A new National Institutes of Health funded study found that measuring water loss from the skin at previously healed diabetic foot ulcer sites may help predict which wounds are likely to reopen. 

The method, known as trans-epidermal water loss (TEWL) measurement, could serve as a diagnostic aid to assess whether a wound has fully healed beneath the surface.

Researchers examined more than 400 adults with diabetic foot ulcers that appeared visually closed. They measured water vapor loss at the wound site and monitored participants for recurrence over 16 weeks.

Among participants with high TEWL, 35% experienced a wound recurrence, compared with 17% of those with low TEWL. Individuals with high TEWL were 2.7 times more likely to develop a recurrent ulcer than those with lower levels.

Although a wound may look healed, the skin barrier may remain compromised. TEWL is a noninvasive method that assesses skin barrier function by measuring water evaporation. It is commonly used in burn care to determine whether the deeper layers of skin have recovered. The study authors applied this method to diabetic wounds and found that incomplete skin barrier restoration increases recurrence risk. 

The study was conducted by investigators from multiple institutions in a collaborative network and supported by several NIH research grants. The research team included experts in endocrinology, wound care, and diabetes-related complications.

The findings support further investigation into TEWL as a clinical tool in diabetic foot care and underscore the importance of assessing skin barrier recovery in managing wound outcomes.

Source: National Institutes of Health