Relationship between items of DMIST and healing of diabetic foot ulcers

Abstract

A monitoring tool for the wound-healing process of diabetic foot ulcers (DFUs) was developed. It comprises seven domains, namely, depth, maceration, inflammation/infection, size, tissue type of the wound bed, type of wound edge, and tunnelling/undermining. It was named "DMIST" based on the initials of its domains. Although DMIST is useful for assessing wound-healing processes, the monitoring items related to wound healing remain unclear, thereby making the selection of optimal care based on the assessment difficult. We identified the relationship between the DMIST items and wound healing. This study was a secondary analysis of five previous investigations and was conducted using DMIST based on the diabetic foot ulcer assessment scale score and DFU images. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) after simultaneously controlling for potential confounders. The examined DFU healing status revealed that some DFUs healed at 4 weeks from baseline, whereas some DFUs did not. Variables considered in the models were the scores of each DMIST domain. The study population comprised 146 Indonesian patients and 33 Japanese patients. Depth, maceration, and size were associated with DFU healing at 4 weeks from baseline [depth: OR = 0.317 (95% CI: 0.145-0.693, P = 0.004); maceration: OR = 0.445 (95% CI: 0.221-0.896, P = 0.023); size: OR = 0.623 (95% CI: 0.451-0.862, P = 0.004)]. Our findings suggest that appropriate management of maceration promotes DFU healing.diabetic foot ulcers, maceration, wound healing Key Messages• This study revealed the relationship between the items of DMIST and wound healing • Depth, maceration and size were associated with diabetic foot ulcer healing at 4 weeks from baseline • Our findings suggest that appropriate management of maceration promotes diabetic foot ulcer healing

Evaluating the cost‐effectiveness of diabetic foot ulcer management by wound care specialists in Indonesia

“…Our study selected a healing time of ≤12 weeks as the primary endpoint for the cost‐effectiveness analysis. Private practice wound healing is more effective, as shown by our study's mean HbA1c of 8, 38,39 mean QOL of 0.8, 40,41 and reduction in wound size 18,42 compared to that observed in national hospitals. This can be attributed to several factors.…”

A diabetic foot wound healing assessment tool: A scoping review

“…A secondary analysis of the data produced by Arisandi et al (2016) was used to develop a new seven-domain DFU assessment scale called the DMIST tool [ 7 ], which has been found to be a reliable and valid assessment tool for DFUs [ 11 ]. Three of the seven items on the DMIST scale, namely, depth, size, and maceration, have been found to be significantly correlated to wound healing, while a comparison indicated that the most frequently occurring components were wound extension size, depth, and exudate production or maceration [ 26 ], which are important indicators when monitoring wound healing [ 27 , 28 , 29 ]. In wound care management, a total score scale is essential for assessing wound healing [ 30 , 31 , 32 ].…”

“…According to another study, the variables of size, depth, and maceration of the DMIST tool provided the best model of healing. As they play a critical role in the inhibition of wound healing, they are extremely important factors when it comes to assessing wound healing and must be monitored at all times [ 26 ]. Another study discovered that good wound healing can be expected if the wound size and DMIST score decrease in the first four weeks [ 37 ].…”

“…Another study discovered that good wound healing can be expected if the wound size and DMIST score decrease in the first four weeks [ 37 ]. The DMIST tool has a significant impact on wound care management as it is comprised of several factors, namely, wound size, depth, and maceration, which are critical in wound care management and significantly affect wound healing [ 16 , 18 , 19 , 26 , 29 ]. Apart from the depth, size, and maceration of the wound, other items that are important in wound care management, such as the presence of infection, granulation, necrotic tissue in the wound bed, and tunnelling, which promote wound healing as well as the condition of the edges of the wound, must be included and monitored as the total score increases [ 31 , 38 ].…”

Pengaruh Pembalut Wanita Terhadap Terjadinya Maserasi Pada Luka Kronik Diabetic Foot Ulcer

“…Pembalut wanita adalah alat yang digunakan oleh wanita saat menstruasi yang berfungsi untuk menyerap darah dan juga biasa digunakan pembalut sehari-hari untuk memberikan kenyamanan pada organ reproduksi wanita, yang dalam proses produksinya menggunakan pembalut pemutih salah satunya adalah klorin (Cl2) . (Nasution et al, 2015) (Tsuchiya et al, 2022). Hasil ini berbeda dengan penelitian yang dilakukan oleh Yusuf et al, (2020) yang menyatakan bahwa pembalut wanita sebagai alternatif dressing dapat menurunkan skor DFUAS yang artinya terjadi peningkatan penyembuhan luka.…”