Diabetic Foot Ulcer Treated with High-Voltage Pulsed Current Therapy: Two Case Reports

Diabetic foot ulcers (DFUs) are chronic complications of diabetes mellitus that often result in delayed wound healing and in severe cases, even limb amputation. High-voltage pulsed current (HVPC) therapy has shown potential in promoting angiogenesis and cellular repair. This report describes two cases of chronic DFUs treated with adjunctive HVPC therapy. Two male patients with type 2 diabetes and chronic DFUs received HVPC therapy (3,000 V, 100 μs, 80–100 Hz) using a commercial device. Treatment was delivered every other day for 2 weeks (30 minutes per session), followed by every 3–4 days for an additional 2 weeks (20 minutes per session), alongside standard care including topical epidermal growth factor and systemic antibiotics. Wound healing was evaluated by area reduction, epithelialization time, and pain, using a visual analog scale. In Case 1 (Wagner grade 3, hemoglobin A1c [HbA1c] 6.8%), full epithelialization was achieved in 5 weeks. In Case 2 (Wagner grade 4, smoker, HbA1c 9.5%), complete healing was observed within 7 weeks after distal toe disarticulation. Both patients showed more than 75% wound reduction, pain resolution, and no adverse effects. These findings suggest that HVPC may be a useful adjunctive therapy for chronic DFUs, although controlled studies are needed to validate its clinical efficacy.