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Minimally Invasive Drainage for Diabetic Foot Phlegmon.

Marco Cavallini¹

¹Department of Medical-Surgical Sciences and Translational Medicine, AOU Sant'Andrea, Sapienza, University of Rome, 00189 Rome, Italy.

Journal of Clinical Medicine

|June 13, 2025

Summary

A novel ulcer-piercing drainage (UPD) technique offers a minimally invasive solution for deep diabetic foot ulcers and infections. This method facilitates daily irrigation, improving wound cleansing and potentially reducing complications like scarring and amputation.

Keywords:

diabetic foot ulcer neuro-ischemic foot surgical drainage

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Area of Science:

Podiatry
Infectious Diseases
Surgical Innovation

Background:

Deep diabetic foot ulcers (DFUs) and infections (DFIs) require debridement, antibiotics, and drainage.
Traditional surgical drainage can lead to extensive incisions, scarring, and impaired rehabilitation.
Exudate stasis negatively impacts DFU and DFI healing.

Purpose of the Study:

To introduce an easy, minimally invasive surgical drainage technique for DFUs and DFIs.
To enable adequate ulcer cleansing through daily irrigation of the drained tract.
To mitigate the negative effects of stasis on wound healing.

Main Methods:

A probe is inserted into the ulcer's recesses and used to guide a small silastic tube through the skin.
The tube is secured and tied to form an ulcer-piercing drainage (UPD) ring.
The UPD ring maintains tract patency for daily irrigation via syringe.

Main Results:

The UPD procedure is demonstrated to be easy and safe.
The UPD ring design prevents displacement or accidental removal, suitable for home caregivers.
UPD and irrigation effectively cleanse ulcer recesses, reducing bioburden and bacterial load.

Conclusions:

The UPD technique offers a less invasive alternative to extended surgical incisions for DFUs and DFIs.
This method may prevent long scars, inadequate rehabilitation, relapses, and distal amputations.
UPD facilitates essential wound cleansing, promoting better healing outcomes.