Factors Associated with Healing Outcomes in Primary Care Patients with Diabetic Foot Ulcers: A Retrospective Study in a Multiethnic Sample

Abstract

OBJECTIVE:To identify and determine patient-and ulcer-related factors associated with healing outcomes within 3 months for patients with diabetic foot ulcer (DFU) in a multiethnic primary care sample. METHODS:Retrospective data were collected over 3 months from 520 primary care patients with a DFU between April 1, 2016 and March 31, 2017. Multivariable prevalence ratios (PRs) were calculated using Poisson regression to find associations between patient-and ulcer-related factors and healing outcomes. RESULTS:Most patients were male (66%) and Chinese (49.8%) and had a diabetes mellitus duration longer than 5 years (81.8%). Toe ulcers (64%) were most common. Healing occurred for 33.9% of participants; 19.1% and 1.5% underwent minor and major amputation, respectively. Wound sizes between 1 and 10 cm 2 (PR, 0.61; 95% confidence interval [CI], 0.46-0.76; P < .001) and over 10 cm 2 (PR, 0.

Description and Utilization of Telewound Monitoring Services in Primary Care Patients with Acute Wounds in Singapore: A Retrospective Study

“…The findings align with a recent study conducted in Singapore in a chronic wound population in primary care 21 . The mean wound area in the present study (7.8 ± 21.2 cm 2 ) was comparable to the findings of a recent study conducted in Singapore on patients with diabetic foot ulcer (7.0 ± 12.5 cm 2 ) 22 . However, the mean age of the participants (27.9 ± 12.4 years) in the present study was much younger compared with the reported age of the patients with chronic wounds (61.2 ± 4.6 years) and diabetic foot ulcers (66.3 ± 11.3 years) 21,22 …”

Risk profiling in the prevention and treatment of chronic wounds using artificial intelligence

“…Healing prediction is one of the most challenging issues in wound management and is a key component to achieve wound closure. 14 Most health conditions are complex, but none more so than chronic wounds. The multifactorial complex nature of wounds, in particular those that are chronic, makes prediction by humans difficult (ie, not an exact science).…”

“…In this sense, moving research from isolated risk factors to "wound" pattern recognition, by means of identification of the complex pattern of interactions among the web of the wound and patient impactors, is necessary. 14,27,28 A sort of Wound Bed Preparation (WBP) on steroids! Although difficult, it is feasible to identify and even understand the regularities of a web of impactors using real data and statistical modelling.…”

“…Healing prediction is one of the most challenging issues in wound management and is a key component to achieve wound closure 14 . Most health conditions are complex, but none more so than chronic wounds.…”

“…The adoption of a complex systems approach 18,25,26 may push wound care forward in terms of concepts and methods to improve healing prediction, for example. In this sense, moving research from isolated risk factors to “wound” pattern recognition, by means of identification of the complex pattern of interactions among the web of the wound and patient impactors, is necessary 14,27,28 . A sort of Wound Bed Preparation (WBP) on steroids!…”