Predictors of Healing in Foot Ulceration
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USyd Access
Type
ThesisThesis type
Doctor of PhilosophyAuthor/s
Bechara, NadaAbstract
The role of dietary intake, micronutrient deficiencies, cognitive function, and smoking in foot ulceration remains inadequately understood. The aim of this thesis is to explore whether certain variables can predict healing or presence of foot ulcers.
In multiple chapters, variables ...
See moreThe role of dietary intake, micronutrient deficiencies, cognitive function, and smoking in foot ulceration remains inadequately understood. The aim of this thesis is to explore whether certain variables can predict healing or presence of foot ulcers. In multiple chapters, variables such as smoking, cognitive function, dietary intake, micronutrient deficiencies, and supplementation were investigated. Data was collected using cognition testing tools, blood tests, and dietary recalls. Foot ulcer outcomes were tracked throughout multiple chapters to correlate any variables with the healing or presence of foot ulceration. Vitamin C, D, and zinc deficiencies were highly prevalent among foot ulcer patients with deficiency rates of 75%, 50%, and 38%, respectively. Despite the high deficiency rates, no significant association was found between deficiency or supplementation and healing trajectory. However, those with a deficiency of vitamin D had a 1.20-fold increased risk of non-healing. Current smokers were significantly younger when presenting for care for their foot ulcer. Cognitive impairment was significantly higher in DFU patients, compared to controls, and correlated with QoL scores. Supplementation with vitamin C may improve cognitive function, but ulcer healing was unaffected. While there were high rates of micronutrient deficiencies amongst patients, the impact on healing of foot ulcers was inconclusive, however cognition and circulation both have a significant role. Ulcer clinics may benefit from implementing micronutrient testing and cognitive assessments. Future studies should be large multi-centre trials investigating nutritional interventions, smoking cessation, and cognitive therapy on healing.
See less
See moreThe role of dietary intake, micronutrient deficiencies, cognitive function, and smoking in foot ulceration remains inadequately understood. The aim of this thesis is to explore whether certain variables can predict healing or presence of foot ulcers. In multiple chapters, variables such as smoking, cognitive function, dietary intake, micronutrient deficiencies, and supplementation were investigated. Data was collected using cognition testing tools, blood tests, and dietary recalls. Foot ulcer outcomes were tracked throughout multiple chapters to correlate any variables with the healing or presence of foot ulceration. Vitamin C, D, and zinc deficiencies were highly prevalent among foot ulcer patients with deficiency rates of 75%, 50%, and 38%, respectively. Despite the high deficiency rates, no significant association was found between deficiency or supplementation and healing trajectory. However, those with a deficiency of vitamin D had a 1.20-fold increased risk of non-healing. Current smokers were significantly younger when presenting for care for their foot ulcer. Cognitive impairment was significantly higher in DFU patients, compared to controls, and correlated with QoL scores. Supplementation with vitamin C may improve cognitive function, but ulcer healing was unaffected. While there were high rates of micronutrient deficiencies amongst patients, the impact on healing of foot ulcers was inconclusive, however cognition and circulation both have a significant role. Ulcer clinics may benefit from implementing micronutrient testing and cognitive assessments. Future studies should be large multi-centre trials investigating nutritional interventions, smoking cessation, and cognitive therapy on healing.
See less
Date
2025Rights statement
The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.Faculty/School
Faculty of Medicine and HealthDepartment, Discipline or Centre
Westmead Clinical SchoolAwarding institution
The University of SydneyShare