Successful Foot Salvage in a Patient With Diabetes Following Split-Thickness Skin Grafting and Antidiabetic Therapy: A Case Report

Abstract

Diabetes mellitus remains a major global health burden, particularly affecting wound healing in patients with traumatic injuries. Chronic hyperglycemia impairs tissue regeneration and immune function, increasing the risk of infection, delayed recovery, and potential limb loss. We aim to demonstrate the critical importance of glycemic control and multidisciplinary management in enhancing wound healing outcomes among diabetic patients undergoing surgical interventions. using the case of a 65-year-old male with a crush injury to the left foot following a road traffic accident. The patient underwent surgical debridement and split-thickness skin grafting. Postoperative complications prompted further clinical evaluation, revealing poorly controlled diabetes. A multidisciplinary team approach was initiated, incorporating endocrinological, surgical, nutritional, and antimicrobial strategies. Initial graft take was poor, accompanied by signs of systemic infection, including fever, leukocytosis, and hyperglycemia. However, following glycemic and nutritional optimization, wound healing significantly improved, and graft uptake was observed within two weeks. The patient was discharged after approximately two months with satisfactory healing, therefore highlighting the indispensable role of tight glycemic control in the postoperative care of diabetic patients. A multidisciplinary, holistic approach integrating endocrine, surgical, antimicrobial, and nutritional support significantly improves healing outcomes and reduces the risk of limb loss. Early metabolic intervention is essential to optimize recovery and enhance quality of life in diabetic wound care.