Diabetic foot ulcers, which are slow to heal and often reopen, can significantly impact a patient’s health. A recent study has applied a method used for burn patients to assess the likelihood of a foot ulcer’s recurrence by measuring water loss from the skin. The results suggest this could be a valuable tool for doctors in predicting ulcer relapses.
Foot ulcers are a common complication of diabetes and are a leading cause of non-traumatic amputations. They can be particularly difficult to treat due to their slow healing process and tendency to reopen.
In the study, researchers used a method previously applied to burn patients to measure the degree of water loss from the skin. Burn patients often experience high transepidermal water loss (TEWL) due to damaged skin, which affects healing. TEWL is a well-established indicator of skin barrier function. The study aimed to see if high TEWL, signaling poor skin integrity, could predict the risk of diabetic foot ulcers returning.
“The study is an important step in providing clinicians with a reliable tool to predict ulcer recurrence,” said Dr. Teresa Jones, a co-author of the study and Program Director at the NIH’s National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK). “Being able to assess which wounds are most likely to reopen could save many lives and limbs.”
Over 400 adults with a diabetic foot ulcer that appeared healed were enrolled in the study. Researchers measured TEWL at five points around the wound, as well as on healthy skin on the opposite foot. The study followed participants for up to 16 weeks to track whether the ulcers reopened.
Of the participants, 21.5% experienced a recurrence of the ulcer. Among them, 35% had high TEWL, while only 17% with low TEWL had a recurrence. Those with high TEWL were 2.7 times more likely to report a wound reopening than those with low TEWL.
“This research links clinical results, like wound closure, with patient outcomes such as remission days,” the researchers explained. “It emphasizes the need to reconsider how we measure wound healing by including skin barrier restoration at the wound site.”
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