Supplementary wound healing techniques

Several supplementary wound healing techniques have been used in diabetic foot ulcers including the following.

Skin grafts

• To speed healing of large, clean ulcers with a granulating wound bed, a split-skin graft may be harvested from the patient and applied to the ulcer

• If the donor site is chosen from an area within the distribution of the neuropathy, local anaesthetic infiltration of the donor site with a spinal needle will provide sufficient analgesia

• A general anaesthetic can thus be avoided and a donor site from within the distribution of the neuropathy will be less painful

• Careful follow-up of plantar skin grafts will be needed as they often develop callus and if this is allowed to accumulate it will result in neuropathic ulceration.

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