Abstract:
Individuals experiencing homelessness face disproportionately high rates of chronic disease and wound-related complications due to limited access to preventive healthcare, hygiene resources, and longitudinal medical management. Street medicine programs provide a unique opportunity to identify and treat wounds before progression to severe infection or operative intervention. This study characterized the prevalence and distribution of diabetes mellitus and wound-related conditions among patients receiving care through Knoxville Street Medicine Outreach (KSMO). A retrospective chart review was performed using de-identified electronic medical records from 605 patients treated by KSMO between June 12, 2024, and July 10, 2026. Patients with documented diabetes mellitus and wound-related diagnoses were identified through the electronic medical record. Wound diagnoses were categorized by clinical presentation and anatomic location, and descriptive statistics were calculated using Microsoft Excel and R. Among 605 patients, 58 (9.6%) had diabetes mellitus, 86 (14.2%) had documented wound-related conditions, and 10 (1.7%) had both diabetes and wounds. Among patients with diabetes, 17.2% also presented with wounds. Abscesses represented the most frequently documented wound type, followed by lower extremity wounds. Patients with both diabetes and wounds most commonly present with chronic lower extremity wounds, diabetic foot ulcers, and lower extremity abscesses. Most wound patients were unhoused (81.4%), and 90% of patients with both diabetes and wounds were unhoused. Wound-related conditions were common among patients receiving street medicine services and disproportionately affected unhoused individuals. The predominance of abscesses and lower extremity wounds highlights the importance of early identification, timely wound management, and longitudinal community-based care to reduce progression to severe infection, hospitalization, and potential surgical intervention. These findings support the expanding role of street medicine programs in addressing surgical and chronic wound care needs among medically vulnerable populations.
