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DiaComp Funded Abstracts Collaborative Funding Program Funding Programs

Collaborative Funding Program Application Abstract
DFU Recurrence
Chandan Sen   (Columbus, OH)
Diabetes increases susceptibility to infection and infection is a common complication of diabetic foot ulcers (DFU). About 85% of lower-limb amputations in patients with diabetes are preceded by infected foot ulceration. Emerging studies highlight the significant risk that biofilm infection poses to the non-healing DFUs. Using a preclinical swine model of mixed species wound biofilm infection, we struck an unusual observation. Although biofilm infection may or may not influence the rate of wound closure as measured by standard planimetry, it inevitably compromises the functional property of the repaired skin. The wound may close as evaluated visually, but that closed wound lacks barrier function. Such pathology is caused by the perturbation of epithelial junctional proteins in response to biofilm infection. While detecting the biofilm directly is readily not possible at present in the wound clinics, compromised barrier function of the repaired skin can be detected at the point of care of the measurement of trans-epidermal water loss (TEWL). This planning grant will therefore test the hypothesis that TEWL is a reliable biomarker of a history of biofilm infection in DFU. Wounds that appear closed with no discharge and are clinical decided to be closed, may suffer from compromised barrier function. Those that do suffer from such compromise are likely to reopen and contribute to wound recidivism. We propose planning activities including a pilot clinical study to develop a complete clinical study protocol that will be conducted on a collaborative basis between Ohio State and Stanford wound centers. The clinical study will address the following two specific aims testing the following hypotheses: Aim 1. Determine whether wound closure by re-establishment of functional skin is impaired in diabetic foot ulcers with a history of biofilm infection. Aim 2. Test if DFU recidivism is high in closed diabetic foot ulcers with defective barrier function.
Data for this report has not yet been released.