BACKGROUND Aloe vera has been used as a traditional herbal therapy for wound management and dermatological conditions worldwide for thousands of years. Scientific evidence has confirmed that acemannan, the bioactive compound in aloe vera gel, exhibits significant anti-inflammatory and immunomodulatory properties that enhance tissue regeneration. This case report describes the successful application of an innovative acemannan-enriched glycolipid sphere dressing derived from aloe vera gel in diabetic foot ulcer (DFU) treatment, which achieved a clinically remarkable outcome. CASE SUMMARY An 80-year-old female patient with a 20-year history of type 2 diabetes mellitus experienced recurrent diabetic foot pain for 15 years. She had multiple hospitalizations due to acute infections and poorly controlled hyperglycemia. Long-term treatments included metformin and gliclazide. Upon presentation, she had a nonhealing wound on her left dorsal foot, diagnosed as a severe DFU (Texas classification: Grade II, stage D). She declined amputation and opted for conservative treatment. The medical team applied an acemannan-enriched glycolipid sphere dressing five times daily to the left calf and foot, avoiding the wound area. Frequency was reduced to three times daily after scab formation. Weight-bearing on the injured foot was avoided. Through in-person and online consultations, the team managed her lifestyle and diet, emphasizing natural foods. After 5 months, the DFU healed without significant scarring or functional loss. No recurrence was observed during the 2-year follow-up. CONCLUSION Acemannan-enriched glycolipid sphere dressings promote DFU healing. This suggests the potential of these dressings for treating other refractory wounds.
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