Diabetic foot ulcers are among the most serious complications of diabetes mellitus. They affect approximately 15% of diabetic patients over their lifetime, and are responsible for the majority of non-traumatic lower-limb amputations. Despite significant advances in wound care, outcomes remain poor for many patients — highlighting the ongoing need for innovation in multidisciplinary foot care.
Diabetic foot ulcers arise from a combination of peripheral neuropathy (loss of sensation), peripheral arterial disease (reduced blood flow), and repetitive mechanical stress on insensate tissue. Because patients with peripheral neuropathy cannot feel pain in their feet, minor injuries, pressure sores, and early ulceration may go unnoticed until they become seriously infected.
Classification systems such as the Wagner Grade scale (0–5) or the University of Texas Wound Classification System help clinicians standardise assessment and treatment planning. Grades range from superficial ulcers with no infection to deep wounds penetrating to bone with severe infection or gangrene.
Evidence-based management of diabetic foot ulcers is multidisciplinary and structured around several core interventions:
• Offloading: Removing pressure from the wound is the single most important intervention for plantar (sole of foot) ulcers. Total contact casting remains the gold standard; removable offloading devices are second-line. Without effective offloading, healing is severely compromised regardless of what else is done.
• Debridement: Sharp debridement removes devitalised tissue, reduces biofilm load, and stimulates the wound to re-enter the proliferative healing phase. Regular debridement is often required throughout the healing period.
• Infection management: Wound cultures guide antibiotic selection. Osteomyelitis (bone infection) requires extended antibiotic courses or surgical intervention. Silver-containing dressings are frequently used for local antimicrobial activity.
• Vascular assessment and intervention: Ankle-brachial pressure index (ABPI) assessment identifies those with significant arterial disease. Revascularisation — angioplasty or bypass surgery — significantly improves healing outcomes in ischaemic wounds.
• Glycaemic control: Elevated blood glucose impairs neutrophil function, collagen synthesis, and overall healing. Optimising HbA1c is a core component of care.
Within the framework of standard care, several adjunctive technologies are used to support the healing environment when first-line measures alone are insufficient. These include negative pressure wound therapy (NPWT), hyperbaric oxygen therapy, bioengineered skin substitutes, and growth factor applications.
Electrical stimulation has also been explored as an adjunctive modality. The rationale includes its potential to support fibroblast activity, influence the wound's bioelectrical environment, and assist cellular ATP production — all processes that are often impaired in chronic diabetic wounds.
The KFH NOVO is a microcurrent electrotherapy device CE-marked as a Class IIa medical device. Its use in wound care is supported by clinical observations, including documentation from the wound care team at Tameside Hospital NHS Foundation Trust, where it was used as part of a multi-modal protocol for a chronic diabetic foot wound.
The Tameside case documented the KFH NOVO's integration into an existing wound care plan after standard approaches had reached a plateau. The wound care team monitored outcomes including wound dimensions and wound bed condition over subsequent treatment weeks. The observations were sufficiently encouraging to support further clinical interest in the device.
As with all adjunctive technologies in wound care, KFH NOVO should be considered as a complement to — not a replacement for — evidence-based standard care. Its role is to support the healing environment, and it should be selected and monitored by qualified wound care professionals.
KFHealth provides clinical evidence dossiers, training materials, and treatment protocol guidance to wound care teams considering the KFH NOVO. Volume pricing and professional support are available through the KFHealth professional programme. Contact the professional team via kfhealth.eu for further information.
DISCLAIMER: This article is directed at healthcare professionals in the European Union. KFH NOVO is a CE-marked medical device for use as an adjunct within a multidisciplinary wound care plan under professional supervision. It is not a standalone wound treatment and does not replace standard wound care protocols. Individual patient outcomes will vary. Prescribing and use should comply with all applicable medical device regulations and institutional policies.
