Extracorporeal shockwave therapy as a key component of interdisciplinary wound management in diabetic foot syndrome : A case report.
Richard Crevenna, Zoltan Vass, Michael Mickel et al.
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Case in brief
A 57-year-old man presented with newly recognized severe type 2 diabetes and diabetic foot syndrome complicated by osteomyelitis. He received conservative, multimodal interdisciplinary wound care, including focused extracorporeal shockwave therapy (fESWT). After five fESWT sessions, local wound management led to removal of a substantial bony sequestrum. A large cavity remained at the right great toe, approximately the size of a phalanx; substantial granulation of the deep cavity was observed within 4 days. The report describes fESWT as a possible adjunct in selected cases and notes that prospective randomized trials are needed.
What made this case unusual
The notable wound response was substantial granulation of a deep, phalanx-sized cavity within 4 days after sequestrum removal, during interdisciplinary care that included fESWT.
Diagnostic / clinical pearl
In diabetic foot syndrome with osteomyelitis, a bony sequestrum may be identified and removed during local wound management; this case also illustrates the need to interpret rapid healing observed alongside fESWT as a case-level finding, not proof of treatment effect.
Why it matters
The case supports considering fESWT as a potential adjunct in selected complicated diabetic foot wounds, while underscoring the need for prospective randomized controlled trials.