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More Frequent Visits to Wound Care Clinics Result in Faster Times to Close Diabetic Foot and Venous Leg Ulcers

Warriner, Robert A. III MD, ABPM/UHM, FACA, FCCP, FCCWS; Wilcox, James R. BSN; Carter, Marissa J. PhD, MA; Stewart, Deborah G. MD

doi: 10.1097/01.ASW.0000422629.03053.06
Features: Original Investigations

OBJECTIVE: To determine whether patients with Wagner grades 1 and 2 diabetic foot ulcers (DFUs) or venous leg ulcers (VLUs) differed in terms of time to close depending on visit frequency to wound care centers.

DESIGN: Retrospective cohort study.

SETTING: Outpatients wound care centers.

PATIENTS: Two hundred six patients with Wagner grade 1 or 2 DFUs and 215 patients with VLUs in the lower extremities collected from 9 wound care centers in 5 states (6 states for VLUs) during 2009/2010 and whose wounds had closed.

INTERVENTIONS: For each type of DFU/VLU, 1 group had every-other-week visits, defined as more than 10 days between visits in the first 4 weeks, whereas the other group had weekly visits, defined as at least once a week.

MAIN OUTCOMES MEASURES: Median time to close.

MAIN RESULTS: For patients with DFUs, 63.8% of wounds had closed in the weekly visit group after 4 weeks compared with 2.0% in the every-other-week group (P = 2.3 × 10−14); for patients with VLUs, 78 of 105 wounds (52%) closed in the weekly visit group compared with 0% in the every-other-week group (P = 2.40 × 10−15). After controlling for all covariates in a Cox regression model, median time to close for weekly patients was 28 days versus 66 days for patients seen every other week. Adjusted median times to close VLUs in the same groups were 25 versus 55 days.

CONCLUSIONS: More frequent visits can be extremely beneficial, with implications of lower costs and higher quality of life for patients.

This study examines whether patients with Wagner grades 1 and 2 diabetic foot ulcers or venous leg ulcers differed in terms of time to close depending on visit frequency to wound care centers.

Robert A. Warriner III, MD, ABPM/UHM, FACA, FCCP, FCCWS, was Chief Medical Officer, Healogics, Inc, Jacksonville, Florida. (Editor’s note: Sadly, Dr Warriner passed away just a few months before this article was published.) James R. Wilcox, BSN, is Director of Research & Quality for Medical Affairs, at Healogics, Inc, Jacksonville, Florida. Marissa J. Carter, PhD, MA, is President, Strategic Solutions, Cody, Wyoming. Deborah G. Stewart, MD, works at Healogics, Inc, Jacksonville, Florida. Dr Warriner, Mr Wilcox, and Dr Stewart have disclosed that they are employees of Healogics, Inc, which incorporated the former Diversified Clinical Services and National Healing Corporation. Dr Carter has disclosed that she is/was a consultant/advisor to Diversified Clinical Services.

Submitted November 11, 2011; accepted in revised form August 16, 2012.

© 2012 Lippincott Williams & Wilkins, Inc.