018 Healing Rate for Diabetic Neuropathic Foot Ulcer

The goal of this study was to benchmark by year the likelihood that an individual with a diabetic neuropathic foot ulcer (DNFU) will heal. We observed these rates over a more than 10 year period (1988–2000). For this study, we designed a cohort study within the multi‐center Curative Health System wound care network of diabetics who have DNFU and whether they healed by the 20 th week of care stratified by calendar year. In total, we evaluated 27, 193 individuals with a DNFU. For, example, between 1988 and 1990 approximately 66% of patients did not heal. By 1999 this percentage had decreased to 49%. Most of the change in improvement occurred before 1998. We noted that the change in the rate of failure to heal was very closely associated with an increase over time in the proportion of patients seen with wounds identified as prognostically favorable as determined by a previously published prognostic model (i.e., individuals with wounds ≤ 2 cm2, wound less ≤2 months old, and wound of grade less ≤ 2). Among those most likely to heal, the likelihood of failing to heal went from 62% in 1990 to 32% in 2000. Therefore, the overall decrease in likelihood that a patient with a DNFU would not heal is not just due to the enrollment of less severe cases. There was, however, no real improvement in the likelihood that those with wounds that were unlikely to heal over time and fewer patients with these wounds sought care over time. In conclusion, those with a DFFU seeking care are more likely to heal today than 10 years ago. This improvement is related to the fact that individuals are seeking care when their wounds are most easily treated and these wounds are now more likely to heal. Unfortunately, those with the most severe wounds are not anymore likely to heal today than they were 10 years ago.