Emilio Galea
Urgo International, UAE
Keynote: J Diabetes Metab
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 encouragin g 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 groundbreaking
double-blind study published in â??The Lancetâ??, that has identified effective local treatment of these devastating ulcers.
Recent Publications
1. Galea E (2018) A Breakthrough in the management of neuro-ischemic diabetic foot ulcers. Diabetic Foot Journal Middle
East; 4(1): 46 49.
References
1. Dalla Paola L, Carone A, Vasilache L and Pattavina M (2015) Overview on diabetic foot: a dangerous, but still orphan,
disease. Eur Heart J; 17: A64-8.
2. Dinh T, Tecilazich F, Kafanas A, et al. (2012) Mechanisms involved in the development and healing of diabetic foot
ulceration. Diabetes; 61(11): 2937-47.
3. Münter K C, Meaume S, Augustin M, et al. (2017) The reality of routine practice: a pooled data analysis on chronic wounds
treated with TLC-NOSF wound dressings. J Wound Care; 26(2): S4-15.
4. Ren Y, Gu G, Yao M and Driver V R (2014) Role of matrix metalloproteinases in chronic wound healing: diagnostic and
therapeutic implications. Chin Med J; 127(8): 1572-81.
5. Schaper N C, Van Netten J J, Apelqvist J, Lipsky B A and Bakker K (2016) Prevention and management of foot problems in
diabetes: a Summary Guidance for Daily Practice 2015, based on the IWGDF Guidance Documents. Diabetes/Metabolism
Research and Reviews; 32(1): 7-15.
Emilio Galea has started his career in healthcare in 1985 in Malta where he held different positions, from direct care, Clinical Instructor and Examiner with the Institute of Healthcare and managerial positions. He went to the Middle East in 2007 as a Clinical Resource Nurse and then as an Assistant Director of Nursing. His role included the function of Wound Management Advisor. He contributes regularly to magazines and wound care journals and published the ‘Wound Care Product Catalogue’ that provided guidelines regarding advanced wound care products in SEHA facilities. He is currently the International Medical Director for Urgo International. He holds an MSc Skin Integrity Skills and Treatment from the University of Hertfordshire, UK and his personal and professional objective is to facilitate, through education, evidence based wound management practice.
E-mail: emiliogalea@mail.com
