Management of a diabetic foot ulcer based on the Persian medicine: A case report

Abstract Background Diabetic foot ulcers (DFUs) are one of the most important medical issues. Neurological, vascular, immune complications beside other factors in diabetic patients, may lead to delayed wound healing. Most current treatments are expensive, show variable efficacy and they are not available to all patients. Herbal and traditional medicines are potential candidates that, following pharmacological evaluations, can be considered for development of new therapeutics against various diseases. According to Persian Medicine (PM) literatures, Myrtle (Myrtus communis) fruits and leaves, when applied topically, are able to repair wounds and foot ulcers. Polyphenols and anthocyanins are the most important bioactive compounds found in M. communis which exert wound healing properties. Case summary The case was a diabetic 66 year old women who had complaints related to a necrotic wound at the distal tip of the first digit of the right foot. She was treated with a surgical debridement and antibiotic regime and had an erythematous margin, no malodor and minimal discharge. An excisional debridement showed that the skin, subcutaneous tissue and periosteum were involved. Also, there was no evidence of osteomyelitis in radiographs. Intervention After sharp debridement, the wound area was washed with sterile normal saline and dried. Then, the wound was dressed with a myrtle gel 6%. The dressing was changed twice a day for 12 weeks and diabetes medications and antibiotic regime were continued. Conclusion Promising results obtained following application of myrtle gel, implied potential beneficial effect of the product on DFUs. On the basis of the results, it appears that currently used medicines in combination with topical myrtle gel as a PM remedy, can be more effective in DFUs.