The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index; none of the 11 sources its claims cite is checked for support yet.
Multifactorial Insights into Chronic Leg Ulcers: Experience from a Tertiary Wound Care Center
Open accessAbstract
Objective: To analyze the demographic features, etiological factors, clinical profiles, and treatment outcomes of patients with chronic lower extremity wounds managed at a tertiary wound care center. Materials and Methods A retrospective review was conducted on 783 patients treated for chronic lower extremity wounds between May 2014 and January 2022. Patient demographics, comorbidities, wound etiology, microbiological data, histopathological findings, and treatment modalities were evaluated. Patients with trauma-related wounds or incomplete follow-up were excluded. Results: The mean age was 62.1 years, with females comprising 32% of the cohort. Diabetes was the leading cause of chronic lower extremity wounds (68.6%), followed by PAD in non-diabetic patients (21%), venous insufficiency (5.6%), and stasis dermatitis (3%). Pyoderma gangrenosum and drug reactions represented less common etiologies. Among diabetic foot ulcer patients, 55% were Wagner Grade 1–2, while 45% were Grade 3 or higher. Smoking prevalence was 74%, and associated with longer healing times. Wound closure was achieved via skin grafting in 58% of cases, secondary intention in 21%, and amputation in 12%. Negative pressure wound therapy was employed in 15% of cases. Staphylococcus aureus, Enterococcus spp., and Pseudomonas spp. were the most commonly isolated pathogens. Pyoderma gangrenosum was histologically confirmed in 6 patients. Conclusion: Diabetes and PAD remain the predominant etiologies of chronic lower extremity wounds. High smoking prevalence, delayed referrals, and advanced Wagner grades at presentation underscore the importance of early multidisciplinary intervention and standardized treatment protocols. The judicious use of negative pressure wound therapy, tailored antibiotic stewardship, and consideration of non-infectious etiologies in non-healing wounds are vital. Nationwide multicenter prospective studies are needed to develop uniform strategies for reducing the clinical and economic burden of chronic lower extremity wounds. a multidisciplinary approach are essential to improving outcomes and reducing the risk of limb loss.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This retrospective single-center study of 783 patients with chronic lower extremity wounds found diabetes and peripheral arterial disease to be the leading etiologies, with high smoking prevalence and advanced Wagner grades at presentation. Treatment outcomes included skin grafting in 58%, amputation in 12%, and negative pressure wound therapy in 15%, with the authors calling for earlier multidisciplinary intervention and standardized protocols.
Key findings
- Among 783 patients (mean age 62.1 years, range 24–82; 32% female), wound etiologies were diabetes 68.6%, peripheral arterial disease in non-diabetic patients 21%, venous insufficiency 5.6%, and stasis dermatitis 3%.
- Among diabetic foot ulcer patients, 55% were Wagner Grade 1–2 and 45% were Grade 3 or higher; smoking prevalence was 74%, and smokers had the longest treatment durations.
- Wound closure was achieved by skin grafting in 58%, secondary intention in 21%, and amputation in 12%; negative pressure wound therapy was used in 15%. The most common pathogens were *Staphylococcus aureus* (28%), *Enterococcus* spp. (20%), and *Pseudomonas* spp. (16%). Pyoderma gangrenosum was histologically confirmed in 6 patients.
- Amputation data showed 94 amputee patients: 69 diabetic and 25 PAD patients (73% vs 27%), with average follow-up durations of 70.6 days and 50.9 days, respectively. The paper also reports that 8.3% of diabetic foot ulcer patients underwent major or minor amputation, while 29.8% of patients presenting with peripheral arterial disease underwent major or minor amputation.
Methods
- Retrospective review of 783 patients treated for chronic lower extremity wounds at a tertiary wound care center between May 2014 and January 2022. Patients with trauma-related wounds or incomplete follow-up were excluded.
- Chronic wounds were defined as wounds open for more than four weeks with a Bates-Jensen Wound Assessment Tool score above 20 at admission. Data collected included demographics, comorbidities, wound etiology, microbiological results, histopathological findings, imaging, and treatment modalities.
- Ankle-brachial index was measured in patients with diabetes, smoking history, or ischemic heart disease; ABI below 0.9 prompted vascular surgery referral, and non-diabetic patients with low ABI were classified as having peripheral arterial disease-related ulcers. Venous Doppler ultrasonography was used for suspected stasis dermatitis. Healing was defined as Bates-Jensen score below 15 or wound closure through amputation.
Limitations
- The authors state that this was a retrospective analysis in a single tertiary care center, subject to selection, referral, and reporting biases; referred patients may represent more severe or complex presentations, limiting generalizability.
- The authors also state that the retrospective design introduced variability in clinical documentation, data completeness, and follow-up duration, potentially affecting consistency and reliability.
- Evident from the text: the study lacks a prospective or multicenter design, and the reported average follow-up of 64 days may limit assessment of longer-term wound outcomes.
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Claims the paper makes
23 Own result · 6 No full text of the sources · 4 Check pending · 4 Own method · 1 Not checked yet · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our culture data demonstrated a predominance of Staphylococcus aureus, Enterococcus spp., and Pseudomonas spp., which are among the most common organisms reported in chronic wounds (21).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
boosted- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A retrospective review was conducted on 783 patients treated for chronic lower extremity wounds between May 2014 and January 2022.”
- Also stated in: § RESULTS · plain
“A total of 783 patients meeting the inclusion criteria were analyzed.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and amputation in 12%.”
- Also stated in: § RESULTS · plain
“Amputation was performed in 12% of patients, and 21% achieved wound closure via secondary intention (Table 2).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and stasis dermatitis (3%).”
- Also stated in: § RESULTS · plain
“and stasis dermatitis (3%) (Table 1).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“followed by PAD in non-diabetic patients (21%), venous insufficiency (5.6%), and stasis dermatitis (3%).”
- Also stated in: § RESULTS · plain
“peripheral arterial disease in non-diabetic patients (21%), venous insufficiency (5.6%), and stasis dermatitis (3%) (Table 1).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Smoking prevalence was 74%, and associated with longer healing times.”
- Also stated in: § RESULTS · plain
“Among all patients, 74% were active smokers, and those who smoked had the longest treatment durations.”
- Also stated in: § DISCUSSION · plain
“In our cohort, the high incidence of smoking (74%) is a striking finding, supporting its known vasoconstrictive effects and detrimental impact on both microcirculation and immune response.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“while 45% were Grade 3 or higher.”
- Also stated in: § DISCUSSION · plain
“However, a major concern is that 45% of the patients had wounds classified as Grade 3 or higher, which represents a significantly high proportion.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Diabetic foot the leading cause of amputations.”
- Also stated in: § DISCUSSION · plain
“Additionally, diabetic wounds were the leading cause of lower limb amputations, underlining the need for early detection, glycemic control, and timely referral to multidisciplinary wound care teams (14).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > RESULTS
plainstates a cause- Asserted: passes — The authors put it forward as true.
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- Also stated in: § DISCUSSION · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Diabetes was the leading cause of chronic lower extremity wounds (68.6%), followed by PAD in non-diabetic patients (21%), venous insufficiency (5.6%), and stasis dermatitis (3%).”
- Also stated in: § RESULTS · plain
“The most common causes of chronic wounds were diabetes (68.6%), peripheral arterial disease in non-diabetic patients (21%), venous insufficiency (5.6%), and stasis dermatitis (3%) (Table 1).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainstates a causen = 783- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pyoderma gangrenosum was histologically confirmed in 6 patients.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 6- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In our study, 8.3% of the patients who presented with diabetic foot ulcers underwent either major or minor amputation.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Wound closure was achieved via skin grafting in 58% of cases, secondary intention in 21%, and amputation in 12%.”
- Also stated in: § RESULTS · plain
“Wounds not requiring amputation were treated mostly with partial-or full-thickness skin grafting (58%) (Figure 3).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among patients presenting with peripheral arterial disease, the rate of major or minor amputation was notably high at 29.8%.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“venous insufficiency (5.6%), and stasis dermatitis (3%).”
- Also stated in: § RESULTS · plain
“venous insufficiency (5.6%), and stasis dermatitis (3%) (Table 1).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean age was 62.1 years, with females comprising 32% of the cohort.”
- Also stated in: § RESULTS · plain
“The mean age was 62.1 years (range: 24-82), with 32% being female (mean age: 66.2).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Negative pressure wound therapy was employed in 15% of cases.”
- Also stated in: § RESULTS · plain
“In patients with high exudate levels, oscillating negative pressure wound therapy was used (15%).”
- Also stated in: § DISCUSSION · plain
“The use of negative pressure wound therapy (NPWT) in 15% of cases was associated with highly exudative wounds, consistent with its established role in reducing edema, promoting granulation tissue formation, and enhancing perfusion (19).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plain- Asserted: passes — The authors put it forward as true.
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- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among diabetic foot ulcer patients, 55% were Wagner Grade 1-2, while 45% were Grade 3 or higher.”
- Also stated in: § RESULTS · plain
“Among the patients presenting with diabetic foot, 55% were classified as Grade 1 or 2 according to the Wagner classification (Figure 2).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“secondary intention in 21%, and amputation in 12%.”
- Also stated in: § RESULTS · plain
“Amputation was performed in 12% of patients, and 21% achieved wound closure via secondary intention (Table 2).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Delayed or missed diagnoses of inflammatory dermatoses can lead to inappropriate treatments and worsened outcomes (23).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Check pendingcites [23] 23. George C, Deroide F, Rustin M. Pyoderma gangrenosum - a guide to diagnosis and management . Clin Med (Lond). 2019;19(3):224-228. source
plainstates a cause- Asserted: passes — The authors put it forward as true.
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In the paper
“In patients with an ankle-brachial index (ABI) below 0.6, its use may lead to progression of tissue necrosis.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [20] 20. Vig S, Dowsett C, Berg L, et al. Evidence-based recommendations for the use of negative pressure wound therapy in chronic wounds: steps towards an international consensus. J Tissue Viability. 2011;20 Suppl 1:S1-S18. source
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
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In the paper
“In contrast, studies from other countries report that only around 20% of patients presenting with diabetic foot ulcers fall into Grade 3 or higher categories (11).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Check pendingcites [11] 11. Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001 Jan;24(1):84-8. source
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, the retrospective nature of the study introduces variability in clinical documentation, data completeness, and follow-up duration, potentially affecting the consistency and reliability of collected information.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
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In the paper
“It must be emphasized that NPWT cannot serve as an alternative to appropriate revascularization procedures (20).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [20] 20. Vig S, Dowsett C, Berg L, et al. Evidence-based recommendations for the use of negative pressure wound therapy in chronic wounds: steps towards an international consensus. J Tissue Viability. 2011;20 Suppl 1:S1-S18. source
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The distal lower limb, especially the ankle and foot regions, has relatively poor perfusion compared to the proximal limb.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
plainstates an association- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 11
- It may state two separate claims as one. 5
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Approximately 61% of patients first presented through the outpatient clinic, while 19.6% were admitted via the emergency department.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > RESULTS
plainn = 783- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The average follow-up duration was 64 days, with the shortest healing time being 10 days.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > RESULTS
plainn = 783- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During follow-up, wound care was most frequently performed using conventional moist dressings.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > RESULTS
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean age was 62.1 years, with females comprising 32% of the cohort.”
- Also stated in: § RESULTS · plain
“The mean age was 62.1 years (range: 24-82), with 32% being female (mean age: 66.2).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainn = 783- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Smoking prevalence was 74%, and associated with longer healing times.”
- Also stated in: § RESULTS · plain
“Among all patients, 74% were active smokers, and those who smoked had the longest treatment durations.”
- Also stated in: § DISCUSSION · plain
“Our findings also highlight the prolonged treatment durations in smokers, in line with studies reporting delayed epithelialization and higher rates of infection and dehiscence in this group.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > Abstract
plainstates an associationn = 783- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Informed consent forms were obtained from all patients for the use of their clinical photographs.”
- Also stated in: § Additional information · plain
“Written informed consent was obtained from all patients for the use of their clinical data and photographs.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > MATERIALS AND METHODS
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Additional information · plain
In the paper
“The lower extremity, which bears the body's weight and contains dense muscular tissue for this purpose, is the most common site of chronic wounds (1).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [1] 1. Martinengo L, Olsson M, Bajpai R, et al. Prevalence of chronic wounds in the general population: Systematic review and meta-analysis of observational studies. Ann Epidemiol 2019;29:8–15 source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“where diabetic foot ulcers are reported to account for up to 70% of chronic lower extremity wounds (6).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Not checked yetcites [6] 6. Armstrong DG, Tan TW, Boulton AJM, Bus SA. Diabetic Foot Ulcers: A Review. JAMA. 2023;330(1):62-75. doi:10.1001/jama.2023.10578 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Furthermore, gravitational effects and compromised venous return contribute to stasis, edema, and tissue hypoxia, all of which hinder wound healing (12).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Check pendingcites [12] 12. Edmonds M, Manu C, Vas P. The current burden of diabetic foot disease. J Clin Orthop Trauma. 2021;17:88-93. Published 2021 Feb 8. source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“As a retrospective analysis conducted in a single tertiary care center, it is inherently subject to selection, referral, and reporting biases.”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Pathogens isolated from diabetic foot wounds are frequently characterized by a high degree of antimicrobial resistance (22).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Check pendingcites [22] 22. Hung SY, Chiu CH, Huang CH, et al. Impact of wound microbiology on limb preservation in patients with diabetic foot infection. J Diabetes Investig. 2022;13(2):336-343. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Smoking negatively affects both the healing rate and overall healing outcomes of diabetic foot ulcers (13).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [13] 13. Álvaro-Afonso FJ, Lázaro-Martínez JL, Papanas N. To Smoke or Not To Smoke: Cigarettes Have a Negative Effect on Wound Healing of Diabetic Foot Ulcers. Int J Low Extrem Wounds. 2018 Dec;17(4):258-260. source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The primary cause of chronic lower extremity wounds associated with diabetes is neuropathy (7).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [7] 7. Morbach S, Lutale JK, Viswanathan V, Möllenberg J, Ochs HR, Rajashekar S, Ramachandran A, Abbas ZG. Regional differences in risk factors and clinical presentation of diabetic foot lesions. Diabet Med. 2004 Jan;21(1):91-5. source
plainstates a cause- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“it is widely acknowledged among researchers that chronic wounds occur more frequently in male patients (8)”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [8] 8. Sorensen L, Molyneaux L, Yue DK. Insensate versus painful diabetic neuropathy: the effects of height, gender, ethnicity and glycaemic control. Diabetes Res Clin Pract. 2002 Jul;57(1):45-51. source
boostedstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This study was approved by the local ethics committee on January 5, 2022, with decision number 2022-01.”
- Also stated in: § Additional information · plain
“This study was approved by the Çanakkale Onsekiz Mart University Ethics Committee on January 5, 2022 (decision number 2022-01, application number 2011-KAEK-27/2021-2100214566).”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > MATERIALS AND METHODS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Additional information · plain
The paper relies on this without support.
The majority of patients with advanced Wagner grade (Grade 3+) were referred from other healthcare centers.
“Notably, the majority of these patients were referred from other healthcare centers.”
The paper relies on this without support.
Patients referred to tertiary centers often represent more severe or complex clinical presentations.
“Patients referred to tertiary centers often represent more severe or complex clinical presentations, which may limit the generalizability of the findings to the broader population with chronic lower extremity wounds.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“| Others | 14 | 9 | 5 | 0.8% |”
§ MULTIFACTORIAL INSIGHTS INTO CHRONIC LEG ULCERS: EXPERIENCE FROM A TERTIARY WOUND CARE CENTER > CONCLUSION
Reported 0.8 · recomputed 1.787995
Citations
Cites
Human skin wounds: A major and snowballing threat to public health and the economy
Sen, C. K., Gordillo, G. M., Roy, S., Kirsner, R., Lambert, L., Hunt, T. K., Gottrup, F., Gurtner, G. C., & Longaker, M. T. (2009) · Wound Repair and Regeneration · doi:10.1111/j.1524-475x.2009.00543.x · Cited by 2,965
Diabetic Foot Ulcers: A Review
Armstrong, D. G., Tan, T.-W., Boulton, A. J. M., & Bus, S. A. (2023) · JAMA · doi:10.1001/jama.2023.10578 · Cited by 1,928
Martinengo, L., Olsson, M., Bajpai, R., Soljak, M., Upton, Z., Schmidtchen, A., Car, J., & Järbrink, K. (2019) · Annals of Epidemiology · doi:10.1016/j.annepidem.2018.10.005 · Cited by 686
A Comparison of Two Diabetic Foot Ulcer Classification Systems
Oyibo, S. O., Jude, E. B., Tarawneh, I., Nguyen, H. C., Harkless, L. B., & Boulton, A. J. M. (2001) · Diabetes Care · doi:10.2337/diacare.24.1.84 · Cited by 468
The current burden of diabetic foot disease
Edmonds, M., Manu, C., & Vas, P. (2021) · Journal of Clinical Orthopaedics and Trauma · doi:10.1016/j.jcot.2021.01.017 · Cited by 437
Evaluation of Removable and Irremovable Cast Walkers in the Healing of Diabetic Foot Wounds
Armstrong, D. G., Lavery, L. A., Wu, S., & Boulton, A. J. M. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.551 · Cited by 266
Pyoderma gangrenosum – a guide to diagnosis and management
George, C., Deroide, F., & Rustin, M. (2019) · Clinical Medicine · doi:10.7861/clinmedicine.19-3-224 · Cited by 207
Paisey, R., Abbott, A., Levenson, R., Harrington, A., Browne, D., Moore, J., Bamford, M., & Roe, M. (2017) · Diabetic Medicine · doi:10.1111/dme.13512 · Cited by 112
Schneider, C., Stratman, S., & Kirsner, R. S. (2021) · Medical Clinics of North America · doi:10.1016/j.mcna.2021.04.006 · Cited by 91
Vig, S., Dowsett, C., Berg, L., Caravaggi, C., Rome, P., Birke-Sorensen, H., Bruhin, A., Chariker, M., Depoorter, M., Dunn, R., et al. (2011) · Journal of Tissue Viability · doi:10.1016/j.jtv.2011.07.002 · Cited by 86
Cited by
Still being checked.
Metadata
- Authors
- Akyürek, M., Kaya, B., & Bolca, A.
- Affiliations
- Çanakkale Onsekiz Mart Üniversitesi (TR)
- Venue
- Meandros Medical And Dental Journal
- Publisher
- Adnan Menderes University
- Published
- 2025-09-22
- Volume
- 26
- Issue
- 3
- Pages
- 350-355
- ISSN
- 1302-6755 (ISSN-L)
- 2149-9063
- OpenAlex
- W4414384103
- Cited by
- 0
- References
- 22
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Meandros Medical And Dental Journal (publishedVersion)
- Çanakkale Onsekiz Mart University Institutional Repository (submittedVersion, cc-by-nc-nd)
- Çanakkale Onsekiz Mart University AVESIS (submittedVersion)
- DergiPark (Istanbul University) (submittedVersion)
- Funders
- None
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Surgery › Wound Healing and Treatments
- Health Sciences › Medicine › Surgery › Diagnosis and Treatment of Venous Diseases
- Keywords
- chronic leg ulcers, diabetic foot ulcer, peripheral arterial disease, venous insufficiency, stasis dermatitis, pyoderma gangrenosum, smoking, Wagner grade, negative pressure wound therapy, skin grafting, wound microbiology, antibiotic stewardship, limb loss, late referral
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-11-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-11-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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