Diabetic foot ulcers (DFUs) remain one of the most difficult wound types to manage, especially in elderly patients with multiple comorbidities. At SAWC Fall 2025, Dr. Chia-Ding Shih, a respected podiatric surgeon and public-health researcher, presented a striking collection of real-world DFU cases illustrating how early inflammation control and consistent wound-bed support can influence outcomes.
Dr. Shih highlighted a harsh reality: elderly DFU patients face higher rates of non-healing, infection, and major amputation compared with younger populations, due largely to PAD, long-standing diabetes, and impaired perfusion . Despite careful offloading and SOC, many wounds stagnate unless inflammation is addressed directly.
His case series featured several U.S. clinical patients treated with Bonvadis®, many with ulcer durations exceeding 5–9 months prior to intervention. Notably:
Case Highlights
Case 1 — Plantar heel DFU (60-year-old male)
- Ulcer duration: 6.75 months
- Complete closure in 7 weeks
Case 2 — Dorsal midfoot DFU (60-year-old male)
- Long-standing diabetes; strong perfusion
- Healed in 9 weeks
Case 3 — Great toe DFU (75-year-old female)
- Strong vascular assessment; chronic wound
- Healed in 6 weeks
Case 4 — Lateral toe DFU (87-year-old female, PAD)
- Did not fully close within the trial period
- Significant reduction from 1.05 cm² → 0.2 cm²
- Became partial-thickness despite severe comorbidities
Across these cases, several themes emerged:
- Rapid size reduction often within the first few weeks
- High patient compliance due to straightforward application
- No observed adverse effects
- Notable pain improvement, improving patient tolerance
- Potential for limb preservation even in high-risk elderly patients
Dr. Shih’s message centered on reframing DFU management: rather than waiting for wounds to stabilize on their own, clinicians must actively interrupt excessive inflammation and create the conditions for consistent healing. His data suggest that Bonvadis® may serve as a valuable tool for bridging that gap, particularly in frail populations who cannot withstand prolonged non-healing.
