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April 19, 2026The International Journal of Lower Extremity Wounds0 citations

Ulcer Recurrence Impairs Outcomes of Patients with Diabetic Foot

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MSMartina SalviMMMarco MeloniFBF Bonanni

Key Points

  • The study aims to evaluate the prevalence of recurrent diabetic foot ulcers and their impact on clinical outcomes over six months.
  • Single-center retrospective observational design.
  • Included patients with diabetic foot ulcers requiring hospitalization.
  • Divided participants into recurrent ulcer and first-time ulcer groups.
  • Utilized a multidisciplinary team for treatment according to guidelines.
  • Outcomes measured included healing, major amputation, and mortality at six months.
  • Healing rates were 47.7% for recurrent DFUs compared to 62.8% for first-time DFUs.
  • Major amputation rates were similar: 4.6% for recurrent versus 5% for first-time DFUs.
  • Mortality was significantly higher in recurrent DFUs (12.3%) compared to first-time DFUs (4.3%).
  • Ulcer recurrence was identified as an independent predictor of non-healing.

Abstract

Background and Aims The aim of the study was to evaluate the prevalence of recurrent diabetic foot ulcers (DFUs) requiring hospital admission and to assess their impact on mid-term clinical outcomes. Methods and Results It is a single-center retrospective observational study including a population of patients with DFUs requiring hospitalization managed between January and September 2024 in a tertiary level diabetic foot service. All patients were treated by a local multidisciplinary team in accordance with international guidelines. The study cohort consisted of two groups: patients with a recurrent DFU and those with a first-time DFU. After discharge, all patients were regularly followed as outpatients. After six months of follow-up, the following outcomes were evaluated and compared between groups: healing, major amputation, and mortality. Overall, 205 patients were included (31.7% recurrent DFU vs 68.3% first-time DFU). The mean age was 68.9 ± 12.3 years, the majority had type 2 diabetes (93.4%) with a mean diabetes duration of 20.9 ± 12.6 years; 155 (75.6%) patients presented with ischemic DFUs, and 158 (77.1%) patients had diabetic foot infections. There were no significant differences between the two groups at the assessment, except for the higher rate of ischemic heart disease in recurrent patients when compared to not recurrent (50.8 vs 30.7%, P = .006). Conclusion Six-months outcomes (recurrent DFU vs first-time DFU) were as follows: wound healing (47.7 vs 62.8%, P = .04), major amputation (4.6 vs 5%, P = .2), and mortality (12.3 vs 4.3% P = .03), respectively. Multivariate logistic regression analysis showed that ulcer recurrence was an independent predictor of non-healing, while it did not significantly influence the risk of major amputation or mortality.

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Cite This Study

Salvi et al. (2026) studied this question.

synapsesocial.com/papers/69e471c5010ef96374d8dff2https://doi.org/10.1177/15347346261442764
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