Diabetic foot ulcers (DFUs) are the primary source of hospitalizations and amputations in persons with diabetes. In the U.S. alone, over 100,000 diabetes-related amputations are performed each year, with roughly half of them involving people 65 or older. As many as one out of four patients with diabetes will develop a DFU during their lifetime, and up to a quarter of these result in amputation. Amputations in patients with diabetes are associated with high morbidity and a 5-year survival rate of 31%.
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ILLUSTRATIONS: The case shown in the photos below illustrates how, even if a patient has diabetes and poor glyemic control, healing is not only possible but expected when the Winthrop Wound Healing Center’s protocols are followed. This patient had a diabetic ulcer of the left big toe that was infected down to the bone (top left) and a hemoglobin A1c level of 12.7. Though the open wound was small at 1cm x 1cm, the surrounding callus was considerably larger, being approximately 4cm x 2cm (top right). We performed a wide surgical debridement to remove the callus and surrounding tissue. Analysis of the removed toenail showed bacteria and organisms consistent with fungus (bottom left). Two months later, during the healing process, a small callus developed that was immediately removed (bottom right). By following our wound care protocol, the diabetic ulcer healed completely.