Foot Soaking in Household Water and Staged Skin Graft to Treat Diabetic Ulcers

Abstract

The Aims of this paper is to evaluate a regimen of daily soaking with household water to increase the healing rate of diabetic foot ulcers. Ulceration of the foot in diabetes is both common and disabling, and frequently leads to amputation of the leg. Infection is the main factor affecting morbidity and should be resolved as a first priority. Besides surgical debridement, daily wound care to remove minor debris is also important. Here we introduce daily foot soaking in household water to improve wound condition. The protocol for treating diabetic feet ulcers consisted of: (1) blood sugar control, (2) improving nutrition, (3) adequate wound debridement, (4) daily foot soaking with either normal saline or household water, and (5) staged surgical wound closure. Forty-eight patients (89%) had promising results controlling wound infection. Following grafting a part of the wound, the entire wound had improved vasculature and granulation tissue. There were no cases in which wound infections worsened after soaking. In summary, daily wound soaking removes deep debris and improves local infection in 1-weeks. Soaking in household water has the same effect as normal saline. Following staged split thickness skin graft, patients with large diabetic ulcers experienced gradual improvement in 2-4 months, and the amputation rate was reduced.