Navigating Treatment Pathways in Diabetic Foot Infection: A Practical Retrospective Analysis of Healing Predictors and the WIfI System.
5 affiliations
- 1School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 2School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 3Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 4Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
- 5Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
Diabetic foot infection (DFI) is a major cause of lower-extremity amputation. Evidence on optimal management remains inconsistent, and real-world data from multidisciplinary centres are limited. This study describes the characteristics, treatment patterns, and outcomes of patients with DFI at a tertiary referral centre. This retrospective cross-sectional study included all patients with diabetes and confirmed DFI presenting since 2022. Demographic, clinical, laboratory, radiologic, and wound-related data were recorded, and wounds were classified using the Wound, Ischemia, and foot Infection (WIfI) system. Correlation and multiple linear regression analyses identified predictors of healing duration. 69 patients were included (mean age 56.4 ± 13.2 years; 58% male). Most wounds were deep (88.2%); osteomyelitis occurred in 42.2%. Conservative wound care was used in 73.9%, and 79.7% underwent bedside debridement. Minor and major amputation rates were 16.2% and 1.4%. The median healing time was 45 days (interquartile range [IQR] 54), and the mean healing time was 56.0 ± 44.9 days. Healing duration correlated with wound grade, WIfI stage, infection severity, erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, international normalized ratio (INR), wound area, and delay to specialist assessment. Wound grade was the only independent predictor of healing time (β = 0.606, p = 0.001). Limb-preserving management was associated with a low major amputation rate. Wound severity was the strongest determinant of healing duration, underscoring the importance of early referral and structured risk stratification in DFI care.
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BibTeX
@article{tabashiri2026navigating,
title = {{Navigating Treatment Pathways in Diabetic Foot Infection: A Practical Retrospective Analysis of Healing Predictors and the WIfI System.}},
author = {Arefeh Tabashiri and Fatemeh Ghodratnia and Pourya Sam Daliri and Ali Farahani and Sepehr Golaghapour Niazi and Homayoun Rezaee and Ilad Alavi Darazam},
journal = {International wound journal},
year = {2026},
month = oct,
doi = {10.1111/iwj.71082},
url = {https://europepmc.org/article/MED/42906888},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Navigating Treatment Pathways in Diabetic Foot Infection: A Practical Retrospective Analysis of Healing Predictors and the WIfI System.
AU - Arefeh Tabashiri
AU - Fatemeh Ghodratnia
AU - Pourya Sam Daliri
AU - Ali Farahani
AU - Sepehr Golaghapour Niazi
AU - Homayoun Rezaee
AU - Ilad Alavi Darazam
PY - 2026
DA - 2026/10/01
JO - International wound journal
DO - 10.1111/iwj.71082
UR - https://europepmc.org/article/MED/42906888
AB - Diabetic foot infection (DFI) is a major cause of lower-extremity amputation. Evidence on optimal management remains inconsistent, and real-world data from multidisciplinary centres are limited. This study describes the characteristics, treatment patterns, and outcomes of patients with DFI at a tertiary referral centre. This retrospective cross-sectional study included all patients with diabetes and confirmed DFI presenting since 2022. Demographic, clinical, laboratory, radiologic, and wound-related data were recorded, and wounds were classified using the Wound, Ischemia, and foot Infection (WIfI) system. Correlation and multiple linear regression analyses identified predictors of healing duration. 69 patients were included (mean age 56.4 ± 13.2 years; 58% male). Most wounds were deep (88.2%); osteomyelitis occurred in 42.2%. Conservative wound care was used in 73.9%, and 79.7% underwent bedside debridement. Minor and major amputation rates were 16.2% and 1.4%. The median healing time was 45 days (interquartile range [IQR] 54), and the mean healing time was 56.0 ± 44.9 days. Healing duration correlated with wound grade, WIfI stage, infection severity, erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, international normalized ratio (INR), wound area, and delay to specialist assessment. Wound grade was the only independent predictor of healing time (β = 0.606, p = 0.001). Limb-preserving management was associated with a low major amputation rate. Wound severity was the strongest determinant of healing duration, underscoring the importance of early referral and structured risk stratification in DFI care.
SN - 1742-4801
SN - 1742-481X
ER -