TEWL Reveals Hidden Risk of Diabetic Foot Ulcer Recurrence

Dr. G explains transepidermal water loss (TEWL) and why a clinically closed diabetic foot ulcer can still have a compromised skin barrier. He outlines how TEWL reflects epidermal function, how diabetes and neuropathy impair skin recovery, and why “functional closure” differs from simple epithelialization.A multicenter study found higher TEWL at recently closed ulcer sites was linked to increased and earlier recurrence, suggesting TEWL could help guide extended offloading, closer follow‑up, and targeted care to reduce re‑ulceration risk.