Treatment of recalcitrant diabetic ulcers using trichloroacetic acid

BACKGROUND: Despite using different treatment modalities, treatment of diabetic foot ulcer is still a very important challenge. In this case series, we report successful treatment of 6 patients with resistant diabetic ulcers using topical application of trichloroacetic acid (TCA). METHODS: Six patients with type 2 diabetes mellitus received standard treatment for 6 weeks. TCA 70% was applied to the periphery of the ulcer while TCA 50% was applied to the center of the ulcer every week until the first significant reepithelialization was observed. RESULTS: All wounds in all 6 treated patients were improved after a mean duration of 7.5 ± 0.83 weeks. In fact, significant reductions were observed in the areas and infection scores of the ulcers. CONCLUSIONS: The range of improvement efficacy ranged from 68.6% to 100% with no complications after 1, 2, and 3 months of follow-up. The observed efficacy of TCA on diabetic ulcer healing is due to production of granulation tissue and epithelial cells.