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Wound fluid lactate concentration: a helpful marker for diagnosing soft‐tissue infection in diabetic foot ulcers? Preliminary findings
Published on Feb 1, 2011in Diabetic Medicine 3.13
· DOI :10.1111/j.1464-5491.2010.03123.x
M. Löffler1
Estimated H-index: 1
,
D. Zieker1
Estimated H-index: 1
+ 7 AuthorsStefan Beckert16
Estimated H-index: 16
Abstract
Diabet. Med. 28, 175–178 (2011) Abstract Aims  To investigate the impact of wound fluid lactate concentration on diagnosing soft-tissue infection in diabetic foot ulcers. Methods  Lactate concentration in wound fluid obtained from diabetic foot ulcers was determined using a lactate analyser and compared with clinical examination findings. Results  Overall median wound fluid lactate concentration was 21.03 mm (5.58–80.40 mm). Wound lactate levels were significantly higher in infected compared with non-infected diabetic foot ulcers (P = 0.001). Non-infected diabetic foot ulcers that healed within 6 months of treatment showed a significantly lower wound fluid lactate concentration at baseline as opposed to those that did not heal (P = 0.007). Conclusions  Non-healing diabetic foot ulcers are characterized by high wound fluid lactate levels. Assessment of wound fluid lactate concentration might be helpful for confirming the suspicion of soft tissue infection, particularly when clinical signs are atypical.
  • References (14)
  • Cited By (19)
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References14
Published on Mar 1, 2000in British Journal of Surgery 5.43
Nigel Unwin50
Estimated H-index: 50
(University of Newcastle)
Background: This study was established to enable a comparison of lower extremity amputation incidence rates between different centres around the world. Methods: Ten centres, all with populations greater than 200 000, in Japan, Taiwan, Spain, Italy, North America and England collected data on all amputations done between July 1995 and June 1997. Patients were identified from at least two data sources (to allow checks on ascertainment); denominator populations were based on census figures. Results...
245 Citations Source Cite
Published on Aug 1, 2007in Antioxidants & Redox Signaling 6.53
Thomas K. Hunt65
Estimated H-index: 65
(University of California, San Francisco),
Rummana Aslam10
Estimated H-index: 10
+ 5 AuthorsChandan K. Sen74
Estimated H-index: 74
Hypoxia serves as a physiological cue to drive angiogenic response via HIF-dependent mechanisms. Interestingly, minor elevation of lactate levels in the tissue produces the same effect under aerobic conditions. Aerobic glycolysis contributes to lactate accumulation in the presence of oxygen especially under inflammatory conditions. We have previously postulated that aerobic lactate accumulation, already known to stimulate collagen deposition, will also stimulate angiogenesis. If substantiated, t...
122 Citations Source Cite
Published on May 1, 2006in Diabetes Care 13.40
Stefan Beckert16
Estimated H-index: 16
,
Maria B. Witte13
Estimated H-index: 13
+ 2 AuthorsStephan Coerper16
Estimated H-index: 16
OBJECTIVE —Several well-accepted classification systems are available for diabetic foot ulcers. However, there are only a few and scientifically not validated severity scores. The aim of this study was to establish a new wound-based clinical scoring system for diabetic foot ulcers suitable for daily clinical practice anticipating chances for healing and risk of amputation. RESEARCH DESIGN AND METHODS —Four clinically defined parameters, namely palpable pedal pulses, probing to bone, ulcer locati...
86 Citations Source Cite
Published on Jun 1, 2007in Journal of Bacteriology 3.22
Stephan Fuchs16
Estimated H-index: 16
,
Jan Pané-Farré18
Estimated H-index: 18
+ 2 AuthorsSusanne Engelmann44
Estimated H-index: 44
An investigation of gene expression in Staphylococcus aureus after a switch from aerobic to anaerobic growth was initiated by using the proteomic and transcriptomic approaches. In the absence of external electron acceptors like oxygen or nitrate, an induction of glycolytic enzymes was observed. At the same time the amount of tricarboxylic acid cycle enzymes was very low. NAD is regenerated by mixed acid and butanediol fermentation, as indicated by an elevated synthesis level of fermentation enzy...
179 Citations Source Cite
Published on Mar 1, 2007in Journal of Investigative Dermatology 6.45
Sabine A. Eming35
Estimated H-index: 35
(University of Cologne),
Thomas Krieg58
Estimated H-index: 58
(University of Cologne),
Jeffrey M. Davidson56
Estimated H-index: 56
(Vanderbilt University)
In post-natal life the inflammatory response is an inevitable consequence of tissue injury. Experimental studies established the dogma that inflammation is essential to the establishment of cutaneous homeostasis following injury, and in recent years information about specific subsets of inflammatory cell lineages and the cytokine network orchestrating inflammation associated with tissue repair has increased. Recently, this dogma has been challenged, and reports have raised questions on the valid...
1,030 Citations Source Cite
Published on Apr 1, 2006in Diabetic Medicine 3.13
Susan O'Meara22
Estimated H-index: 22
(University of York),
E. A. Nelson24
Estimated H-index: 24
(University of York)
+ 3 AuthorsCynthia P Iglesias29
Estimated H-index: 29
(University of York)
Aim To undertake a systematic review of the diagnostic performance of clinical examination, sample acquisition and sample analysis in infected foot ulcers in diabetes. Methods Nineteen electronic databases plus other sources were searched. To be included, studies had to fulfil the following criteria: (i) compare a method of clinical assessment, sample collection or sample analysis with a reference standard; (ii) recruit diabetic individuals with foot ulcers; (ii) present 2 × 2 diagnostic data. S...
40 Citations Source Cite
Published on Dec 5, 2005in International Journal of Medical Microbiology 3.30
Christian Kohler15
Estimated H-index: 15
,
Susanne Wolff6
Estimated H-index: 6
+ 5 AuthorsMichael Hecker83
Estimated H-index: 83
Abstract Staphylococcus aureus is a versatile human pathogen causing a wide variety of diseases ranging from wound infection to endocarditis, osteomyelitis, and sepsis. In order to investigate this pathogen, we sought to analyze the cytoplasmic proteome of S. aureus COL by using two different approaches: two-dimensional (2D) gel analyses combined with matrix-assisted laser ionization-time of flight mass spectrometry and a gel-free system using multidimensional liquid chromatography followed by m...
71 Citations Source Cite
David G. Armstrong14
Estimated H-index: 14
(University of Texas at San Antonio),
Theresa A. Perales1
Estimated H-index: 1
+ 2 AuthorsJohn G. Welchon1
Estimated H-index: 1
(University of Texas at San Antonio)
The authors reviewed the admission leukocyte indices of 338 consecutive admissions (203 males, 135 females, mean age of 60.2 +/- 12.9 years) with a primary diagnosis of diabetic foot infection in a multicenter retrospective study. The mean white blood cell count on admission for all subjects studied was calculated at 11.9 +/- 5.4 x 103 cells/mm3. Of all white blood cell counts secured for patients admitted with a diabetic foot infection, 56% (189 out of 338) were within normal limits. The averag...
53 Citations Source Cite
Published on Nov 1, 2005in The Lancet 53.25
Peter R. Cavanagh69
Estimated H-index: 69
(Cleveland Clinic Lerner College of Medicine),
Benjamin A. Lipsky68
Estimated H-index: 68
(University of Washington)
+ 1 AuthorsGeorgeanne Botek9
Estimated H-index: 9
(Cleveland Clinic)
People with diabetes develop foot ulcers because of neuropathy (sensory, motor, and autonomic deficits), ischaemia, or both. The initiating injury may be from acute mechanical or thermal trauma or from repetitively or continuously applied mechanical stress. Patients with clinically significant limb ischaemia should be assessed by a vascular surgeon to determine the need for angioplasty, stenting, or femorodistal bypass. When infection complicates a foot ulcer, the combination can be limb or life...
273 Citations Source Cite
Published on Nov 1, 2005in The Lancet 53.25
Andrew J.M. Boulton84
Estimated H-index: 84
(University of Manchester),
Loretta Vileikyte24
Estimated H-index: 24
(University of Manchester)
+ 1 AuthorsJan Apelqvist53
Estimated H-index: 53
(Lund University)
Diabetic foot problems are common throughout the world, resulting in major economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable, in developing countries, which will experience the greatest rise in the prevalence of type 2 diabetes in the next 20 years. People at greatest risk of ulceration can easily be identified by careful clinical examination of the feet: education and frequent follow-...
1,152 Citations Source Cite
Cited By19
Published on Jan 1, 2012
Sabrina R. Kapoor3
Estimated H-index: 3
,
Martin Fitzpatrick4
Estimated H-index: 4
+ 3 AuthorsStephen P. Young2
Estimated H-index: 2
Inflammation is a normal and extraordinarily important component of responses to infection and injury. The cardinal features of swelling, redness, stiffness and increasing temperature are strong indicators of the significant changes in tissue metabolism and the ingress of immune cells into the tissues. The increase in blood flow which underlies many of these changes may result in changes to the supply of nutrients and in particular the level of oxygen in the tissues. Inward migration of immune c...
3 Citations Source Cite
Published on Jan 1, 2011
Markus Löffler1
Estimated H-index: 1
,
Michael Schmohl4
Estimated H-index: 4
+ 1 AuthorsStefan Beckert16
Estimated H-index: 16
Wound fluid seems -at least theoreticallyeasily accessible and might open a new window to the local wound microenvironment that cannot be evaluated by the analysis of serum or plasma markers. Recently, this strategy has been supported by a first time wound fluid proteome analysis comparing acute and chronic wounds (Eming et al. 2010). Interestingly, there seem to be essential differences with respect to wound fluid protein composition when comparing acute and chronic wounds. The wound fluid prot...
5 Citations Source Cite
Published on Nov 1, 2015in Diabetes Research and Clinical Practice 2.55
Emer Van Ryswyk4
Estimated H-index: 4
(University of Adelaide),
Philippa Middleton43
Estimated H-index: 43
(University of Adelaide)
+ 2 AuthorsCaroline A Crowther56
Estimated H-index: 56
(University of Adelaide)
Abstract Aim To identify factors influencing postpartum healthcare seeking, from the perspective of women who have experienced gestational diabetes mellitus (GDM). Methods Systematic review that searched PubMed, Web of Science, EMBASE and CINAHL on 27th February 2013. Qualitative studies and surveys, with women as participants, which reported pre-specified outcomes, including barriers and facilitators to healthcare seeking for GDM after birth, were included. Two authors independently extracted d...
13 Citations Source Cite
Markus W. Löffler8
Estimated H-index: 8
(University of Tübingen),
Heiko Schuster12
Estimated H-index: 12
(University of Tübingen)
+ 1 AuthorsStefan Beckert16
Estimated H-index: 16
(University of Tübingen)
Valid and reproducible sampling techniques as well as processing protocols are required for the assessment of biomarkers and mediators contained in wound exudate. Moreover, the ideal technique should be easy to use even in daily clinical routine. This is challenging since wound fluid represents an inhomogeneous mixture of different exogenous and endogenous sources. Analyzing wound fluid, however, may facilitate clinical decision making. Many techniques for obtaining wound fluid have been describ...
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Published on Jan 1, 2012in Cellular Physiology and Biochemistry 5.50
Carl-Christoph Schneider1
Estimated H-index: 1
,
Atesch Ateschrang10
Estimated H-index: 10
+ 6 AuthorsDerek Zieker17
Estimated H-index: 17
Background/Aims: Wounds, especially non-healing wounds are characterized by elevated tissue lactate concentrations. Lactate is known for being able to stimulate collagen synthesis and vessel growth. Lately it has been shown that lactate, in vivo, plays an important role in homing of stem cells. With this work we aimed to show the influence of lactate on the gene expressionprofile of human mesenchymal stem cells (hMSC). Materials and Methods: hMSCs were obtained from bone marrow and characterized...
2 Citations Source Cite
Aqsa Ali1
Estimated H-index: 1
(Frankston Hospital),
John Botha12
Estimated H-index: 12
(Frankston Hospital),
Ravindranath Tiruvoipati7
Estimated H-index: 7
(Frankston Hospital)
Abstract INTRODUCTION Acinetobacter baumannii is usually associated with respiratory tract, urinary tract and bloodstream infections. Recent reports suggest that it is increasingly causing skin and soft tissue infections. It is also evolving as a multidrug resistant organism that can be difficult to treat. We present a fatal case of multidrug resistant A. baumannii soft tissue infection and review of relevant literature. PRESENTATION OF CASE A 41 year old morbidly obese man, with history of alco...
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Published on Nov 1, 2012in Diabetes Care 13.40
Michael Schmohl4
Estimated H-index: 4
(University of Tübingen),
Stefan Beckert16
Estimated H-index: 16
(University of Tübingen)
+ 3 AuthorsMarkus W. Löffler8
Estimated H-index: 8
(University of Tübingen)
OBJECTIVE In diabetic foot ulcers, wound fluid inflammatory mediators have previously been proposed as surrogate markers for nonhealing. However, currently available wound fluid sampling techniques are not suitable for clinical practice due to low levels of exudate and a high logistical effort. The aim of this investigation was to assess 1 ) the technique of superficial wound swabbing for harvesting wound fluid; and 2 ) the quality of the collected fluid for immunoassay analysis of inflammatory ...
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Published on Jul 1, 2012in Biotechnology Progress 1.95
Stephen T. Britland9
Estimated H-index: 9
(University of Bradford),
Oliver Ross-Smith1
Estimated H-index: 1
(University of Bradford)
+ 3 AuthorsPeter Vowden22
Estimated H-index: 22
(Bradford Royal Infirmary)
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Published on Jul 1, 2015in Wound Repair and Regeneration 2.95
Carla Kruse5
Estimated H-index: 5
(Brigham and Women's Hospital),
Kristo Nuutila8
Estimated H-index: 8
(Brigham and Women's Hospital)
+ 5 AuthorsJens Ahm Sørensen23
Estimated H-index: 23
(Odense University Hospital)
The skin wound microenvironment can be divided into two main components that influence healing: the external wound microenvironment, which is outside the wound surface; and the internal wound microenvironment, underneath the surface, to which the cells within the wound are exposed. Treatment methods that directly alter the features of the external wound microenvironment indirectly affect the internal wound microenvironment due to the exchange between the two compartments. In this review, we focu...
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Published on Sep 1, 2014in Wound Repair and Regeneration 2.95
Mette Sørensen33
Estimated H-index: 33
(University of Copenhagen),
Lars Jelstrup Petersen25
Estimated H-index: 25
(Aalborg University)
+ 2 AuthorsStine Jacobsen24
Estimated H-index: 24
(University of Copenhagen)
As in other fibroproliferative disorders, hypoxia has been suggested to play a key role in the pathogenesis of exuberant granulation tissue (EGT). The purpose of this study was to investigate metabolism and blood flow locally in full-thickness wounds healing with (limb wounds) and without (body wounds) formation of EGT. Microdialysis was used to recover endogenous metabolites from the wounds, and laser Doppler flowmetry was used to measure blood flow. Measurements were performed before wounding ...
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