Abstract

Background: Diabetic foot ulcers (DFUs) are one of the most important medical issues facing patient with diabetes. Neurological, vascular and immune factors may lead to delayed wound healing in diabetics. Current treatments for DFUs are often expensive, show variable efficacy and are not available to all patients. Pharmacological evaluation highlights several herbal and traditional medicines offer potential treatment candidates that can be considered for development of new therapeutics against various diseases. According to Persian Medicine (PM) literature, Myrtle (Myrtus communis) fruits and leaves, when applied topically, may be 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 woman 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 a gel containing Myrtle (M. communis), implied potential beneficial effect of Myrtle gel on DFUs. Myrtle gel (M. communis) used in combination with conventional diabetic medicines may offer an effective too for management of DFUs. (C) 2020 Elsevier Ltd. All rights reserved.