VA doctor publishes research highlighting diabetic wound care

A paper published in the academic journal, Advances in Wound Care in October, highlights an ongoing study into diabetic wound care that is being championed by VA providers such as Dr. Aliza Lee, Podiatry Attending at the Salem VA Health Care System in Virginia. Working with Dr. Matthew Garoufalis from the Jessie Brown VAMC in Chicago, Illinois, the research team’s findings show growing evidence for Topical Wound Oxygen, or TWO2, therapy.

The TWO2 therapy uses a plastic sleeve to encase the affected limb and floods the area with oxygen. Early studies with the therapy have shown a markedly improved healthcare outcome as evidenced by a 2018 paper by Lee and her team that appeared in the magazine, Diabetes. The current article is featured in Advances in Wound Care and is part of a Salem Research Institute-funded study.

For the latest study, 202 patients suffering from Diabetic Foot Ulcers (DFU) had their records screened to determine whether they were involved with hospitalization and/or amputation within 12 months of their initial wound documentation. With this baseline information in hand, the group was divided so that 91 patients were treated with TWO2 and 111 were treated with other, appropriate therapies.

“The concept of TWO2 therapy has been around for about a decade,” Lee said. “An earlier study looked at enrolled patients with specific wound limitations and watched them for 12 weeks. This study is a Real-World Evidence (RWE) study that looks at the charts of a wider variety of patients looking for outcomes.”

Of the 91 patients treated with TWO2 therapy, there was an 88% reduction in hospitalization and a 71% reduction in amputations over a 12-month period compared to those who did not have the TWO2 therapy. “140 people, 70 with the therapy and 70 without, showed 82% fewer hospitalizations and 73% fewer amputations over 12 months,” she said.

A mathematical regression of the data showed that patients who don’t get the TWO2 therapy are 8.9 times more likely to be hospitalized, and 4.9 times more likely to have an amputation than Veterans with DFU who do get the therapy.

“The five-year mortality rate after limb amputation is 68%,” Lee said. “That’s second only to lung cancer which has an 86% mortality rate after five years. Saving limbs is saving lives and this technology helps us get these patients into remission, reducing amputations and hospitalizations.”