Challenges in Preventing Diabetic Foot Ulcers – an Illustrational Case Study

Introduction: Chronic foot ulcers are a severe complication for patients with diabetes, significantly impacting quality of life, increasing financial burden, and leading to non-traumatic amputations in the United States. The high prevalence of diabetic foot ulcers (DFUs) is due to mechanical and physiological factors. Mechanically, neuropathy-induced pressure points make the skin prone to breakdown. Physiologically, reduced circulation and immunity contribute to chronic ulcer development. Effective prevention and treatment of DFUs require a multifaceted approach.Methods:Case Study: A 65-year-old Caucasian male with a history of a left below-knee amputation and right second toe amputation presented with multiple right foot ulcers post-hospitalization. Initial assessment revealed ulcers and scabs on the dorsum of the right foot, first ray, hallux, and third and fourth toes. The patient reported the ulcers had been present for at least three months. Initial treatment with hydrocolloid dressings and foam was partially effective, but ulcers on the dorsum of the right hallux, third, and fourth toes persisted after one week. Given his medical history, a retention-processed tri-layer amnion/chorion* was selected for its growth factor preservation. Following one application, the ulcers on the third and fourth toes healed, but the hallux ulcer remained resistant. Increased mobility and subsequent trauma, along with new pressure points on the right hallux, medial right heel, and plantar aspect of the right fifth metatarsophalangeal joint, were observed. Advanced optical technology# was used to monitor skin temperature and tissue oxygenation. Offloading devices were implemented, and the patient continues to recover under close supervision.Results:Discussion: This case highlights the complexity of managing DFUs, especially in patients with significant comorbidities and mobility issues. Advanced wound care products can promote healing, but comprehensive management must also address mechanical factors like pressure and trauma. Technologies are crucial for monitoring and optimizing the wound environment. A multifaceted approach, including advanced dressings, vigilant monitoring, and mechanical offloading, is essential for effective DFU management and prevention. Continued research and innovation in wound care technologies are vital for improving outcomes in diabetic patients with foot ulcers.References: