Skin Hydration Level as a Predictor for Diabetic Wound Healing: A Retrospective Study

Background: Xerosis, defined as abnormal skin dryness and scaling, is a common disorder in patients with diabetes. The skin may crack and develop fissures, potentially allowing bacterial entry and increasing vulnerability to ulceration and infection. Therefore, maintaining adequate skin hydration may be crucial for diabetic wound healing. However, no clinical study has addressed this issue. This study aimed to determine and compare the effect of the skin hydration level on diabetic wound healing with that of the tissue oxygenation level, which is recognized as the most reliable parameter in predicting diabetic wound healing. Materials and Methods: This retrospective study included 263 diabetic patients with forefoot ulcers. Skin hydration and transcutaneous oxygen pressure (TcPO2) data collected before and after percutaneous transluminal angioplasty (PTA) were analyzed. Skin hydration and tissue oxygenation were graded as poor, moderate, or acceptable. Wound healing outcomes were graded as healed without amputation, minor amputation, or major amputation. Wound healing outcomes were compared using four parameters: skin hydration at baseline, TcPO2 at baseline, skin hydration post-PTA, and TcPO2 post-PTA. Results: Each of the four parameters exhibited statistically significant correlations with wound healing outcomes. In the concurrent analysis of both skin hydration and TcPO2, skin hydration was a dominant parameter (p = 0.0018) at baseline, whereas TcPO2 was a dominant parameter (p

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