A Pilot Study to Explore a Correlation between Inflammatory Markers and the Wound Healing Rate in Diabetic Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Treatment Protocol and Laboratory Examination
2.3. Measurement of Wound Characteristics including WHR
2.4. Patient Evaluation and Criteria
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics of the Patients
3.2. Wound Measurements
3.3. Correlations between Inflammatory Markers and WHR
4. Discussion
- (1)
- We evaluated only patients who were hospitalized at a single, secondary medical institution.
- (2)
- We enrolled a small number of patients in the current study. We therefore cannot completely rule out the possibility of selection bias.
- (3)
- We failed to consider the possibility that factors such as aging, obesity or exercise might affect the wound healing process. It is well established that the normal WH process may be impaired in elderly or obese individuals; these patients are susceptible to infection, prolonged pain and other complications [45,46]. Moreover, recent studies have suggested that physical exercise may promote the WH process even in the presence of aging and obesity [47].
- (4)
- We failed to analyze the effects of confounding factors, such as hypertension, congestive heart failure or the location and shape of wounds, on WHR.
- (5)
- We failed to perform a wound fluid assay of inflammatory cytokines and proteases involved in WH; proteases such as matrix metalloproteinase-2 and -9 (MMP-2 and -9) as well as inflammatory markers such as IL-1 and tumor necrosis factor-α (TNF-α) are significantly elevated in chronic wounds as compared to their acute counterparts, which has been well described in the literature [48].
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Values | p-Value | |
---|---|---|---|
Early WH Group (n = 27) | Late WH Group (n = 33) | ||
Age (years) | 45.2 ± 19.3 | 51.4 ± 18.3 | 0.208 |
Sex (male-to-female ratio) | 14:13 | 16:17 | 0.128 |
Height (cm) | 167.2 ± 8.3 | 161.6 ± 7.1 | 0.067 |
Weight (kg) | 68.3 ± 10.2 | 62.9 ± 8.4 | 0.091 |
BMI (kg/m2) | 27.3 ± 4.0 | 21.1 ± 2.2 | 0.113 |
BG (mg/dL) | 189.3 ± 86.3 | 237.1 ± 72.5 | <0.0001 |
HbA1c (%) | 7.13 ± 2.5 | 9.22 ± 5.7 | |
Underlying diseases | |||
Hypertension | 12 (44.4%) | 19 (57.6%) | >0.05 |
Hepatitis | 4 (14.8%) | 4 (12.1%) | |
Tuberculosis | 2 (7.4%) | 3 (9.09%) | |
Stroke | 4 (14.8%) | 3 (9.09%) | |
Chronic renal failure | 3 (11.1%) | 2 (6.06%) | |
Congestive heart failure | 1 (3.7%) | 2 (6.06%) | |
Verruca | 1 (3.7%) | 0 (0%) | |
Wound characteristics | |||
Location | |||
Upper extremity | 13 (48.1%) | 16 (48.5%) | >0.05 |
Lower extremity | 13 (48.1%) | 15 (45.5%) | |
Trunk | 9 (33.3%) | 11 (33.3%) | |
Back | 3 (11.1%) | 3 (9.09%) | |
Flank | 1 (3.7%) | 2 (6.06%) | |
Chest | 1 (3.7%) | 1 (3.0%) | |
Lower abdomen | 1 (3.7%) | 0 (0%) | |
Shape | |||
Trapezoid | 7 (25.9%) | 9 (27.3%) | >0.05 |
Round | 8 (29.6%) | 8 (24.2%) | |
Rod | 5 (18.5%) | 7 (21.2%) | |
Irregular | 5 (18.5%) | 5 (15.2%) | |
Triangle | 2 (7.4%) | 4 (12.1%) | |
Surface area | |||
≥100 mm2 | 12 (44.4%) | 15 (45.5%) | >0.05 |
<100 mm2 | 15 (55.6%) | 18 (54.5%) | |
Bacterial infection | |||
No growth | 25 (92.6%) | 30 (90.9%) | >0.05 |
MRSA | 1 (3.7%) | 2 (6.0%) | |
Staphylococcus epidermidis | 1 (3.7%) | 1 (3.0%) |
Variables | Values | p-Value | |
---|---|---|---|
Early WH Group (n = 27) | Late WH Group (n = 33) | ||
WBC (×106/L) | 15,300 ± 6400 | 8000 ± 5300 | 0.027 * |
CRP (mg/L) | 34.62 ± 13.75 | 146.28 ± 112.46 | 0.036 * |
ESR (mm/h) | 16.34 ± 5.26 | 29.14 ± 6.88 | 0.043 * |
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Song, Y.; Jo, Y.; Sohn, J.; Kim, R. A Pilot Study to Explore a Correlation between Inflammatory Markers and the Wound Healing Rate in Diabetic Patients. Medicina 2022, 58, 390. https://doi.org/10.3390/medicina58030390
Song Y, Jo Y, Sohn J, Kim R. A Pilot Study to Explore a Correlation between Inflammatory Markers and the Wound Healing Rate in Diabetic Patients. Medicina. 2022; 58(3):390. https://doi.org/10.3390/medicina58030390
Chicago/Turabian StyleSong, Yukwan, Yongkyu Jo, Jeongeun Sohn, and Robert Kim. 2022. "A Pilot Study to Explore a Correlation between Inflammatory Markers and the Wound Healing Rate in Diabetic Patients" Medicina 58, no. 3: 390. https://doi.org/10.3390/medicina58030390