Extracorporeal Shock Wave Therapy in the Treatment of Non-Healing Diabetic Ulcer: A Pilot Study

Abstract

Abstract15-20% of all diabetic patients develop a foot ulcer. Diabetic ulcer is the major cause of non-traumatic lower extremity amputation. Extracorporeal shock wave therapy (ESWT) has emerged as a promising therapy in the field of wound healing. In this study, Five patients with diabetic foot (mean age of 58.2 ± 19.63 years, mean ulcer duration: 1.6 years), received ESWT in 6-8 weekly sessions, at a flux density of 0.25 mJ/mm 2 , delivered as 500 shocks at wound margin and 1000 shocks distal to the wound. All patients had evidence of peripheral vascular disease and neuropathy before treatment. A significant reduction in ulcer surface area was observed in four patients (mean reduction: 1.21 ± 0.82 cm2, p value=0.03). All patients showed improvement in the ankle brachial index and monofilament test after treatment. In sum, ESWT may be a promising adjunct in the treatment of chronic, nonhealing diabetic ulcers.