch D, Asla R. Management of diabetic foot lesions.UpToDateVer 18.1 (updated 31 Jan 2010).
Lavery LA.AmstrongDG,Harkless LB.Classification of diabetic foot ulcerations 1. FootAnkle Surg 1996; 35: 528-31
Wagner.The diabetic foot.Orthopedics. .l987; 10: l63-l72.
Kalish J, Hamdan A.Management of diabetic foot problems.JVasc surg 2010; 51(2):476-486
Kargar, Saeid; Javadzadeh-Shahshahani, Hayedeh;Tabkhi, Naeimeh. The effect of platelet gel on treatment of diabetic foot ulcers. Research Quarterly of Blood,2009; 6: 91-283.
Ardeshir-Larijani, Mohammad-Bagher; Afshari,Mojgan; Fadaei, Manijeh; Bastan-Hagh, Mohammad-Hassan; Baradar-Jalili, Reza; Pajouhi, Mohammad;"Study on the Effect of local epidermal growth factor onwound healing in diabetic foot". Iranian Journal of Endocrinology andMetabolism, 2003; 5: 107-110.
Moudi, Hesam; Akbari, Asghar; Ghiasi, Fatemeh;Mahmoudzadeh-Sagheb, Hamidreza; Heidari, Zahra;Rashidi, Homeyra. "The impact of transpression Vacuum-compression therapy (VCT) on healing the diabetic foot ulcers". Scientific Journal of Zanjan University ofMedicalSciences, 2006; 14: 15-22.
Ataei-Fashtami, Leila; Esmaeili-Javid, Alireza;Kaviani, Ahmad; Ardeshir-Larijani, Mohammad-Bagher; Razavi, Laleh; Salami, Maliheh; Fateh,Mohsen; Fatemi, Seyed-Mostafa; Mortazavi, Seyed-Mohammad-Javad. The role of laser therapy in treatment of diabetic foot ulcers: a randomized, doubleblind clinical trial:Medical laser, 2008; 5: 6-11.
Zahmatkesh, Mohsen; Rashidi, Maryam. Report of a treatment case of diabetic foot ulcer by topical honey and olive oil.MedicinalPlants, 2008; 8: 36-40.
Bahrami, Amir; Ali-Asgarzadeh, Akbar; Sarabchian,Mohammad-Ali; Mobseri, Majid; Heshmat, Ramin;Ghoujazadeh, Morteza. "Double blind clinical trial for evaluating the effect of oral"Angi Pars" drug on chronic diabetic foot ulcers. Journal of Endocrinology and Metabolism, 2009; 11: 647-55.
Kashef,Nasim; Shojaeifard,Abolfazl; Esmaeili-Javid,Alireza; Mohajeri, Mohammadreza; Rezaei, Razieh;Salami, Maliheh; Ghodsi, Maryam; Fateh, Mohsen.Study on the low-power laser in treatment of chronic diabetic foot ulcers: microbiological quantitativeassessment.Medical laser.Summer 2009; 6: 31-35.
Kazemikhou, Noushafarin; Khamseh, Mohammad-Ebrahim; Hashem-Dabbaghian, Fattaneh; Hajizadeh,Mitra; Akrami, Seyed-Mohammad. "The study on the effects of low-power laser in treatment of diabetic foot ulcers grades 2 and 3 (short report)". Iranian Journal of Diabetes and Metabolism (Iranian Journal of Diabetes andLipid), 2008; 8: 195-202.
Amini, Sareh; Rezaei-Homami,Mohsen;Anabestani,Zohreh; Shaygan-Mehr, Zahra; Ardeshir-Larijani,Mo h amma d -Ba g h e r ; Mo h a j e r i - Te h r a n i ,Mohammadreza. "The effect of low-frequency ultrasound on diabetic foot ulcerswith osteomyelitis in a randomized clinical trial". Iranian Journal of Diabetes andMetabolism (Iranian Journal of Diabetes and Lipid,2011; 10: 543-52.
Khadem-Haghighian, Hossein; Koushan, Yaghoub;Asgarzadeh, Akbar-Ali. Report of a treatment case of diabetic foot ulcer using propolis heated in olive oil,(brief report)". Journal of knowledge and health, 2011;6: 35-38.
Ardeshir-Larijani, Mohammad-Bagher; Afshari,Mojgan; Bastan-Hagh, Mohammad-Hassan; Pajouhi,Mohammad; Baradar-Jalili, Reza; Maadi, Mansoureh."Study on the prevalence of lower limb amputation in patients with diabetic foot ulcer at Shariati and Imam Khomeini Hospital from 1969 to 2001". Scientific Journal of IRIMedicalCouncil, 2005; 23: 25-29.
Keshavarzi, Azam; Larijani, Bagher; Mohajeri-Tehrani, Mohammadreza. "Modern treatment of diabetic foot ulcer (reviewed article). Scientific Journal of IRIMedicalCouncil, 2011; 29: 90-376.
Alami-Harandi, Bahador; Alami-Harandi, Armin;Siavashi,Babak. "Areviewof diabetic foot ulcers and its newtherapeutic approaches". Journal of Iranian surgery,2008; 16: 1-7.
Ghanei, Laleh; Harati, Hadi; Hadaegh, Farzad;Azizi,Fereydoun. "Study on the impact of lifestyle change on incidence of type II diabetes over a 3.5-year study:Tehran Lipid and Glucose Study". Research on medicine, 2009; 33: 21-29.