Sheehan P, Jones P, Giurini JM, Caselli A, Veves A, et al.
Plastic and reconstructive surgery. Date of publication 2006 Jun 1;volume 117(7 Suppl):239S-244S.
1. Plast Reconstr Surg. 2006 Jun;117(7 Suppl):239S-244S.
Percent change in wound area of diabetic foot ulcers over a 4-week period is a
robust predictor of complete healing in a 12-week prospective trial.
Sheehan P(1), Jones P, Giurini JM, Caselli A, Veves A.
Author information:
(1)Diabetes Foot and Ankle Center, Hospital for Joint Diseases Orthopaedic
Institute, New York University School of Medicine, New York, NY, USA.
Republished from
Diabetes Care. 2003 Jun;26(6):1879-82.
OBJECTIVE: To assess the ability of the 4-week healing rate to predict complete
healing over a 12-week period in a large prospective multicenter trial of
diabetic patients with foot ulceration.
RESEARCH DESIGN AND METHODS: We examined the change in ulcer area over a 4-week
period as a predictor of wound healing within 12 weeks in patients who were seen
weekly in a prospective, randomized controlled trial.
RESULTS: Wound area measurements at baseline and after 4 weeks were performed in
203 patients. The midpoint between the percentage area reduction from baseline at
4 weeks in patients healed versus those not healed at 12 weeks was found to be
53%. Subjects with a reduction in ulcer area greater than the 4-week median had a
12-week healing rate of 58%, whereas those with reduction in ulcer area less than
the 4-week median had a healing rate of only 9% (P < 0.01). The absolute change
in ulcer area at 4 weeks was significantly greater in healers versus nonhealers
(1.5 versus 0.8 cm2, P < 0.02). The percent change in wound area at 4 weeks in
those who healed was 82% (95% CI 70-94), whereas in those who failed to heal, the
percent change in wound area was 25% (15-35; P < 0.001).
CONCLUSIONS: The percent change in foot ulcer area after 4 weeks of observation
is a robust predictor of healing at 12 weeks. This simple tool may serve as a
pivotal clinical decision point in the care of diabetic foot ulcers for early
identification of patients who may not respond to standard care and may need
additional treatment.
DOI: 10.1097/01.prs.0000222891.74489.33
PMID: 16799391
