Combination Therapy Revives Hope for Patients with Diabetic Foot Ulcer: A Case Report

Abstract BackgroundDiabetic foot ulcers, as one of the most debilitating complications of diabetes, can lead to amputation. Treatment and management of diabetic foot ulcers are among the most critical challenges for the patients and their families. Case presentationThe present case report is of a 63-year-old man with a 5-year history of uncontrolled type 2 diabetes who has had diabetic foot ulcers for the past three years on three sites of the left external ankle in the form of two deep circular ulcers with sizes of 6×4 cm and 6×8 cm, the sole as a superficial ulcer with a size of 6×3 cm, and the left heel as a deep skin groove. Moreover, the left hallux was completely gangrenous. The patient's ulcers were infected with Staphylococcus aureus and multidrug-resistant Pseudomonas aeruginosa. Despite antibiotic therapy and routine dressing changes, the patient showed no improvement during the hospital stay. Accordingly, the patient was transferred to our service after consulting with the wound management team. Diabetic foot ulcers were treated and managed using a combination of maggot therapy, the Negative Pressure Wound Therapy (NPWT), and silver foam dressing. After three months and ten days, the patient's ulcers completely healed, and he was discharged from our service with the excellent and stable condition. ConclusionsBased on the present case report study's clinical results, wound-care teams can use the combination therapy applied in this study to treat refractory diabetic foot ulcers.