Defective closure of diabetic foot ulcers associated with a higher risk of wound recurrence

Results from a new study of diabetic foot ulcers and the risk of wound recurrence show that a new approach can help healthcare workers measure the likelihood that the wound will reopen in the future. Researchers say these findings are likely to lead to further studies aimed at decreasing amputation rates for the tens of millions of people with diabetes in the United States.

"Diabetic foot ulcers develop in diabetic patients with diabetic neuropathy, a condition which causes numbness in the foot," said Chandan Sen, Ph.D., Distinguished Professor and J Stanley Battersby Chair of Surgery at IU School of Medicine. "The nerves in the skin become dysfunctional, which can cause patients to injure the affected foot without feeling it. Those untreated wounds can lead to infections, and if an infection is not treated quickly, an amputation may be necessary."

Sen is the principal investigator of the transepidermal water loss (TEWL) trial of the Diabetic Foot Consortium, which includes seven sites across the country. It's the first consortium for diabetic foot ulcers in the U.S.

Researchers found those with a high TEWL reading (>30 grams per meter squared per hour), signifying poor skin barrier function, had twice the incidence of wound recurrence compared to those with a low TEWL reading (<30g.m-2.h-1). In addition, participants' self-reported recurrence was highly concordant with the clinician’s assessment of wound recurrence. Although TEWL was not validated as a biomarker in this study, the findings of the study are an important advancement in that direction.

Sen said wound recurrence is a major healthcare cost burden, but this method of measuring TEWL is easy for healthcare providers to use with just 30 minutes of training.

"This is a transformative scientific discovery that will help further efforts to validate the biomarker and therefore improve the quality of life of patients with diabetes," Sen said. "We look forward to future studies of this method that will ultimately lead to new clinical practices to help patients all over the world."

Reference: Defective closure of diabetic foot ulcers associated with a higher risk of wound recurrence

https://medicaldialogues.in/diabetes-endocrinology/news/defective-closure-of-diabetic-foot-ulcers-associated-with-higher-risk-of-wound-recurrence-113620.