Use of autologous whole blood clot for hard-to-heal diabetic foot ulcers: a case series

Abstract

Objective: Diabetic foot ulcers (DFUs) are a severe complication of diabetes, contributing significantly to patient morbidity, healthcare costs and amputations. Current treatment approaches often fall short in addressing the challenges posed by hard-to-heal (chronic) wounds. This study evaluates the efficacy of autologous whole blood clot (AWBC) therapy in treating hard-to-heal DFUs. Method: Patients with hard-to-heal DFUs who were unresponsive to previous treatments were included in this case series. Prior to AWBC application, the wounds underwent debridement and cleansing of the wound bed. For the treatment, 18ml of blood was drawn from the patients to create the clot placed on the wound. Patients were evaluated weekly for wound healing progress. Results: AWBC treatment was initiated in 20 patients, resulting in an average wound size reduction of 59% (p<0.001). The mean number of applications per patient was 5.3 +/- 1.5. Adverse events included contact dermatitis in one patient and discontinuation by another due to slower-than-expected healing. Conclusion: The results of this case series underscore AWBC's potential to restore the wound healing cascade by mimicking the extracellular matrix and promoting re-epithelialisation, angiogenesis and macrophage phenotype transition. AWBC represents a promising, cost-effective solution for DFU management, particularly in patients with complex comorbidities. Declaration of interest: The authors have no conflicts of interest.