Management of heel ulcers in diabetes

Diabetic foot ulcers, especially those affecting the heel, are among the most challenging and severe complications of diabetes mellitus. These ulcers are associated with high rates of morbidity, risk of limb loss, and significant healthcare costs. This comprehensive review provides an updated synthesis of the pathogenesis, classification, conventional and emerging treatment modalities, and the essential role of interdisciplinary care in the management of heel ulcers in diabetic patients. We further share our experience of the past 15 years of diabetic foot management at a tertiary care center. While established interventions like debridement, off-loading, infection control, vascular assessment, and wound closure remain foundational, novel therapies such as negative pressure wound therapy, hyperbaric oxygen, and biological products are increasingly being integrated, particularly for refractory cases. A multidisciplinary approach, incorporating patient education and preventive strategies, is indispensable for improving outcomes and reducing recurrence.