Recognizing Delayed Wound Healing in Diabetic Foot Ulcers Treated with Dermal Regeneration Templates
Diabetic foot ulcers (DFUs) represent a major clinical challenge due to their chronic nature and high risk of complications. A recent open-access study investigated how to better identify patients at risk of delayed wound healing when treated with dermal regeneration templates — a technique used in complex and deep DFUs where granulation tissue needs support.
Study Overview
Researchers evaluated 48 patients with complex DFUs treated using a dermal regeneration template and total contact cast system. Their goal was to determine early clinical indicators that predict delayed healing outcomes. Identifying these signs promptly can help clinicians modify treatment before wounds stagnate or worsen.
Key Findings
- Delayed healing was associated with a longer ulcer duration prior to treatment and larger wound areas at baseline.
- 30-day wound improvement was a strong predictor: patients who showed <50% area reduction in the first month were much more likely to have prolonged healing timelines.
- Deep ulcers and presence of osteomyelitis were significant clinical factors that correlated with poor healing response despite advanced therapies.
Importantly, the authors emphasize that **monitoring early response to offloading systems and advanced dressings** such as dermal templates is critical to optimizing care. If little improvement is seen at 4 weeks, clinicians may need to reassess infection control, pressure relief, or comorbidities.
Implications for Practice
This study supports using a total contact cast system in conjunction with biologically active scaffolds to treat complex DFUs. However, healing trajectories should be re-evaluated at the 30-day mark to ensure continued progress. Integrating structured wound assessments with offloading and regenerative therapies may reduce the risk of stalled healing and future amputation.
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