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Diabetic foot ulcers (DFUs) are a major burden on the health-care system. The purpose of this study is to investigate factors affecting the healing rate of DFU in a university wound care center. Records of DFU patients treated between July 2013 and February 2015 were reviewed. Demographics, comorbidities, wound characteristics, and treatment modalities including offloading, hyperbaric oxygen treatment, total contact casting, and bioengineered skin were investigated. All patients underwent weekly debridement regardless of treatment modality. A total of 114 patients ages 18 to 98 comprised the study population. Total contact casting was the only treatment associated with increased healing (P = 0.02). Smoking (P = 0.004) and deep vein thrombosis history (P = 0.001) significantly decreased the likelihood of wound healing. Patients with past vascular event trended toward longer healing times (P = 0.07). Total contact casting in combination with weekly wound debridement showed benefit in DFU wound healing, whereas patients with a history of deep vein thrombosis and smoking were less likely to heal.
ACCORDING TO THE American Diabetes Association, the annual cost of diabetes was $245 billion in 2012: $176 billion in excess health-care expenditures and $69 billion in reduced workforce productivity.1 Diabetes mellitus has many complications linked to the disease; one prominent and costly issue associated with diabetes is diabetic ulcers. The estimated cost for care of diabetic foot ulcers (DFU) is approximately $1.5 billion annually.2 Diabetic ulcers pose an additional health threat to a patient. If left untreated, diabetic ulcers can lead to possible amputation and death. Wound treatment is vital to how quickly healing occurs, and many different factors account for the healing time of diabetic ulcers. Chronic wounds have also been shown to have a significant impact on quality of life. Individuals with chronic wounds have a quality of life comparable to those with long-term or progressive diseases, such as heart failure.3-5 This retrospective study aims to investigate the variables that influence the healing of diabetic ulcers to provide improved treatment in a wound care population treated at a university-based wound care center.
Methods
Population
In this study, patient variables were collected in a retrospective fashion and analyzed to better understand their association with a healed wound. Deidentified data from records of all patients treated for DFU in...