Breaking the stalemate: a case of a laser-accelerated healing of a chronic tendon-exposed diabetic foot ulcer.
Mohamed Hamdy Serour , Hussain Mohammad , Omar Aziza , Ibrahim Samir , AbdulAziz Almaheed , Naser Al-Humaidi
First published: 19 June 2026 │https://doi.org/10.1093/jscr/rjag109
Abstract
Chronic diabetic foot ulcers remain a major clinical challenge, particularly when complicated by tendon exposure and failure to respond to standard care.
We report a 47-year-old male with Type II diabetes mellitus with a history of smoking who developed a chronic ulcer of the fourth web space of the left foot. Following resolution of an initial soft tissue infection, the wound progressed to a non-healing ulcer with exposed but viable extensor digitorum longus tendon.
Despite guideline-directed management, healing plateaued. Adjunctive Erbium:YAG laser therapy was introduced only after failure of prolonged standard conservative management as a secondary intervention, resulting in progressive wound contraction, tendon coverage, and complete epithelialization by 8 weeks.
This case illustrates a stepwise approach to chronic diabetic foot ulcer management and the potential role of laser therapy after failure of standard care.