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

**Authors:** Ernest Chukwuma, Ehondor Michael, Ehondor Malcolm, Amietubodie Miebaka, Anita Osawota, Kalu Victor O., Joy Agu, Ginika S Okafor, Ebenezer Tamunoseipiriye, Chinua Onyebuchi

PMC · DOI: 10.7759/cureus.101889 · Cureus · 2026-01-20

## TL;DR

A diabetic patient's foot was successfully treated with skin grafting and improved diabetes management, showing the importance of controlling blood sugar and teamwork in wound healing.

## Contribution

Demonstrates the effectiveness of tight glycemic control and multidisciplinary care in diabetic wound healing.

## Key findings

- Poor initial graft take improved after glycemic and nutritional optimization.
- Multidisciplinary care reduced infection and enhanced wound healing.
- The patient achieved satisfactory healing and was discharged after two months.

## 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.

## Linked entities

- **Diseases:** diabetes mellitus (MONDO:0005015)

## Full-text entities

- **Genes:** TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}
- **Diseases:** road traffic accident (MESH:D000081084), adrenal abnormalities (MESH:D000224), febrile (MESH:D000071072), tachycardia (MESH:D013610), bleeding (MESH:D006470), superinfection (MESH:D015163), fever (MESH:D005334), metabolic derangements (MESH:D008659), degloving injury (MESH:D000069836), dehiscence (MESH:D013529), asthmatic (MESH:D013224), Lisfranc fracture (MESH:D050723), Pain (MESH:D010146), head trauma (MESH:D006259), Hyperglycemia (MESH:D006943), inflammatory (MESH:D007249), Lisfranc injury (MESH:D014947), Diabetes (MESH:D003920), LOC (MESH:D014474), drug allergies (MESH:D004342), postoperative infections (MESH:D013530), hepatitis (MESH:D056486), infectious disease (MESH:D003141), sepsis (MESH:D018805), autonomic neuropathy (MESH:D009422), necrosis (MESH:D009336), Lisfranc dislocation (MESH:D004204), HIV (MESH:D015658), Malnutrition (MESH:D044342), crush injury (MESH:D000071576), limb loss (MESH:D001259), Hypertension (MESH:D006973), epileptic (MESH:D004827), amputated (MESH:C565682), DFUs (MESH:D017719), anemia (MESH:D000740), insulin resistance (MESH:D007333), tachypnea (MESH:D059246), leukocytosis (MESH:D007964), dehydrated (MESH:D003681), avulsion (MESH:D000071562), endocrine dysfunctions (MESH:D004700), Postoperative complications (MESH:D011183), foot trauma (MESH:D005530), Infection (MESH:D007239), protein deficiency (MESH:D011488)
- **Chemicals:** metformin (MESH:D008687), blood glucose (MESH:D001786), tinidazole (MESH:D014011), paracetamol (MESH:D000082), oxygen (MESH:D010100), salt (MESH:D012492), metronidazole (MESH:D008795), Telmisartan (MESH:D000077333), Nifedipine (MESH:D009543), betadine (MESH:D011206), glucose (MESH:D005947), cefotaxime (MESH:D002439), STSG (-), pentazocine (MESH:D010423), ceftriaxone (MESH:D002443)
- **Species:** Nicotiana tabacum (American tobacco, species) [taxon 4097], Homo sapiens (human, species) [taxon 9606]

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12917927/full.md

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12917927/full.md

## References

8 references — full list in the complete paper: https://tomesphere.com/paper/PMC12917927/full.md

---
Source: https://tomesphere.com/paper/PMC12917927