Background:Diabetic foot ulcer (DFU) is a serious health problem affecting 15% of patients with diabetes mellitus. Diabetic foot ulcers cause a decrease in the quality of life of patients like job loss, long-term hospital stay, financial burden and also lower extremity amputation. Many methods have been applied to treat patients with DFU, but amputations have not been prevented. In this study, we presented patients who had been referred to us from various hospitals with a decision for major amputation, but treated by us using intralesional epidermal growth factor therapy (EGF) combined with negative-pressure wound therapy (NPWT) to prevent below-knee amputation. Methods:Patients who had been referred to us from various hospitals with a decision for major amputation, but treated by us using combined therapy to prevent below-knee amputation. The efficacy of treatment was assessed according to wound closure and amputation prevention. Results:According to Wagner's classification, 17 (51.6%) out of 33 patients were the grade 3, and 16 (48.4%) were the grade 4 patients. Major amputation was performed in one patient. Infection was present in 24 (75%) of the patients. Necrosis was present in 12 (37.5%) of these patients. The average wound size was 18 cm (10-25 cm). Complete skin closure was achieved in 27 patients (84.3%), and closure with 100% granulation was achieved in 5 patients (15.6%). None of the patients underwent major amputation. EGF+NPWT treatment were administered for 45 days on average. Infections were developed in three patients during one-year of follow-up approximately, and medical treatment was administered.Conclusions: Our patients were in the high risk group for major amputation, which were referred from various hospitals with the recommendation of major amputation. We believe that the regular application of NPWT combined with EGF can prevent major amputations.