Study of the Day: Another Possible Cause for Wounds That Don't Heal

Research suggests that, though most injuries that take time to improve are related to diabetes, autoimmune diseases may also be a culprit

PROBLEM: Millions suffer from injuries that don't heal, and most of these cases are due to diabetes, a disease that damages blood vessels and inhibits normal skin repair. Georgetown rheumatologist Victoria Shanmugam began noticing in her patients with autoimmune diseases, however, that their recovery times from open wounds were at times even longer than those of diabetes patients.

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METHODOLOGY: Georgetown University Medical Center researchers led by Shanmugam conducted a chart review of people who sought care at a high-volume wound clinic to determine the prevalence of autoimmune diseases. The study included 340 patients with open wounds, which mostly involved leg ulcers that were treated during a three-month period in 2009.

RESULTS: Nearly half of the patients in the review had diabetes and almost a quarter had an underlying autoimmune disease. The 78 patients who had issues with their immune systems had either rheumatoid arthritis, lupus, or livedoid vasculopathy, a type of vascular disease.

CONCLUSION: Autoimmune diseases may be another possible underlying cause of wounds that don't heal.

IMPLICATION: Shanmugam hopes doctors would consider the link she found between autoimmune diseases and injuries in their practice. While it is much too invasive and costly to recommend that all patients with wounds be tested for autoimmune diseases, she says in a statement, "If a doctor has a patient with a leg ulcer that won't heal after three or four months and they have done all the appropriate treatments, I hope they will look for the presence of an autoimmune disorder."

SOURCE: The study, "A Higher Than Expected Prevalence of Autoimmune Disease in a Cohort of Patients With Recalcitrant Leg Ulcers," will be presented tomorrow in Chicago at the annual meeting of the American College of Rheumatology.

Image: Anatoliy Samara/Shutterstock.