A Case of a Patient with Combined Diabetic Peripheral Neuropathy and Peripheral Vasculopathy Who Achieved Healing After Combined Multidisciplinary Outpatient Treatment of the Diabetic Foot

Abstract

Diabetic foot ulcer is one of the serious complications of diabetes, which is a chronic wound caused by a combination of factors such as limb ischemia, infection, lower limb neuropathy, etc. Its treatment and wound management pose significant challenges to all healthcare professionals. Currently, treatment for diabetic foot ulcers often focuses on surgical interventions such as skin grafting and amputation, significantly impacting patients’ quality of life. A 61-year-old female patient presented to the clinic due to a swollen skin breakdown on the right inner ankle. She was diagnosed with diabetes at the age of 53 and developed her first diabetic foot ulcer at the age of 60. Laboratory results from this visit revealed a glycosylated hemoglobin level of 9.7%, a glycosylated albumin level of 26.8% and a fasting blood glucose level of 16.1 mmol/L. Ultrasonography of the lower limb arteries showed localized intimal-medial thickening with multiple sclerotic plaque formation on both lower limbs. For this patient, the multidisciplinary joint outpatient clinic for the diabetic foot was given systemic treatments such as blood glucose control, nerve nourishment, circulation improvement, lipid regulation and plaque fixation, while the diabetic foot care specialist gave an individualized wound treatment plan of cleansing, debridement and dressing coverage by evaluating the wound’s pH, infection grading and exudate traits, among other indicators. After 2 months of comprehensive treatment, the patient’s blood glucose control was stable and the ulcer healed. This case of recurrent ulcer rehabilitation provides new ideas for diabetic foot ulcer wound treatment and individualized wound treatment based on diabetic foot care led by experts holds promise as another effective means for healing diabetic foot ulcers.