A groundbreaking study funded by the National Institutes of Health (NIH) has identified a new way to predict whether a seemingly healed diabetic foot ulcer will reopen. By measuring trans-epidermal water loss (TEWL), researchers found that skin barrier function could reveal hidden risks of wound recurrence.
The findings, published in Diabetes Care, suggest that current wound healing assessments may miss underlying vulnerabilities. While a wound may look closed on the surface, weakened skin barrier function—detected by higher water loss—signals a greater chance of reopening.
Key Findings:
35% of patients with high TEWL (more water loss) saw ulcers return within 16 weeks, compared to just 17% with low TEWL.
Those with high TEWL were 2.7 times more likely to experience recurrence.
The method, already used in burn care, could be adapted for diabetic wound management.
Why It Matters:
Diabetic foot ulcers are a leading cause of non-traumatic amputations and can be deadly if untreated. Many patients with diabetes suffer from nerve damage (neuropathy), making it hard to detect wounds early. Even “healed” ulcers may not fully repair beneath the skin, leaving patients at risk.
Expert Insight:
“This study gives clinicians their first reliable tool to assess ulcer recurrence risk,” said Dr. Teresa Jones of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Identifying high-risk wounds could save limbs—and lives.”
Next Steps:
The research, conducted by the NIDDK Diabetic Foot Consortium, involved over 400 participants. Scientists now urge integrating TEWL measurements into standard wound care to improve long-term outcomes.
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