The aim of this study was to identify diabetic foot ulcer (DFU) patients at risk for the development of a hard-to-heal wound. This is a post-hoc analysis of a prospective cohort study including a total of 208 patients with a DFU. The primary endpoints were time to healing and the development of a hard-to-heal-wound. Univariable and multivariable logistic and Cox regression analysis were used to study the associations of patient characteristics with the primary endpoints. The number of previous DFUs [odds ratio (OR): 1.42, 95% confidence interval (CI): 1.01-1.99, P =.04], University of Texas (UT) classification grade 2 (OR: 2.93, 95% CI: 1.27-6.72, P =.01), UT classification grade 3 (OR: 2.80, 95% CI: 1.17-6.71, P =.02), and a diagnosis of foot stand deformation (OR: 1.54, 95% CI: 0.77-3.08, P =.05) were significantly associated with the development of a hard-to-heal wound. Only UT classification grade 3 (HR: 0.61, 95% CI: 0.41-0.90, P =.01) was associated with time to healing. The number of previous DFUs, UT classification grade, and a diagnosis of foot deformation are significantly associated with development of a hard-to-heal wound in patients with a DFU. The only predictor significantly associated with time to healing was UT classification grade 3. These patient characteristics can be used to identify patients at risk for the development of hard-to-heal wounds, who might need an early intervention to prevent wound problems.

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Keywords diabetic foot ulcer, multidisciplinary team, prediction model, wound care, wound healing
Persistent URL,
Series VSNU Open Access deal
Journal International Wound Journal
Mohammad Zadeh, M. (Maryam), Lingsma, H.F, van Neck, J.W, Vasilic, D. (Dalibor), & van Dishoeck, A.M. (2019). Outcome predictors for wound healing in patients with a diabetic foot ulcer. International Wound Journal. doi:10.1111/iwj.13194