Researchers are calling on the Centers for Medicare & Medicaid Services to adopt new quality measures that encourage more frequent debridement and other advanced care for hard-to-treat wounds.

Citing amputation and five-year mortality rates among diabetic wound patients, they argued that “quality measures need to be considered at each patient inflection point to drive increased compliance with best practices in order to redirect patients whose therapies fail.” The International Wound Journal study was co-authored by William Tettelbach of the College of Podiatric Medicine, Western University of Health Sciences and biologist Allyn Forsyth of San Diego State University.

Despite broad research showing regular sharp debridements are key for diabetic patients with lower-extremity ulcers, a Medicare analysis found only 21% of such beneficiaries received it often enough to stave off amputation. The same analysis found wound care providers have not been applying skin substitutes early enough.

“Evidence-supported practices will provide the best patient outcomes and lower amputation rates,” authors wrote of promoting quality measures.