Study from Pittsburgh researchers detects invisible diabetic wounds
Diabetic foot ulcers are a common and major complication for people living with type 1 and type 2 diabetes that can lead to amputation and even death.
When it comes to healing these ulcers, looks can be deceiving. But a new study published by University of Pittsburgh researchers is offering solutions. One of the lead authors told KDKA that what they found could change the definition of wound closure and save lives.
Pitt study could change how wound closure is defined
Jim Bennett, a retired Franklin Park Borough police officer, developed diabetes in his 40s and started getting diabetic foot ulcers. These wounds have high rates of recurrence.
"It does take away from your quality of what you want to do, but not really your quality of life, just something to deal with," Bennett said.
He eventually had several surgeries to amputate six of his toes, including all of them on his left foot.
"I could not continue working because I couldn't wear the uniform shoes, so I had to retire eight months earlier than I had planned," he said.
Bennett's 40-year career in the Franklin Park police force ended in 2014. Now, the 73-year-old said he goes to the wound clinic at UPMC Passavant once a week.
"There are some open wounds that appeared at the bottom of my foot, and that's what's taking so long to heal right now. It starts to close up, then it opens up. And then another infection comes along and starts all over again," Bennett said.
Because of the on-again, off-again wounds and the special boots he has to wear, there are a lot of things Bennett enjoys doing that he can't anymore.
"I've always been pretty active, and I like to do things outside at the home and do things that you can't do anymore. I am hoping when I get out of these boots to be able to do those things again, some of them," said Bennett.
Dr. Chandan Sen, director of the McGowan Institute for Regenerative Medicine at the University of Pittsburgh, calls diabetic foot ulcers "invisible wounds." Sen is also a professor in the Department of Surgery at Pitt and the chief scientific officer of Wound Healing Services at UPMC.
He said the diabetic ulcers may appear healed and meet the Food and Drug Administration's definition of wound closure, which is when it's covered by new skin and has not had any discharge for two weeks.
"That definition does not consider the functionality of the skin that just grew back," Sen said.
In a new study with nearly 400 participants, Dr. Sen and his team show it's possible to detect invisible wounds by measuring water loss with a handheld device.
"When we place the pen-like device, it gives us how much water is the body leaking," he said.
"Using this device, you can test the functionality and in a matter of five to 10 minutes know whether the skin that is covering the wound is properly functioning or nonfunctioning. ... Now that we know which wounds are more likely to reoccur, we need additional care for them so that they stay closed," Dr. Sen added.
He said these findings show the FDA's definition of wound closure needs to be updated.
"Because it is not sufficient to close the wound with the skin, you also need to restore barrier function. That aspect is missing in today's definition of wound closure. This study and studies after this hopefully will go on to make a policy change in how wound closure is defined going forward. And that's a significant contribution to overall care of wounds clinically," Dr. Sen said.
"The goal is to keep on going until we have no amputation," he added.
If you have diabetes and find an ulcer on your foot, even if it's a tiny wound, seek help and see a doctor as soon as possible.
