This case report describes the successful management of a chronic diabetic foot ulcer with exposed extensor tendon after failure of prolonged guideline-directed standard care. Following six weeks of conservative treatment without meaningful healing progression, adjunctive Er:YAG laser therapy was introduced while continuing standard wound management. Progressive granulation, tendon coverage, and complete wound epithelialization were subsequently achieved.
Key Findings
47-year-old patient with Type II diabetes and chronic tendon-exposed diabetic foot ulcer
Six weeks of standard wound care resulted in minimal healing progression
Weekly adjunctive Er:YAG laser therapy was performed for six sessions
Wound area reduced from 2.8 cm² to 0.37 cm² within six weeks
Complete tendon coverage was achieved
Full epithelialization occurred 8 weeks after initiation of laser therapy
No treatment-related complications were reported.
Clinical Relevance
This case illustrates a structured escalation strategy for diabetic foot ulcers that fail to respond to guideline-directed standard care. Adjunctive Er:YAG laser therapy was introduced only after healing had plateaued and was associated with rapid granulation tissue formation, preservation of the exposed tendon, and complete wound closure. The report supports the potential role of laser therapy as a tissue-preserving secondary intervention in selected non-healing diabetic foot ulcers.
Citation
Serour MH, Mohammad H, Aziza O, Samir I, Almaheed A, Al-Humaidi N.
Breaking the stalemate: a case of a laser-accelerated healing of a chronic tendon-exposed diabetic foot ulcer.
Journal of Surgical Case Reports. 2026;2026(6):rjag109.