PMID- 32141182
OWN - NLM
STAT- MEDLINE
DCOM- 20210721
LR  - 20210721
IS  - 1524-475X (Electronic)
IS  - 1067-1927 (Linking)
VI  - 28
IP  - 4
DP  - 2020 Jul
TI  - High-dose folic acid and its effect on early stage diabetic foot ulcer wound 
      healing.
PG  - 517-525
LID - 10.1111/wrr.12804 [doi]
AB  - High-dose folic acid (HDFA; vitamin B9)-5 mg, given daily, has not been evaluated 
      as a treatment to improve early stage-diabetic foot ulcer (ES-DFU) wound healing. 
      However, HDFA has been demonstrated to correct: (a) endothelial dysfunction and 
      decreased nitric oxide (NO) bioavailability, associated with type-2 diabetes 
      mellitus (T2DM); and (b) hyperhomocysteinemia (HHcy) that may promote impaired 
      DFU-wound healing. Measures of wound area (cm(2) ) reduction (wound closure; WC), 
      over a 4-week period (4 W-WC), greater than 50% of the wound area, have been 
      reported as a robust indicator of the potential for DFU-wound healing. By using 
      this model, we examined the effectiveness of a wound treatment in promoting 
      progressive healing and complete wound closure for the chronic, nonhealing 
      DFU-wound. To investigate this possible relationship between HDFA and ES-DFU 
      wound healing, a retrospective cohort study of medical records, between November 
      2018 and April 2019, was performed for Veterans with T2DM and ES-DFUs following 
      treatment with HDFA. During the study period 29 (n = 29) Veterans with ES-DFU 
      wounds who received HDFA treatment were identified. Medical record reviews of 
      this retrospective cohort of ES-DFU Veterans receiving HDFA report 90% (26/29) 
      experiencing complete DFU-wound closure during the study period. Of the 29 
      Veterans with ES-DFUs receiving HDFA, the medical records of nine (30%), with 
      healed wounds, provided documentation suitable for 4 W-WC, pre- and post-HDFA 
      treatment study comparisons. This study documents significant (P < .05) 
      improvements comparing 4 W-WC values for standard treatment for Veterans with 
      poorly progressing, worsening or stagnating ES-DFU-wounds to those for the same 
      subjects following HDFA treatment. These observations suggest that chronic 
      ES-DFUs treated with HDFA may experience significantly improved wound closure and 
      complete healing (re-epithelialization) when compared with standard treatments 
      without HDFA. With validation from RCTs, HDFA may be established as an effective 
      treatment to promote wound healing and closure for nonhealing ES-DFUs.
CI  - Published 2020. This article is a U.S. Government work and is in the public 
      domain in the USA.
FAU - Boykin, Joseph V Jr
AU  - Boykin JV Jr
AUID- ORCID: 0000-0002-1583-7001
AD  - Department of Surgery/Plastic Surgery, Hunter Holmes McGuire Department of 
      Veterans Affairs Medical Center, Richmond, Virginia, USA.
AD  - Department of Surgery/Plastic Surgery, Virginia Commonwealth University Health 
      System, Richmond, Virginia, USA.
FAU - Hoke, Glenn D
AU  - Hoke GD
AD  - Department of Surgery/Plastic Surgery, Hunter Holmes McGuire Department of 
      Veterans Affairs Medical Center, Richmond, Virginia, USA.
FAU - Driscoll, Cassandra R
AU  - Driscoll CR
AD  - Department of Surgery/Plastic Surgery, Hunter Holmes McGuire Department of 
      Veterans Affairs Medical Center, Richmond, Virginia, USA.
AD  - Department of Surgery/Plastic Surgery, Virginia Commonwealth University Health 
      System, Richmond, Virginia, USA.
FAU - Dharmaraj, Benita S
AU  - Dharmaraj BS
AD  - Department of Surgery/Plastic Surgery, Hunter Holmes McGuire Department of 
      Veterans Affairs Medical Center, Richmond, Virginia, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20200330
PL  - United States
TA  - Wound Repair Regen
JT  - Wound repair and regeneration : official publication of the Wound Healing Society 
      [and] the European Tissue Repair Society
JID - 9310939
RN  - 12001-76-2 (Vitamin B Complex)
RN  - 935E97BOY8 (Folic Acid)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Diabetes Mellitus, Type 2/*complications
MH  - Diabetic Foot/*drug therapy/etiology
MH  - Female
MH  - Folic Acid/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Re-Epithelialization
MH  - Retrospective Studies
MH  - Veterans
MH  - Vitamin B Complex/*administration & dosage
MH  - *Wound Healing
EDAT- 2020/03/07 06:00
MHDA- 2021/07/22 06:00
CRDT- 2020/03/07 06:00
PHST- 2019/10/07 00:00 [received]
PHST- 2020/02/08 00:00 [revised]
PHST- 2020/02/20 00:00 [accepted]
PHST- 2020/03/07 06:00 [pubmed]
PHST- 2021/07/22 06:00 [medline]
PHST- 2020/03/07 06:00 [entrez]
AID - 10.1111/wrr.12804 [doi]
PST - ppublish
SO  - Wound Repair Regen. 2020 Jul;28(4):517-525. doi: 10.1111/wrr.12804. Epub 2020 Mar 
      30.