In a study to determine the rate at which plantar forefoot ulcers healed among patients with diabetes, researchers at Skåne University Hospital and Lund University, Sweden, found that 79.6 percent of participants healed without the need for amputation. The study was published online June 17 in the journal Wound Repair and Regeneration.
All patients at a multidisciplinary diabetes foot clinic who had a plantar forefoot ulcer from January 1, 1983, to December 31, 2012, were considered for the study. Of the 770 total patients, 701 patients fulfilled the inclusion criteria and were followed according to a set protocol until final outcome, which was defined as healing or death. The median age of the participants was 67 years, ranging from 22 to 95 years old.
Severe peripheral vascular disease was present in 26 percent of the patients and 14 percent had evidence of deep infection upon arrival at the foot clinic. Fifty-five percent of the patients healed without foot surgery, 25 percent healed after major debridement, 9 percent healed after minor or major amputation and 12 percent died unhealed. Median healing time was 17 weeks.
An ulcer classified with the Wagner Ulcer Grade Classification System as grade 1 or grade 2 at inclusion and independent living were factors associated with a higher healing rate, according the the study’s authors.