This protocol addresses the clinical scenario in which a diabetic foot ulcer fails to show signs of healing after 6 weeks of comprehensive, optimised standard wound care — and defines the next management step.
Standard first-line care comprised offloading with a non-removable knee-high device, repeated debridement with removal of surrounding callus, appropriate dressings to maintain a moist wound environment, optimisation of glycaemic control, and correction of oedema or malnutrition where present.
Escalation trigger: no signs of healing of the foot ulcer within 6 weeks of this optimal management.
When a non-infected diabetic foot ulcer does not respond to optimal standard care, specific adjunctive wound-care interventions are considered — with the choice determined by the ulcer's vascular and tissue characteristics.
The complete protocol specifies which adjunctive approach applies and under what conditions.