WITHDRAWN: Effectiveness of continuous home wound care on wound healing, self-management behavior, and medical expenses of patients with diabetic foot ulcers

Abstract

To explore the effectiveness of continuous home wound care on wound healing, self-management behavior, and medical expenses of patients with diabetic foot ulcers. Patients were grouped by the campuses they were hospitalized. One group received home wound care, and the other one received outpatient wound care after their discharge. Non-inferiority testing was performed to compare ulcer healing. Their Diabetes-related Foot Ulcer Self-Management Behavior Scale (DFUSMBS) scores and medical expenses were compared. Between October 2021 and December 2022, fifty-five patients in the home wound care group and fifty-two in the outpatient wound care group completed the study. The home wound care was non-inferior concerning ulcer complete healing rate in total or stratified by Wagner grade or baseline ulcer area. Concerning wound healing time, the home wound care group was inferior for Wagner Grade Ⅲ ulcers (hazard ratio=0.7772, 95% CI=0.2799-2.1581). In contrast, for ulcers with baseline area>5cm2, the home care group was non-inferior and even can be superior, although the superiority was not statistically significant (Log-rank X2=0.257, p=0.612). Moreover, the home wound care group showed significant improvement concerning timely wound treatment (t=23.045, p<0.001, Cohen's d=4.460, Effect Size=0.912) and wound care behavior (t=33.410, p<0.001, Cohen's d=6.454, Effect Size=0.955), while that of diabetes self-management was not statistically significant (t=-0.673, p=0.502, Cohen's d=0.128, Effect Size=0.064). The medium direct medical expense per capita of the patients in the outpatient care group was statistically significantly heavier than that of the home wound care group (Z=-6.877, p<0.001). The home wound care practice did not compromise ulcer healing, enhanced timely wound treatment and wound care behavior of the patients, and saved their medical expenses, hopefully providing a feasible wound care alternative with economic benefits for the physically and economically devastated patients.