Evidence map›Paper›PMID 40445117›Full record

ArticleDiabetes care2025

High Transepidermal Water Loss at the Site of Wound Closure Is Associated With Increased Recurrence of Diabetic Foot Ulcers: The NIDDK Diabetic Foot Consortium TEWL Study.

Chandan K Sen, Gayle M Gordillo, Sashwati Roy, Jordan Jahnke, Mithun Sinha, Lava Timsina, Shomita S Mathew-Steiner, Michael S Conte, Crystal Holmes, Teresa L Z Jones and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Exploring the Role of GLP-1 Agents in Managing Diabetic Foot Ulcers: A Narrative and Systematic Review.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society
    Pooled it
  3. Article
  4. Review
  5. Review
  6. Article
  7. Healing Efficacy ofGels (Basel, Switzerland) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Chandan K SenMcGowan Institute for Regenerative Medicine, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.ORCID 0000-0003-3151-5202
Gayle M GordilloMcGowan Institute for Regenerative Medicine, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Sashwati RoyMcGowan Institute for Regenerative Medicine, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Jordan JahnkeData Coordinating Center of the Diabetic Foot Consortium, Statistical Analysis of Biomedical and Educational Research Group Unit, Department of Biostatistics, University of Michigan, Ann Arbor, MI.
Mithun SinhaIndiana Center for Regenerative Medicine and Engineering, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.
Lava TimsinaInternational Drug Development Institute, Raleigh, NC.
Shomita S Mathew-SteinerMcGowan Institute for Regenerative Medicine, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Michael S ConteDivision of Vascular and Endovascular Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA.
Crystal HolmesDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
Teresa L Z JonesNational Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
Rodica Pop-BusuiDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
Giselle KolenicData Coordinating Center of the Diabetic Foot Consortium, Statistical Analysis of Biomedical and Educational Research Group Unit, Department of Biostatistics, University of Michigan, Ann Arbor, MI.
Cathie SpinoData Coordinating Center of the Diabetic Foot Consortium, Statistical Analysis of Biomedical and Educational Research Group Unit, Department of Biostatistics, University of Michigan, Ann Arbor, MI.
Geoffrey C GurtnerDepartment of Surgery, University of Arizona, Tucson, AZ.
NIDDK Diabetic Foot Consortium TEWL Study

Funding

Regional Pilot And Feasibility Study Grants ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DAVID P OLSON · 2013 to 2026
$24.3M
University of Michigan Data Coordinating Center for the Diabetic Foot ConsortiumU24DK122927 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Catherine A Spino · 2019 to 2026
$19.0M
NIDDK Diabetic Foot Consortium Clinical Research UnitU01DK119083 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI RODICA BUSUI (POP-BUSUI), Crystal Murray Holmes · 2018 to 2026
$5.5M
Diabetic Foot Ulcer Clinical Research UnitU01DK119099 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Gayle M Gordillo, Sashwati Roy · 2018 to 2026
$5.4M
The University of Arizona Wound Care Center Clinical Research UnitU01DK119094 · NIDDK · UNIVERSITY OF ARIZONA · PI GEOFFREY C GURTNER, Wei Zhou · 2018 to 2026
$5.1M
UCSF Diabetic Foot Clinical Research UnitU01DK119100 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Michael S Conte · 2018 to 2026
$5.0M
University of Miami Clinical Research Unit of the Diabetic Foot ConsortiumU01DK119085 · NIDDK · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI KIRSNER, ROBERT SCOTT, LEV-TOV, HADAR · 2018 to 2022
$1.8M
Integrated Clinical and Research Systems for Diabetic Foot Wound CareU01DK119102 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI RUBIN, J PETER · 2018 to 2021
$1.3M
NIDDK NIH HHS P30 DK020572NIDDK NIH HHS U01 DK119083NIDDK NIH HHS U01DK119083NIDDK NIH HHS U01 DK119085NIDDK NIH HHS U01DK119085NIDDK NIH HHS U01 DK119094NIDDK NIH HHS U01DK119094NIDDK NIH HHS U01 DK119099NIDDK NIH HHS U01DK119099NIDDK NIH HHS U01 DK119100NIDDK NIH HHS U01DK119100NIDDK NIH HHS U01 DK119102NIDDK NIH HHS U01DK119102NIDDK NIH HHS U24 DK122927NIDDK NIH HHS U24DK122927
6 · The paper itself

Abstract

objectiveThe National Institute of Diabetes and Digestive and Kidney Diseases Diabetic Foot Consortium tested the hypothesis that compromised restoration of the skin barrier function of closed diabetic foot ulcers (DFUs), as measured by high transepidermal water loss (TEWL), is associated with an increased risk of DFU recurrence. RESEARCH DESIGN AND

methodsThis was a multicenter noninterventional study measuring TEWL in 418 adult participants with diabetes and a recently healed DFU. TEWL was measured at the center of the closed wound and at an anatomically similar reference area on the contralateral foot within 2 weeks of wound closure (visit 1); measurements were repeated at a wound closure confirmation visit 2 weeks later (visit 2). Participants were observed for up to 16 weeks to assess for wound recurrence. Participant self-reported and clinician assessments of DFU wound recurrence were recorded.

resultsDFU recurrence by week 16 occurred in 21.5% of participants. Mean TEWL at the center of the healed DFU at visit 1 was higher for those with recurrence compared with those without (P = 0.006). Among participants with high TEWL (>30.05 g · m-2 · h-1), 35% reported wound recurrence by 16 weeks versus 17% of those with low TEWL. The odds ratio for recurrence for participants with high TEWL was 2.66 (P < 0.001). Self-reported wound recurrence was highly concordant with clinician assessment of wound recurrence.

conclusionsCompromised wound healing mechanisms culminating in wound closure associated with defective skin barrier function is associated with increased risk of DFU recurrence. Measurement of TEWL has value as a predictor of functional wound healing and could affect clinical practice, leading to better outcomes.

Indexed as

Diabetic FootWater Loss, InsensibleWound HealingAdultAgedFemaleHumansMaleMiddle AgedRecurrence

Identifiers

PMID40445117
PMCPMC12178626

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.