Healing times and prediction of wound healing in neuropathic diabetic foot ulcers: a prospective study

Time line of wound healing and prediction of healing times in diabetic foot ulcers is an important issue. Usually, the percentage of wounds healed within a defined period is used for characterization of wound healing. This prospective study evaluates wound healing in 41 diabetic patients with neuropathic foot ulcers to confirm an equation established previously for the prediction of healing times in neuropathic diabetic foot ulcers. Ulcer healing was assessed by planimetric measurement of the wound area every second week until wound healing. The time course of wound healing was compared to the expected healing time calculated by the weekly wound radius reduction using the equation R = root A/pi (R, radius; A, planimetric wound area; pi, constant 3.14), and the wound radius reduction was 0.39 mm/week which was previously established. The initial average wound area was 96.9 +/- 13.1 mm(2) (mean +/- SEM), and 3.61 +/- 1.6 mm(2) after ten weeks with an average healing time of 75.9 (95 %-CI 71 - 81) days. Using the equation mentioned above and the calculated weekly wound radius reduction, the predicted healing time in the test group was 86.9 (95%-CI 73-101) days. The predicted and the observed healing times were significantly correlated with each other (r = 0.55, p = 0.0002). Providing standard care, the time needed for wound healing can reliably be predicted in neuropathic diabetic foot ulcers. This may be a useful tool in daily clinical practice to predict wound healing and recognize ulcers who do not respond adequately to the treatment.