The impact of an aggressive clinic-based diabetic foot protocol: a single-center case series

The considerable health and economic burden of hard-to-heal wounds has become increasingly prominent. Diabetic foot ulcers (DFUs), as a representative type of these wounds, pose substantial challenges for health care professionals in both treatment and long-term management.

To evaluate the efficacy of a standardized wound hygiene protocol in promoting healing outcomes for DFUs and to provide supplementary clinical evidence to inform wound care practices.

Diabetic foot care specialists administered a wound hygiene protocol to 20 patients with DFUs. The protocol comprised 4 key components: cleansing, debridement, wound edge refashioning, and dressing coverage. Wound healing progress was monitored and documented over a 12-week observation period.

After 12 weeks of treatment with the wound hygiene protocol in the multidisciplinary diabetic foot clinic, 16 of the 20 patients achieved complete wound healing, while the remaining 4 patients showed significant wound improvement, resulting in a healing rate of 80%. Wound area, exudate level, and pain scores all showed significant improvement compared to baseline, with statistically significant differences (P < .001). The overall mean (SD) wound area reduction rate was 95.11% (10.46%), with a mean healing rate of 1.32 (0.36) cm² per week. The average healing time for patients with complete healing was 56.44 (25.12) days.

This case series demonstrates that the implementation of a wound hygiene protocol significantly enhances healing outcomes in patients with DFUs. These findings provide critical insights for the management of diverse hard-to-heal wounds in clinical practice.