# Minimally Invasive Drainage for Diabetic Foot Phlegmon

## TL;DR

A new minimally invasive drainage technique is introduced to treat diabetic foot ulcers and infections more effectively and with fewer complications.

## Contribution

A novel, minimally invasive drainage system called the UPD ring is developed to improve wound healing and reduce surgical risks.

## Key findings

- The UPD ring allows for daily irrigation of infected ulcers, reducing bacterial load and bioburden.
- The technique avoids extended surgical incisions and reduces the risk of ulcer recurrence and amputation.
- The UPD system is safe, easy to use, and can be managed by caregivers at home.

## Abstract

Treatment for deep diabetic foot ulcers (DFUs) and infections (DFIs) includes debridement of any dead/infected non-viable tissue, systemic antibiotics, and surgical drainage to avoid exudate stasis. Surgical drainage can cause extended incisions leading to long scars which expose these sites to ulcer recurrence and inadequate rehabilitation. In order to treat the negative impact of stasis on wound healing, we have designed an easy, minimally invasive surgical drainage technique which allows adequate ulcer cleansing by daily irrigation of any drained tract. A probe is passed along the ulcer’s infected recesses until the end and pushed against the skin, which is incised and pierced. A small 6 Fr-size silastic tube is then anchored to the probe and pulled backwards. The two ends of the tube are tied together to construct an ulcer-piercing drainage (UPD) ring. The UPD ring is designed to keep any tract open for irrigation with a syringe through both sides of the skin opening. The UPD procedure is easy and safe. The constructed blocked ring of tubing the system avoids the possibility for drainage displacement or accidental removal and can be easily utilized by any home caregiver. The UPD and irrigation are useful to provide any recess cleansing, reduce critical and negative ulcer bioburden and bacterial load, and it could avoid unnecessary and untimely extended surgical incisions leading to long uncomfortable scars, inadequate rehabilitation, relapses, or distal amputations.