Effect on infection control and wound healing of diabetic foot ulcer with Indonesia complementary therapy

• Project/Area Number: 16H05852
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 海外学術
• Research Field: Clinical nursing
• Research Institution: Kanazawa University
• Principal Investigator: SUGAMA JUNKO 金沢大学, 新学術創成研究機構, 教授 (00203307)
• Co-Investigator(Kenkyū-buntansha): 真田 弘美 東京大学, 大学院医学系研究科(医学部), 教授 (50143920) ; 大江 真琴 東京大学, 大学院医学系研究科(医学部), 特任准教授 (60389939) ; 仲上 豪二朗 東京大学, 大学院医学系研究科(医学部), 准教授 (70547827)
• Research Collaborator: SURIADI
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥10,660,000 (Direct Cost: ¥8,200,000、Indirect Cost: ¥2,460,000); Fiscal Year 2018: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000); Fiscal Year 2017: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000); Fiscal Year 2016: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
• Keywords: 糖尿病性足病変 / 感染管理 / バイオフィルム / 補完代替療法 / 糖尿病 / 足潰瘍

Outline of Final Research Achievements

This study goal is to explore the new local wound infection control therapy. We conducted the prospective studies at the wound care clinic in Pontianak, West Borneo, Indonesia. At this clinic, the complementary therapies are used to manage the severe infected DFU.
The DFU wound healing, bacterial control status and biomarkers were examined every 2 weeks. Total number of this study participants was 168. Inflammatory cytokine, such as Tumor necrosis factor (TNF-α) decreased with time in sea cucumber group. Also sea cucumber showed the significant effectiveness on DFU with macerated peri-wound. However, there was no significant differences in wound healing without maceration between the sea cucumber and Apis dorsata honey. Moreover, there was no significant differences in recurrent DFU healing between Torigona honey and date. These results indicated that effect on infection control and wound healing of diabetic foot ulcer with Indonesia complementary therapy.

Academic Significance and Societal Importance of the Research Achievements

糖尿病足潰瘍は容易に感染を併発し、治癒が遷延するだけでなく、重症化すると下肢切断や敗血症による生命危機をもたらす。さらに、日常生活制限をもたらし、患者の生活の質を低下させる創傷でもある。このため局所管理において、いかに感染制御を行うかが鍵となる。欧米や本邦においては、ヨウ素外用薬、銀含有創傷被覆材を使用することが推奨されている。しかしこれらの管理法は、組織障害性、緩徐な抗菌効果などの問題点があった。本調査結果により、蜂蜜、ナマコ、ナツメヤシ等の補完代替療法が糖尿足潰瘍の感染管理に有用であることが示唆された。今後これらの成分解析、創傷治癒促進の機序解明が行われ、創傷被覆材の開発に寄与する。