Every 20 seconds, a limb is lost due to diabetes. The five-year mortality rate for patients with some types of diabetic wounds is more than 50 percent higher than breast and colon cancers. 5 year mortality for patients with diabetic foot ulcer(DFU) is 2.5 times higher than patient with diabetes who does not have a foot ulcer. It is estimated that 50% of DFU gets infected and approximately 20% of moderate to severe diabetic foot infections lead to some level of amputation.
In 2017, an estimated 6.7 million patients are suffering from non-healing wounds. According to some estimates, Medicare alone spends at least $25 billion a year for treatment of these wounds.
Health care services and outcome study among estimated 6.7 million DFU by Skrepnek et al suggests that diabetic foot ulcers are common, complex, and costly. DFU’s are more common and deadly than CHF, MI or Stroke. It also showed that DFU’s have increased risk of emergency department visits and inpatient admissions.
Each year 2.9 million patients of age 75 and above acquire pressure ulcer. Each year in the US, there are more deaths from pressure ulcer acquired in hospitals or nursing homes than deaths from influenza, pneumonia, traffic accident or firearm injuries.
Unfortunately, such a huge and costly problem does not get deserved attention. There is lack of sufficient wound care fellowship globally. Wound care or hyperbaric medicine is not considered a specialty under CMS specialty designation. There are no wound care awareness walks, there is no wound care awareness day and there is not enough funding for wound care studies. NIH only spends 0.1% studying wound treatment out of more than estimated $32 billion a year budget in medical research.
June 5-9, 2017 was wound care awareness week. We need to start a wound care awareness ribbon campaign. I propose we celebrate November 16, 2017, as our wound care awareness day. NPUAP has already announced that day as pressure injury prevention day. Let us combine that with amputation prevention and wound healing. Wear red ribbon for wound healing.
We need to collectively advocate for more NIH funding so these dreadful wound problems can have evidence based solutions in the near future.

Dr. Jayesh Shah
Health Care Service and Outcomes Among an Estimated 6.7 Million Ambulatory Care Diabetic Foot Cases in the U.S. Skrepnek GH1, Mills JL Sr2, Lavery LA3, Armstrong DG4.Diabetes Care. 2017 Jul;40(7):936-942. doi: 10.2337/dc16-2189. Epub 2017 May 11.
Diabetic Foot Ulcers and Their Recurrence, David G. Armstrong, D.P.M., M.D., Ph.D., Andrew J.M. Boulton, M.D., and Sicco A. Bus, Ph.D. N Engl J Med 2017; 376:2367-2375June 15, 2017DOI: 10.1056/NEJMra1615439