Evaluation of the efficacy of integrative programs in improving diabetic foot ulcers’ outcomes: A cross-sectional study

Background: Treatment of a diabetic foot is a principal step in rehabilitative approaches to the complications of diabetes mellitus. Use of integrative educational courses for diabetic patients is dependent on several factors such as cultural entities of the population, patient perceptions of classes, and their previous trainings about diabetes and related complications. The aim of this study was to determine the efficacy of integrative programs to improve diabetic patients’ outcomes for wound care. Methods: We included 100 patients with diabetic wounds from August, 2014–December, 2014. Resources in this study included educational classes, brochures, and pamphlets. We implemented the educational course for three months in 50 patients and compared the results with 50 controls who received no educational course. The educational course was conducted over a three-month period and we evaluated reduction of HbA1C, fasting blood sugar (FBS), 60-second Diabetic Foot Screen score, STONES (Size, Temperature, Os [bone], New areas of breakdown, Exudate, erythema, edema, Smell) and NERDSS (Non-healing wound, Exudative wound, Red and bleeding wound, Debries in the wound, Smell form the wound) parameters implemented for evaluation of infectious diabetic wounds. Results: We followed STONES and NERDS changes (positive to negative) in 42 (84%) patients from the intervention group and 21 (42%) control group patients (P=0.001). Reduction in the 60-second Diabetic Foot Screen score was 34 (68%) for the intervention group and 24 (48%) in the control group (P=0.03). Conclusion: Possibly the use of interventional educational programs is effective in reduction of harm in patients with diabetic wounds, which will lead to decreased infections and better dynamic conditions.