Description: This publication reports that in people with recently healed diabetic foot ulcers, higher transepidermal water loss (TEWL)—a measure of poor skin barrier function—at the site of closure was associated with a substantially greater risk of the ulcer reopening within 16 weeks . In this multicenter study of 418 adults, 21.5% had recurrence by week 16, and participants with high TEWL (>30.05 g·m−2·h−1) had about double to triple the odds of recurrence compared with those with lower TEWL . The authors argue that a wound that looks closed may not be functionally healed unless the skin barrier has also recovered, and they suggest TEWL could be a useful point-of-care biomarker to identify patients at high risk for recurrence.

Citation: Sen, C. K., Gordillo, G. M., Roy, S., Jahnke, J., Sinha, M., Timsina, L., Mathew-Steiner, S. S., Conte, M. S., Holmes, C., Jones, T. L. Z., Pop-Busui, R., Kolenic, G., Spino, C., Gurtner, G. C., & NIDDK Diabetic Foot Consortium TEWL Study (2025). High Transepidermal Water Loss at the Site of Wound Closure Is Associated With Increased Recurrence of Diabetic Foot Ulcers: The NIDDK Diabetic Foot Consortium TEWL Study. Diabetes care, 48(7), 1233–1240. https://doi.org/10.2337/dc25-0300