Published online Aug 15, 2023. doi: 10.4239/wjd.v14.i8.1323
Peer-review started: April 24, 2023
First decision: May 8, 2023
Revised: May 16, 2023
Accepted: July 14, 2023
Article in press: July 14, 2023
Published online: August 15, 2023
Processing time: 109 Days and 3.1 Hours
Diabetic foot ulcers (DFUs) are common in patients with diabetes, especially those undergoing hemodialysis. In severe cases, these ulcers can cause damage to the lower extremities and lead to amputation. Traditional treatments such as flap transposition and transfemoral amputation are not always applicable in all cases. Therefore, there is a need for alternative treatment methods.
This report describes a 62-year-old female patient who was admitted to the hospital with plantar and heel ulcers on her left foot. The patient had a history of renal failure and was undergoing regular hemodialysis. Digital subtraction angiography showed extensive stenosis and occlusion in the left superficial femoral artery, left peroneal artery and left posterior tibial artery. Following evaluation by a multidisciplinary team, the patient was diagnosed with type 2 DFUs (TEXAS 4D). Traditional treatments were deemed unsuitable, and the patient was treated with endovascular surgery in the affected area, in addition to supportive medical treatment, local debridement, and sequential repair using split-thickness skin and tissue-engineered skin grafts combined with negative pressure treatment. After four months, the wound had completely healed, and the patient was able to walk with a walking aid.
This study demonstrates a new treatment method for DFUs was successful, using angioplasty, skin grafts, and negative pressure.
Core Tip: Diabetic foot ulcers can be a serious and common complication of diabetes. In severe cases, they can lead to lower extremity damage and amputation. Traditional treatments such as flap transposition and transfemoral amputation are not always applicable in all cases. This report describes the successful treatment of ischemic diabetic plantar and heel ulcers in a patient undergoing hemodialysis using sequential treatment involving percutaneous transluminal angioplasty, tissue-engineered skin grafts, and negative pressure wound therapy. This treatment method may be a viable alternative for patients who are unsuitable for traditional treatments and could help prevent the need for amputation.