{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T18:56:14Z","timestamp":1789239374614,"version":"build-2803163510"},"reference-count":38,"publisher":"Mark Allen Group","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2018,12,2]]},"abstract":"<jats:sec><jats:title>Objectives:<\/jats:title><jats:p> The mechanism of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in diabetic foot ulcers (DFUs) is unclear. The purpose of this study was to describe changes in MMP-1, MMP-9, and TIMP-1 levels during DFU healing, and to search for any correlation in the changes in MMP levels with wound healing, in order to find possible predictors of healing. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Patients with a DFU were recruited and placed into two groups, according to the degree of wound healing: \u2018good healers\u2019 and \u2018poor healers\u2019. Levels of MMP-1, MMP-9, and TIMP-1 were analysed by ELISA (enzyme-linked immunosorbent assay). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> A total of 22 patients participated in the study. The MMP-1 level was significantly higher at weeks zero (W0) and 12 (W12) in \u2018good healers\u2019 than in \u2018poor healers\u2019 (p=0.045 and 0.008, respectively). In contrast, the MMP-9 level was significantly lower in \u2018good healers\u2019 than in \u2018poor healers\u2019 at W0, W4, and W12 (p=0.001, 0.001 and 0.028, respectively). Receiver operator curve (ROC) analysis of the MMP-9 level, MMP-1\/TIMP-1 ratio, and MMP-9\/TIMP-1 ratio at W0 provided cut-off levels of 0.38, 0.056, and 9.06, respectively, which were best predictive of a reduction in wound area at W4 (\u2018good healers\u2019 versus \u2018poor healers\u2019; thereby predicting wound healing condition at W12) with a sensitivity of 81.8%, 81.8%, and 90.9%, and a specificity of 64.6%, 55%, and 64.6%, respectively. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> A \u2018poor healing scoring system\u2019 is therefore proposed that could be determined on patient admission, which has the potential to be used clinically as a predictor of healing, thus allowing an appropriate treatment plan to be developed. 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