Prognostic Markers of Diabetic Foot Ulcer Healing in A Resource‐Limited Setting

ABSTRACT

This study aimed to identify the prognostic markers for Diabetic Foot Ulcer (DFU) healing using routinely collected clinical data. A prospective cohort study of 1075 (M/F: 664/411) patients who attended the foot clinic with a DFU was conducted. At baseline, detailed clinical data were collected and ulcer characteristics were systematically assessed and classified. During 167 ± 408 days follow‐up, ulcers of 1039 patients healed and 36 did not. Ulcers with SINBAD classifications 4, 5 and 6 (compared to SINBAD‐3) showed 50%, 60% and 70% increase in the risk of not healing and 2.2, 2.8 and 3.3 folds increase in healing duration respectively. Also, deeper ulcer and having previous ulcer history showed 68% and 47% increase in the risk of ulcer not healing and 57% and 20% increase in healing duration respectively. Each day delay in presentation increased the risk of ulcer not healing by 0.5%. The duration of healing was 2.4 times longer for bigger ulcers (> 1 cm ² ) and 24% longer in patients with peripheral arterial disease. SINBAD score was the strongest predictor of ulcer healing. Among SINBAD constitutive components, ulcer depth (deep‐vs‐shallow) was the strongest predictor of risk of ulcer not healing, while ulcer size (bigger‐vs‐smaller than 1 cm ² ) was the strongest predictor of ulcer healing duration.