Introduction and Objective: To identify risk factors and clinical outcomes for non-healing surgical wounds in patients admitted to the hospital for moderate and severe diabetic foot infections.Methods: This was a pooled analysis of patient level data from 2 RTCs. Moderate and severe diabetic foot infection (DFI) was based on criteria of the International Working Group on the Diabetic Foot infection classification. Non-healing was defined as failure of complete epithelialization of wound. We used χ2 and t-test to compare clinical outcomes, with alpha of <0.05.Results: We evaluated 233 patients that required foot surgery for DFI; 31.3% (n=73) failed to heal at 1 year. Risk factors identified for not healing includes higher baseline CRP, ESR, vibration perception threshold, ankle brachial index <0.9, history of Charcot, severe infection, and wound size (Figure 1). Re-infection was 2.6 times more common (NHW 43.8% vs HW 22.5%, p=0.001) and amputations were 8.7 times more common (NHW 31.5%, HW 5.0% p=0.001) in people with wounds that did not heal. People that did not heal had significantly longer antibiotic therapy (NHW 56.7 ± 35.5 vs. HW 47.4 ± 35.1 days, p=0.01) and longer hospitalizations (NHW 25.4 ± 17.8 vs. HW 18.5 ± 14.3 days, p=0.001). There was no difference in all cause hospitalizations (57.1% vs 61.5% p=0.67).Conclusion: After surgery for infection, failure to heal remains common (31.3%). During follow up, reinfection and amputation are more common in wounds that do not heal.
M.C. Reyes: None. A. Tarricone: None. O.K. Oz: None. L.A. Lavery: Consultant; Limflow, enerenesis Medical, Clyra Medical technologies, Blue Sky, Tissue Health Plus. Stock/Shareholder; Xilas Medical. Consultant; Altrazeal.
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