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DETERMINE THE FACTORS AFFECTING THE DIABETIC FOOT WOUND HEALING: PROSPECTIVE STUDY DESIGN

Dr Athar Nafees Mutahhari, Dr Muhammad Aasam Masoom Maan, Dr Syed Kumail Abbas Razvi

Objective: To determine the risk factors for infected DFUs and their association between ulcers characteristics, with healing time of DFUs.hospital Design: prospective study. Setting: This study was carried out in Hussain Medical Complex Rawalpindi. Patient(s): 340 patients (216 male and 124 female) DFU patients who attended the clinic presented with infection. Main Outcome Measure(s): healing time of wound, factors that causes delayed healing Result(s): 340 patients (216 male and 124 female) DFU patients who attended the Hussain Medical Complex Rawalpindi. (mean age: 58.1±10.8 years old), 41.5% presented with infection with a mean cross-sectional ulcer area of 21.5±33.2cm2. Binary logistic regression analysis revealed that patients of Chinese ethnicity (OR: 3.39; 95%CI 1.49 to 7.70), with fasting blood glucose ≥7mmol/l (OR: 3.41; 95%CI 1.57 to 7.39), ulcer size ≥10cm2 (OR: 2.90; 95%CI 1.45 to 5.82) and blood pressure ≥140/90mmHg (OR: 2.52; 95%CI 1.54 to 4.14) were more likely to develop DFI. The median healing time for patients with DFUs was three months. Six variables were significantly associated with prolonged healing time of DFU, namely presence of infection (p<0.05) poor glycemic control with fasting blood glucose ≥7mmol/l (p<0.05) high blood pressure ≥140/90mmHg (p<0.05) large DFU size ≥2cm2 (p<0.05). History of amputation (p<0.05). And plantar location of the DFU (p<0.05). Conclusion: Increase in healing time of DFUs was correlated with a history of amputation, presence of infection, high blood glucose level, high blood pressure, large DFU size and location on the plantar. The results also showed that, despite being extensively educated, treated with proper wound care and provided with proper offloading, 14.8% of the DFUs patients healed within one to six months and 27.6% of them took >6 months to be healed. Thus, recognizing factors associated with delayed wound healing is important to gain a better understanding of DFUs that do not respond adequately to the treatment. Identifying patients with high risk of delayed healing allows early intervention and preventative measures in future treatments. Key words: diabetic foot ulcer ● healing time ● infection rate ● risk factor ● wound care

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