Risk Factors for Delayed Rate of Diabetic Foot Wound Healing
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- Category: Vol. 78, September 2010
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Risk Factors for Delayed Rate of Diabetic Foot Wound Healing,OSSAMA A. MOSTAFA
Abstract
Objective: To explore the impact of some risk factors on delayed healing of foot ulcers among diabetics, especially in case of suboptimal glycemic control.
Subjects and Methods: This study was conducted at the "Diabetes Center" at the Armed Forces Hospital at the Southern Region, Kingdom of Saudi Arabia. A total of 200 records of diabetic patients with foot ulcers were analyzed. The wound size was calculated by multiplying the length of the wound with its width. A data collection sheet was specially designed by the researcher for the sake of documenting each patient’s data.
Results: Mean rate of healing did not differ significantly according to sex of patient. On the other hand, it was signif-icantly dependent upon type of diabetes, being significantly slower among type 2 diabetics (p=0.026). Excellent glycemic control was associated with faster rate of healing, while poor glycemic control was associated with slow wound healing rate. Differences in wound healing rate according to levels of glycemic control were statistically significant (p<0.001). Mean rate of wound healing was significantly delayed among patients with past history of amputation (p=0.01). Moreover, off-loading was associated with significantly improved rate of wound healing (p=0.011). Significant negative correlations existed between rate of wound healing and age of patient (r=–0.172, p=0.015), duration of diabetes (r=–0.244, p<0.001) and level of glycosylated hemoglobin (r=–0.308, p<0.001).
Conclusions: Rate of wound healing is significantly slower among type 2 diabetics. Off-loading significantly improves the rate of wound healing. There is a significant negative correlation between rate of wound healing with age of patient, duration of diabetes and glycosylated hemoglobin level. Rate of wound healing is significantly delayed among patients with history of ulcer or amputation.
Recommendations: Special health education messages should be delivered to patients on diabetic foot self-care, especially to patients with risk factors of delayed wound healing, e.g., patients with type 2 diabetes, past history of ulcer or amputation, poor glycemic control, etc. Off-loading is highly recommended for patients with diabetic foot ulcers.