High Transepidermal Water Loss at the Site of Wound Closure Is Associated With Increased Recurrence of Diabetic Foot Ulcers: The NIDDK Diabetic Foot Consortium Transepidermal Water Loss (TEWL) Study
Main finding · DFU recurrenceResult — go to the resultOdds ratio 2.66Authors' conclusion
Compromised 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.
Study context
- Population
- Adults with diabetes and a recently healed DFU; TEWL measured at the closed wound center and contralateral reference area within 2 weeks of closure and 2 weeks later
- Participants
- 418 adults
- Exposure
- High TEWL vs low TEWL at healed DFU site
- Outcome
- DFU recurrence
- Follow-up
- Up to 16 weeks
Methodological detailsmulticenter, noninterventional
- Multicenter
- Noninterventional
Main finding
As reported in the abstract
Odds ratio
2.66
P < 0.001
By group
- DFU recurrence by week 16, all participants
- 21.5%
Observational data: associations, not effects.
Further findings
Mean TEWL at center of healed DFU at visit 1, recurrence vs no recurrence
- Mean TEWL higher with recurrence than without
- P = 0.006
Self-reported vs clinician-assessed recurrence
- Self-reported wound recurrence highly concordant with clinician assessment
Original publication
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. Diabetes Care. Published 30 May 2025. doi:10.
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