(CR-074) Determinants Influencing Wound Related Outcomes in Mild Diabetic Foot Infection

Helen Ilumets, MD, PhD; Tiiu Kaha, MD; Anna-Liisa Kubo, PhD; Andres Valkna, PhD; Mariliis Sihtmäe, PhD; Meelis Kadaja, PhD; Olesja Bondarenko, PhD; Grigory Vasiliev, MD, PhD

Introduction: Diabetic foot infections (DFIs) are a major global health concern due to their potential for serious complications, such as amputation, if not properly managed. This post-hoc analysis examines how patient characteristics at the start of treatment influence wound-related outcomes in mild DFIs.

Methods: We conducted a retrospective analysis of a randomized controlled trial comparing a novel wound dressing incorporating synergistic copper and silver nanoparticles with a commercially available gelling fiber silver ion dressing. The trial enrolled 30 patients diagnosed with grade 2 DFIs according to the International Working Group on Diabetic Foot (IWGDF) guidelines.  Baseline data collected included age, sex, initial wound size, bacterial load, pain levels, and quality of life scores.

Results: The trial demonstrated a reduction in mean wound surface area over time, with smaller initial wounds exhibiting greater improvement. Patients presenting with higher initial bacterial loads consistently maintained higher levels throughout the study. Notably, at baseline, female patients had statistically significantly higher bacterial counts compared to male patients, while older patients displayed lower bacterial loads. Pain associated with the wound decreased during the trial but remained correlated with initial pain levels.  The DFS score followed a similar pattern, with baseline scores strongly correlating with subsequent scores. Older patients tended to have higher DFS scores.

Discussion:

This study highlights the significant influence of baseline patient characteristics on wound-related outcomes in mild DFIs. Initial wound size, bacterial load, sex, age, and pain all appear to be determinants of wound-related outcomes.