Document Type

Presentation

Publication Date

Fall 10-5-2026

Abstract

Background: 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 an opportunity to identify and treat wounds before progression to severe infection or operative intervention.

Objectives: To characterize the prevalence and distribution of diabetes mellitus and wound related conditions among patients receiving care through Knoxville Street Medicine Outreach (KSMO).

Method: A retrospective chart review was performed using de-identified electronic medical records from 604 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. Descriptive statistics were calculated using Microsoft Excel and R.

Results: Among 604 patients, 58 (9.6%) had documented 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 had documented wounds. Lower extremity wounds and abscesses were the most frequently documented wound types. Among patients with both diabetes and wounds, abscesses and lower extremity wounds were the most frequently documented wound types. Most patients with wounds were unhoused (81.4%), as were 90% of patients with both diabetes and wounds.

Conclusions: Wound-related conditions were common among patients receiving street medicine services, with most patients with wounds being unhoused. 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 chronic and surgical wound care needs among medically vulnerable populations.

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