20^th Asia Pacific Diabetes Conference

Biography

Biography: Emilio Galea

Abstract

A growing proportion of diabetic foot ulcers are being diagnosed as neuro-ischemic. Diabetic Foot Ulcers (DFUs) score high in the incidence of chronic wounds; the annual population-based incidence of DFUs ranges from 1.0% to 4.1%, with a lifetime incidence that may be as high as 25% globally. Neuro-ischemia predominately leads to the development of ulcers on the margins of the foot, toes and dorsum of the foot rather than at pressure sites from poorly fitting shoes. Management of this type of wound is complex, requiring prompt referral, debridement where indicated, appropriate footwear, offloading, dressings and the treatment of infection. Although neuro-ischemic ulcers are the most common DFUs, until recently, no studies have assessed the superiority of any device in a cohort of patients with only neuro-ischemic ulcers and no device or drug has demonstrated efficacy in neuro-ischemic DFU treatment. The discovery that matrix metalloproteinases and neovascularization are involved has led to the identification and study of nano-oligosaccharide factor (KSOS molecule), which shows promise in treating this challenging condition. Conducted on 240 patients across five European countries, the explorer study represents a clinical research first in the field of diabetic foot ulcers. The randomized, double-blind study compares the efficacy and tolerance of the TLC-NOSF matrix to those of a neutral dressing on neuro-ischemic diabetic foot ulcers. Reactions to the Explorer RCT have been very promising, where it was suggested that the results are certainly more encouraging than findings for most interventions that have been reported to date. An overview will be provided regarding the global burden of diabetic neuro-ischemic ulcers and the results of the ground-breaking double-blind study published in ‘The Lancet’, that has identified effective local treatment of these devastating ulcers.