{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T18:35:36Z","timestamp":1773858936083,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,8,13]],"date-time":"2012-08-13T00:00:00Z","timestamp":1344816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:sec><jats:label\/><jats:p>Diabet. Med. 29, e255\u2010e262 (2012)<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aim\u2002<\/jats:bold> To test the hypothesis that fluconazole plus standard care is superior to the standard care for diabetic foot wounds infected with deep\u2010seated fungal infections.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> We carried out a randomized, controlled, open\u2010label, parallel\u2010arm study in 75 patients with both fungal and bacterial infections in deep tissues of diabetic foot wounds. Thirty\u2010seven patients (control group) were given standard care (surgical debridement\u2003+\u2003culture\u2010specific antibiotics\u2003+\u2003offloading\u2003+\u2003glycaemic control) and 38 patients (treatment group) were given fluconazole 150\u2003mg daily plus standard care. Wound surface area was measured every 2\u2003weeks until the endpoints (complete epithelialization or skin grafting) were met.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> By week\u20034, the mean wound surface area reduced to 27.3 from 111.5\u2003cm<jats:sup>2<\/jats:sup> in the treatment group, as opposed to 67.1 from 87.3\u2003cm<jats:sup>2<\/jats:sup> in the control group. Subsequently, the mean wound surface areas were remarkably smaller in the treatment group compared with the control group, and statistically significant differences (<jats:italic>P<\/jats:italic>\u2003\u2264\u20030.05) in mean wound surface area were observed between the treatment group and the control group at week\u20036. However, no statistically significant (<jats:italic>P<\/jats:italic>\u2003\u2264\u20030.47) difference in complete healing was observed between the treatment group and the control group, 20 vs. 24. The mean wound healing time for the treatment group was 7.3\u2003weeks, whereas for the control group it was 11.3\u2003weeks (<jats:italic>P<\/jats:italic>\u2003\u2264\u20030.022). Similarly, the probability of wound healing in the treatment group was 50 vs. 20% in the control group at week\u200310.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Fluconazole plus standard care was superior to standard care alone in accelerating wound reduction among patients with diabetes with deep\u2010seated fungal infections in diabetic foot wounds. Those in the treatment group who did heal, healed more quickly (<jats:italic>P<\/jats:italic>\u2003\u2264\u20030.022), but overall healing was not different.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1464-5491.2012.03574.x","type":"journal-article","created":{"date-parts":[[2012,1,17]],"date-time":"2012-01-17T05:11:31Z","timestamp":1326777091000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Targeted treatment of invasive fungal infections accelerates healing of foot wounds in patients with Type\u20032 diabetes"],"prefix":"10.1111","volume":"29","author":[{"given":"G.","family":"Chellan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Neethu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. K.","family":"Varma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. S.","family":"Mangalanandan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Shashikala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. R.","family":"Dinesh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. R.","family":"Sundaram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Varma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. V.","family":"Jayakumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,8,13]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2008.00466.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.7.1029"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2008.00457.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.2337\/diab.40.10.1305","article-title":"Chronology and determinants of tissue repair in diabetic lower\u2010extremity ulcers","volume":"40","author":"Pecoraro RE AJ","year":"1991","journal-title":"Diabetes Care"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1534734606297987"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1308\/003588407X205404"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.476"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta13540"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67700-8"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.59.110106.132000"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0901870106"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02035-09"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(09)80301-0"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(90)70075-S"},{"key":"e_1_2_6_16_2","doi-asserted-by":"crossref","first-page":"3396","DOI":"10.1128\/JCM.36.11.3396-3398.1998","article-title":"Efficacy of API\u200320C and ID32C systems for identification of common and rare clinical yeast isolates","volume":"36","author":"Ramani SG","year":"1998","journal-title":"J Clin Microbiol"},{"key":"e_1_2_6_17_2","first-page":"170","article-title":"Identification and antifungal susceptibility of Candida isolates from various clinical specimens in Doctor Behcet Uz Hospital","volume":"3","author":"Tulumoglu S","year":"2009","journal-title":"J Clin Invest"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.6.1879"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2010.00602.x"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-10-54"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31819f1f50"},{"key":"e_1_2_6_22_2","doi-asserted-by":"crossref","first-page":"S161","DOI":"10.1093\/clinids\/14.Supplement_1.S161","article-title":"Azole antifungal agents","volume":"14","author":"Bodey GP","year":"1992","journal-title":"Clinical Infect Dis"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.1997.tb00230.x"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/13693780802144339"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/12.Supplement_3.S318"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.03.021"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1464-5491.2012.03574.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1464-5491.2012.03574.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T06:29:46Z","timestamp":1698733786000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1464-5491.2012.03574.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,8,13]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["10.1111\/j.1464-5491.2012.03574.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1464-5491.2012.03574.x","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,8,13]]},"assertion":[{"value":"2012-08-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}