Complete Closure of a Complex Diabetic Foot Wound Following Adjunctive Treatment With a Wharton’s Jelly Mesenchymal Stromal Cell-Derived Secretome: A Case Report

Diabetes-related foot wounds remain a major clinical challenge because impaired inflammatory regulation, angiogenesis, cellular migration, and extracellular matrix remodeling can delay tissue repair and increase the risk of infection and amputation.We report the case of a 56-year-old man with type 2 diabetes mellitus who presented with a complex left foot wound of approximately two months' duration, associated with purulent drainage, perilesional erythema, and fibrinous tissue.Wound culture yielded Enterococcus faecalis.Intravenous piperacillin-tazobactam, excisional debridement, wound irrigation, and serial local care achieved clinical control of the acute infectious process, although a residual open tissue defect persisted.No specific offloading strategy, specialized footwear, assistive device, or prescribed weight-bearing restriction was used during the treatment period.Adjunctive regenerative treatment with a Wharton's jelly mesenchymal stromal cell (WJ-MSC)-derived secretome was subsequently initiated.The product was administered as a 3 mL frozen liquid formulation in 0.9% sodium chloride using a combined intralesional and perilesional technique.Three applications were performed on days 13, 39, and 69 after hospital admission.During the first treatment session, an intravenous Myers' cocktail and high-dose vitamin C were also administered.Serial clinical photographs demonstrated progressive improvement of the wound bed, granulation tissue formation, wound contraction, and advancement of epithelialization.Complete epithelial closure was documented on day 99, corresponding to 86 days after initiation of secretome treatment and 30 days after the third application.This case documents a progressive healing response temporally associated with repeated administration of a WJ-MSC-derived secretome after clinical control of an infected diabetesrelated foot wound.Although causality cannot be established from a single case, the observed clinical course is consistent with the emerging regenerative potential of MSC-derived paracrine products and supports further investigation of cell-free secretome-based strategies for difficult-to-heal diabetes-related wounds.