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Updated: Feb 8, 2026
Prospective, Randomized, and Controlled Study of a Human Umbilical Cord Mesenchymal Stem Cell Injection for Treating Diabetic Foot Ulcers
Published on: March 3, 2023
Analysis of recurrent ulcerations at a multidisciplinary diabetic Foot unit after implementation of a comprehensive
Sara Jiménez1, José Antonio Rubio2, Julia Álvarez3
1Unidad de Pie Diabético, Hospital Universitario Príncipe de Asturias , Alcalá de Henares, Madrid, España; Departamento de Endocrinología y Nutrición, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
Background And Objective:
The aim of this study was to assess the risk factors associated to recurrent diabetic foot ulcers after implementing a new preventive comprehensive foot care (CFC) program carried out by a podiatrist and an endocrinologist at a multidisciplinary diabetic foot unit (MDFU) and its potential impact in decreasing recurrent ulcers.
Material And Methods:
A retrospective cohort study including consecutive patients who attended the MDFU for the first time from 2008 to 2014 complaining of a diabetic foot ulcer that finally healed. Patients were monitored until ulcer recurred or up to June 30, 2016. Maximum follow-up time was 8.1 years. Cumulative incidence of recurrent ulcers was analyzed during two periods: 2008-2010 (before CFC was implemented) and 2011-2014 (after implementation of CFC).
Results:
A total of 280 subjects with a median age of 69.5 years (Q25:60,2-Q75:78) were included. Of these, 64.6% were males and 92.1% had type 2 diabetes mellitus. One hundred and twenty-six (45%) suffered recurrent ulcers. Median time to recurrent ulceration was 0.97 (Q25:0.44-Q75:1.74) years. Multivariate analysis showed sensory neuropathy (HR [95% CI] 1.58 [0.99-2.54], P=.050); minor amputation (HR [95% CI] 1.66 [0.12-2, 46], P=.011); and 2011-2014 period versus 2008-10 period (HR [95% CI] 0.60 [0.42-0.87], P=.007) to be factors independently associated to recurrent ulcers.
Conclusions:
Sensory neuropathy, minor amputation, and implementation of the CFC program were predictors of reulceration. Implementation of the CFC program was associated to a 40% reduction in reulceration. Prevention of recurrent ulcers is feasible and should be a priority in a MDFU.
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