Can Advance Wound Care Healing Response Be Predicted Based on Wound Area?

Problem: In 2010, there were approximately 26 million people in the US with diabetes and ranked as the seventh leading cause of death.  Over 85% of lower limb amputations in patients with diabetes are preceded by ulceration.  Purpose: To review data from patients treated with a bio-engineered dermal tissue construct to verify if any correlations can be made in regards to wound area and weeks of therapy required to see full wound closure. Method: 24 diabetic foot ulcers after treatment with bio-engineered dermal tissue construct.  Data was collected on DFU location, ulcer area prior to treatment, and weeks of treatment needed until complete wound closure. Results: The average initial wound area of the 24 patients reviewed was 6.55 cm². The wound chronicity averaged over 15 weeks prior to initiation of therapy. The average time to complete closure for the patients was 6.04 weeks. Conclusions: With varying wound sizes/areas and different locations of the foot the ability of a healthcare provider to forecast healing rate or success based on initial wound area is not possible.  The recommendation remains to utilize advanced therapy in diabetic foot ulcers with less than 50% reduction in area over 4 weeks of conventional therapy.  Once that level of clinical experience has been achieved, the ability to heal diabetic foot ulcers regardless of size/location on the foot is possible as seen within our clinical experience. It is hoped that studies of this type will allow for enhanced clinician education, patient safety and prove beneficial to facilities.