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World J Diabetes. Aug 15, 2026; 17(8): 121505
Published online Aug 15, 2026. doi: 10.4239/wjd.121505
Published online Aug 15, 2026. doi: 10.4239/wjd.121505
Risk stratification nomogram for diabetic foot ulcer recurrence after healing in type 2 diabetes
Bo-Wen Dai, Guang-Yao Xu, Wen Sun, Ying-Na Tao, Kan Ze, Department of Surgery VIII (Dermatology and Sores), Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
Fei Qi, Department of Vascular Medicine II, Shanghai Integrated Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200003, China
Co-first authors: Bo-Wen Dai and Fei Qi.
Author contributions: Dai BW was responsible for statistical analysis; Qi F contributed to vascular assessment; Dai BW and Qi F contributed to patient data collection and manuscript drafting, they contributed equally to this article, they are the co-first authors of this manuscript; Xu GY, Sun W, and Tao YN participated in patient recruitment and follow-up; Ze K conceived and supervised the study and critically revised the manuscript; and all authors approved the final version and agreed to be accountable for all aspects of the work.
AI contribution statement: The authors declare that no AI tools were used in any aspect of the preparation of this manuscript, including study design, data collection, data analysis, interpretation of results, manuscript writing, or language editing. The authors assume full responsibility for the integrity, accuracy, originality, and scientific validity of the manuscript and all submitted materials.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, approval No. 2025SHL-KY-67-01.
Informed consent statement: The informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and analyzed during the current study are not publicly available but are available from the corresponding author (Kan Ze; zekan1@163.com) upon reasonable request.
Corresponding author: Kan Ze, MD, Vice-Chief Physician, Department of Surgery VIII (Dermatology and Sores), Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 274 Zhijiang West Road, Jing’an District, Shanghai 200071, China. zekan1@163.com
Received: March 27, 2026
Revised: June 8, 2026
Accepted: July 2, 2026
Published online: August 15, 2026
Processing time: 131 Days and 14.9 Hours
Revised: June 8, 2026
Accepted: July 2, 2026
Published online: August 15, 2026
Processing time: 131 Days and 14.9 Hours
Core Tip
Core Tip: This study introduces a new risk stratification model for recurrent diabetic foot ulcer based on clinical parameters, metabolic biomarkers and vascular assessments. The tool, based on a nomogram, achieves a high predictive accuracy (C-index 0.826) and successfully divides patients into three well-differentiated groups with statistically significant dissimilar recurrence values. This clinically relevant model allows for recognition of patients at high risk, and will guide targeted prevention efforts in this patient population and could lead to a substantial reduction in the burden of recurring diabetic foot ulcers.