{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T02:54:12Z","timestamp":1775789652254,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,7,4]],"date-time":"2021-07-04T00:00:00Z","timestamp":1625356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Diabetic foot ulcer (DFU) is one of the slowest healing wounds that hurt the human body. Many studies from developed countries are concerned about materials, procedures, and equipment that accelerate the healing time. In Sweden, the diabetic foot management costs around 24965$\/patient. In this review, we would evaluate the healing time of DFUs during what is considered one of the worst humanitarian crisis of the 21st century. 1747 DFUs were studied from the main diabetic foot clinic in Damascus (2014\u20102019). We predicted many variables that could prolong the healing time. The cost according to these variables was also reported. The SINBAD Classification was performed to grade the severity of ulcers. We noticed that the median healing time for DFUs was 8 weeks. Almost half of these ulcers healed between 3 and 12 weeks. The time of healing for men was significantly longer than that for women. While the presence of infection doubled the median time of healing, the presence of peripheral artery disease doubled the mean of the direct health care cost. The location of the ulcer acted as another independent risk factor. In conclusion, DFUs face many barriers to heal during a crisis.The environment with resource\u2010poor settings should be added to the traditional risk factors that delay the healing of DFUs for months or even years. More studies from disaster are as are needed to evaluate low\u2010cost materials that could be cost effective in applying standard care of the diabetic foot.<\/jats:p>","DOI":"10.1111\/iwj.13651","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T01:58:27Z","timestamp":1625450307000},"page":"531-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Diabetic foot ulcer, the effect of resource\u2010poor environments on healing time and direct cost: A cohort study during Syrian crisis"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6746-3569","authenticated-orcid":false,"given":"Mhd Belal","family":"Alsabek","sequence":"first","affiliation":[{"name":"Al\u2010Mouwassat University Hospital Faculty of Medicine, Damascus University Damascus Syria"},{"name":"Faculty of Medicine Syrian Private University Damascus Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul Razzak","family":"Abdul Aziz","sequence":"additional","affiliation":[{"name":"Diabetic Foot Clinic, General Assembly of Damascus Teaching Hospital Damascus Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/0470846585.ch28"},{"key":"e_1_2_10_3_1","volume-title":"Diabetes Atlas","author":"IDF","year":"2019"},{"key":"e_1_2_10_4_1","first-page":"107493","article-title":"Diabetic foot and disaster; risk factors for amputation during the Syrian crisis","volume":"01","author":"Aziz ARA","year":"2019","journal-title":"J Diabetes Complications"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ando.2017.11.005"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15010089"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-2367"},{"key":"e_1_2_10_8_1","volume-title":"IBM SPSS Statistics for Windows, Version 25.0","author":"Corp IBM","year":"2017"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018817744513"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13973"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"e3273","DOI":"10.1002\/dmrr.3273","article-title":"International Working Group on the Diabetic Foot (IWGDF) guidelines on the classification of diabetic foot ulcers (IWGDF 2019)","volume":"36","author":"Monteiro\u2010Soares M","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734616654567"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4103\/ijabmr.IJABMR_278_18","article-title":"Clinical profile and outcome in patients of diabetic foot infection","volume":"9","author":"Seth A","year":"2019","journal-title":"Int J Appl Basic Med Res"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0491-1"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0940-0"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13651","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.13651","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.13651","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,5]],"date-time":"2023-11-05T16:56:40Z","timestamp":1699203400000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.13651"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,4]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1111\/iwj.13651"],"URL":"https:\/\/doi.org\/10.1111\/iwj.13651","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,4]]},"assertion":[{"value":"2021-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}