Burn wounds on diabetic feet: early excision and grafting vs. conventional care in preventing diabetic foot progression—a cluster-randomized trial
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: This study evaluates the efficacy of early excision and grafting (EEG) compared to conventional care in preventing the progression of new deep foot wounds into diabetic foot ulcers in patients with type 2 diabetes. A cluster-randomized trial was conducted across three teaching hospitals in Shiraz, Iran. Patients were allocated to either the EEG group (surgical excision and grafting within 30 days of wound formation) or the conventional care group (routine wound care, including antibiotics, dressing, and debridement). Primary outcomes included healing status at discharge, while secondary outcomes assessed amputation rates, length of hospital stay, and number of surgeries performed. Statistical analysis was conducted with a significance threshold of p < 0.05. Of the 43 patients analyzed, the EEG group demonstrated significantly higher complete healing rates at discharge (90.5%) than the conventional group (40.9%, p = 0.001). Amputation rates were markedly lower in the EEG group (4.8% vs. 36.4%, p = 0.01), and the mean number of surgeries required was reduced (1.1 ± 0.3 vs. 2.5 ± 0.7, p < 0.001). However, no significant difference in hospital stay duration was observed between the groups (p = 0.87). Early excision and grafting is a highly effective intervention for promoting wound healing and preventing the progression of diabetic foot ulcers, significantly reducing the need for amputations and surgical procedures. Further large-scale studies are warranted to confirm these findings and assess long-term outcomes. This study was conducted in accordance with the guidelines of the Institutional Review Board (IRB) of Shiraz University of Medical Sciences. The research protocol was reviewed and approved under the trial registration identifier IRCT2017103013880N5, registered at www.IRCT.ir . All procedures adhered to ethical principles and relevant guidelines, including national and institutional regulations. Trial registration: Institutional Review Board of Shiraz University of Medical Sciences identifier, ( www.IRCT.IR ), IRCT2017103013880N5.
Source: Discover Medicine
Authors: Mehdi Ayaz, Dorsa Ayaz, Amir Kheshti
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,290
OpenAlex ID: W4409250682