Characteristics predicting foot ulceration outcomes in the diabetic foot

Abstract

Diabetic foot complications are common amongst people living with diabetes. Foot ulcerations are one of the most feared complications for both people with diabetes and health care providers due to their negative impact on lives resulting in overall poor prognosis of the disease, leading to long periods of hospitalization and substantial health care costs. The literature suggests that diabetes foot complications including ulcerations could be ameliorated and even prevented if this condition is managed correctly. However, although several countries and organizations, such as the World Health Organization, International Working Group on the Diabetic Foot and the International Diabetes Federation, have set guidelines to define standards of care using evidence-based interventions to reduce the rate of amputations by up to 50%, the literature reports variations of care. Data on outcomes and determinants of outcomes in individuals living with diabetic foot ulcerations is either limited or varied with several patient and ulcer characteristics being reported as possible factors which could influence ulcer healing. The ability to predict whether a diabetic foot ulcer is following versus not following a healing trajectory could dramatically alter patient outcomes. The aim of this chapter is to report results from a recent study evaluating patient and ulcer characteristics which could possibly predict wound healing in patients living with diabetes. Although large clinical randomized studies on characteristics predicting foot ulceration outcomes in the diabetic foot are limited, this chapter provides evidence on potential predictors. Findings reported in this chapter have important implications for both clinical practice and future research. Findings suggest that prediction of outcome may be helpful for healthcare professionals in individualizing and optimizing clinical assessment and management of patients. Identification of determinants of outcome could result in improved health outcomes, improved quality of life and lesser diabetes related foot complications.