Mechanism of Action of Extracorporeal Shockwave Induced Diabetic Foot Ulcer Healing

Diabetes is an increasing health problem and one of the commonest complications is diabetic foot ulcers. These hard to heal ulcers can result in uncontrollable infections, leading to amputation. New treatments to help ulcers heal faster and prevent infection are urgently required.


Shockwave therapy as a promising new treatment in which high-power soundwaves (similar to ultrasound) are delivered to the ulcer. This may make ulcers heal faster. However, we do not know why shockwaves help ulcers heal faster.


This study will be undertaken in patients already part of the SOLEFUL study. The SOLEFUL study randomly allocates patients with a diabetic foot ulcer into one of three groups: low dose shockwave therapy, high dose shockwave therapy and sham (no) shockwave therapy. The study monitors patients for 6 months to see which ulcers heal. In this study we are planning to take ulcer swabs, small ulcer samples and blood tests to look for chemicals responsible healing. This will help us to find out how shockwave therapy works and the most effective dose of shockwave therapy.