Investigation of the pain condition in diabetic foot ulcer patients following surgical reconstruction: A cross-sectional observational study

Pain is a characteristic manifestation in some patients suffering from diabetic foot ulcers (DFU). However, there have been few studies focusing on the pain experienced by DFU patients and the impact of surgical reconstruction on their pain. This cross-sectional study aims at investigating the changes in pain status and its influencing factors among DFU patients who have undergone wound repair surgery. The study involved 82 patients with DFU treated at a tertiary academic hospital in Guizhou province from January 2021 to September 2023. The patients were categorized into Pain and No-Pain groups based on their preoperative pain status. Their preoperative and postoperative pain levels were assessed using the brief pain inventory (BPI). Additionally, the pain status and wound healing rate were compared between the DFU patients that received free flap surgery and those who underwent skin transplantation. The total scores of pain intensity and pain-related effects in the pain group decreased from before repair surgery to 6 months after surgery; these scores were higher than those of the no-pain group. In both the free flap group and skin transplantation group of the painful patients, the total scores of pain intensity and pain-related effects at 1 month, 3 months, and 6 months postoperatively were significantly lower than were before surgery. Furthermore, the variations of pain intensity and pain-related effects did not significantly differ between the two groups at 1, 3, and 6 months postoperatively. Additionally, the wound healing rate of all painful patients was significantly lower than that of painless patients and the skin transplantation group. However, in the free flap group, the differences between painful patients and painless patients were not statistically significant. Also, the wound healing rate was not statistically different between the free flap group and skin transplantation group. Our results suggest that repair surgery of DFU patients can effectively alleviate the pain from before operation to 6 months after it. Therefore, they stress the need for intervention to achieve a timely repair of DFUs and relieve patients’ pain.