Traditional and Integrative Medicine 2016. 1(4):151-159.

Treatment of Diabetic Foot Ulcer in a 58-year-old Turkman Patient
Hassan Hajtalebi, Hassan Khani Iurigh, Hamid Reza Hajtalebi

Abstract


Introduction: Diabetic foot ulcer is among serious problems for diabetic patients and its treatment is

very complicated and requires great care. Inappropriate responses to various medical and surgical

treatments have made this complication problematic.

Case Presentation: The patient was a 58-year-old man with diabetes for more than twenty five years

and hospitalized with complaint of diabetic foot ulcers, uncontrolled blood sugar, and sepsis at

Shohadaye Gonbad Kavus hospital in June 2015. The patient's foot ulcer did not respond to

conventional treatments, and amputation order was made by his treating orthopedist. The patient

referred to traditional medicine clinic for counselling. The patient had two wounds on the right foot in

Zone 1 (Right 11 X and 1 XR) with a diameter of approximately 5 cm by 6 cm and Zone 2 (Right 9 Y

and 6, 7, 10 X) with a diameter of approximately 12 cm by 5 cm which was equivalent to STAGE

D/GRADE III according to clinical examination by traditional medicine physician based on the

standards of Texas University Diabetic Wound Classification System, and equivalent to GRADE 4

based on the standards of Wagner Comprehensive System for Wound Diabetic Foot. The patient's

health and nutrition was under control. Pharmaceutical measures in this patient were including the

herbal medicines (including both uni- and multi-component medicines), and conventional

antihyperglycemic drugs. The manual actions were including full back cupping every night until the

end of therapy, massage therapy, and leech therapy inside and around the wound with 10 to 12 fine,

medium and big leeches in 16 sessions every 2 to 4 days. The diabetic foot ulcer healed completely, the

patient's physical and mental states improved, and his blood sugar was controlled after 60 days of

treatment

Conclusion: It seems that combining the modern and traditional medicine can treat most of the

common diseases especially diabetic foot ulcer and it is essential to perform a wide range of

assessments and studies in different diseases based on the Iranian effective medicine.


Keywords


Diabetic Foot Ulcer, Traditional Medicine, Modern Medicine, Leech Therapy

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References


Levin ME. Pathogenesis and management of diabetic

foot lesion. In: Levin ME, O'Neal LW, Bowker JH,

editors. The Diabetic Foot. 5th ed. St. Louis:

Mosby;1993. 17-60.

Wild S,Roglic G,Green A,Sicree R,King H.Global

prevalence of diabetes.DiabetesCare 2004; 1047- 1053

Wieman TJ, Smiell JM, Su Y. Efficacy and Safety of

Topical gel formulation of recombinantHuman platelet-

Derived growth factor- BB (Beclapermin) in patients

with chronicNeuropathicDiabetic ulcers.DiabetesCare

; 21: 822-7.

Larijani B, Afshari M, Bastan Hagh MH, Pajouhi M,

Baradar Jalili R, Moadi M . Prevalence of lower limb

amputation in patients with diabetic foot ulcer in Imam

Khomeini and Shariati hospitals,1979-2001. J Med

Council of Islamic of Iran 2005; 1: 29-25.Persion.

Singh N, Armstrong DG, Lipsky BA. Preventing foot

ulcers in patients with diabetes. JAMA 2005; 12

(293):217-28.

RamachandranA. Specific problems of the diabetic foot

in developing countries. DiabetesMetab Res Rev 2004;

(Suppl 1):S19-22.

TheDiabetesControl andComplicationsTrialResearch

Group. Lifetime benefits and costs of intensive therapy

as practiced in the Diabetes Control and Complications

Trial. JAMA1996; 276:1409-1415.

SaarWE, Lee TH, Berlet GC. The economic burden of

diabetic foot and ankle disorders. Foot Ankle Int 2005;

:27-31.

Reiber GE, Vileikyte L, Boyko EJ,et al. Pathways for

incident lower-extremity ulcers in patientswith diabetes

fromtwo settings.;DiabetesCare 1999;22:157-162.

Larijani B, Afshari M, Darvishzade F, Bastan Hagh

MH, Pajouhi M, Baradar Jalili R, et al. Lower limb

amputation in patientswith diabetic foot ulcer:A22 year

review.MJIRC2006;8(3):21-24.

Alberti KG, Zimmet PZ. Definition, diagnosis and

classification of diabetes mellitus and its-complitions.

Part1: diagnosid and classification of diabetes mellitus,

provisional report of WHO Consulation. Diabet Med

; 15(7):539-53

Wagner FW. Supplement: algorithms of foot care. In:

LevinME,ONealLW, editors.The diabetic foot. 3rd ed.

St.Louis,MO,CV:Mosby; 1983. 291-302.

OyiboSO, JudeEB,Tarawneh I,NguyenHC,Harkless

LB,BoultonAJ.Acomparison of two diabetic foot ulcer

classification systems: theWagner and theUniversity of

Texas wound classification systems. Diabetes Care

; 24:84-8.

Wieman TJ, Smiell JM, SuY. Efficacy and safety of a

topical gel formulation of recombinant human plateletderived

growth factor-BB(becaplermin) in patientswith

chronic neuropathic diabetic ulcers. A phase III

randomized placebo controlled double-blind study.

DiabetesCare 1998;21(5):822-7.

McCulloch D, Asla R. Management of diabetic foot

lesions.UpToDateVer 18.1 (updated 31 Jan 2010).

Lavery LA.AmstrongDG,Harkless LB.Classification

of diabetic foot ulcerations 1. FootAnkle Surg 1996; 35:

-31

Wagner.The diabetic foot.Orthopedics. .l987; 10: l63-

l72.

Kalish J, Hamdan A.Management of diabetic foot

problems.JVasc surg 2010; 51(2):476-486

Kargar, Saeid; Javadzadeh-Shahshahani, Hayedeh;

Tabkhi, Naeimeh. The effect of platelet gel on treatment

of diabetic foot ulcers. Research Quarterly of Blood,

; 6: 91-283.

Ardeshir-Larijani, Mohammad-Bagher; Afshari,

Mojgan; Fadaei, Manijeh; Bastan-Hagh, Mohammad-

Hassan; Baradar-Jalili, Reza; Pajouhi, Mohammad;

"Study on the Effect of local epidermal growth factor on

wound healing in diabetic foot". Iranian Journal of

Endocrinology andMetabolism, 2003; 5: 107-110.

Moudi, Hesam; Akbari, Asghar; Ghiasi, Fatemeh;

Mahmoudzadeh-Sagheb, Hamidreza; Heidari, Zahra;

Rashidi, Homeyra. "The impact of transpression

Vacuum-compression therapy (VCT) on healing the

diabetic foot ulcers". Scientific Journal of Zanjan

University ofMedicalSciences, 2006; 14: 15-22.

Ataei-Fashtami, Leila; Esmaeili-Javid, Alireza;

Kaviani, Ahmad; Ardeshir-Larijani, Mohammad-

Bagher; Razavi, Laleh; Salami, Maliheh; Fateh,

Mohsen; Fatemi, Seyed-Mostafa; Mortazavi, Seyed-

Mohammad-Javad. The role of laser therapy in

treatment of diabetic foot ulcers: a randomized, doubleblind

clinical trial:Medical laser, 2008; 5: 6-11.

Zahmatkesh, Mohsen; Rashidi, Maryam. Report of a

treatment case of diabetic foot ulcer by topical honey and

olive oil.MedicinalPlants, 2008; 8: 36-40.

Bahrami, Amir; Ali-Asgarzadeh, Akbar; Sarabchian,

Mohammad-Ali; Mobseri, Majid; Heshmat, Ramin;

Ghoujazadeh, Morteza. "Double blind clinical trial for

evaluating the effect of oral"Angi Pars" drug on chronic

diabetic foot ulcers. Journal of Endocrinology and

Metabolism, 2009; 11: 647-55.

Kashef,Nasim; Shojaeifard,Abolfazl; Esmaeili-Javid,

Alireza; Mohajeri, Mohammadreza; Rezaei, Razieh;

Salami, Maliheh; Ghodsi, Maryam; Fateh, Mohsen.

Study on the low-power laser in treatment of chronic

diabetic foot ulcers: microbiological quantitative

assessment.Medical laser.Summer 2009; 6: 31-35.

Kazemikhou, Noushafarin; Khamseh, Mohammad-

Ebrahim; Hashem-Dabbaghian, Fattaneh; Hajizadeh,

Mitra; Akrami, Seyed-Mohammad. "The study on the

effects of low-power laser in treatment of diabetic foot

ulcers grades 2 and 3 (short report)". Iranian Journal of

Diabetes and Metabolism (Iranian Journal of Diabetes

andLipid), 2008; 8: 195-202.




Traditional and Integrative Medicine(Quarterly)
pISSN: 2476-5104,  eISSN: 2476-5112 

Tehran University of Medical Sciences, Tehran, Iran. 
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