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Best foot forward for wound healing

Foot ulcers are a major complication of diabetes, caused by the metabolic changes associated with diabetes preventing the wound healing process from working properly. As a result, damage to the foot often doesn't heal naturally in diabetes patients, producing diabetic foot ulcers that can occasionally lead to leg amputation and even death.

There are a number of treatments for diabetic foot ulcers, but different treatments tend to work best with different patients. So physicians need to monitor closely whether a particular treatment is working and switch the patient to another one if it's not causing the wound to heal. At the moment, this usually involves measuring the size of the wound to see whether it's shrinking, which is a highly subjective and rather unreliable way to determine healing, with an accuracy of only around 60%.

Now, in a paper in Wound Repair and Regeneration, a team of US scientists led by Michael Weingarten at Drexel University in Philadelphia has shown that diffuse NIR spectroscopy offers a much more accurate approach. Using diffuse NIR spectroscopy, they monitored total haemoglobin concentrations in and around the foot ulcers of 46 diabetes patients. They found that these concentrations fell in wounds that were healing, but not in wounds that weren't.

Using a fall in concentration of 4μM a week as a sign of wound healing, Weingarten found that he could predict wound healing with an accuracy of 82% in just four weeks. Not only is this diffuse NIR method much more accurate than measuring wound size, but it also allows a much faster assessment of whether a treatment is working.

By allowing ineffective treatments to be stopped earlier, Weingarten estimates that this method could potentially have saved a total of over $370,000 in treatment costs for 30 of the patients in the group.

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