Diabetic foot osteomyelitis remains a major contributor to limb loss in patients with type 2 diabetes mellitus (T2DM), particularly in the setting of infection and antimicrobial resistance. A prospective case series published in Diabetology evaluated clinical outcomes of adjunctive photodynamic therapy (PDT) in patients with infected diabetic foot ulcers that progressed to osteomyelitis.

The study included 16 patients treated at a university hospital with osteomyelitis secondary to diabetic foot ulcers. Clinical data were obtained from medical records, and wound progression was monitored using serial photographic documentation. Outcomes assessed included wound healing, limb preservation, and treatment duration.

Complete healing was observed in 13 patients (81.25%), while 2 patients (12.5%) showed partial healing and remained under treatment, and 1 patient (6.25%) underwent major amputation. Among those who achieved healing, the time to wound closure ranged from 19 to 546 days, with a median of 118 days. The number of PDT sessions varied from 2 to 12, depending on disease severity and treatment response.

Healing duration varied across cases, with longer healing periods corresponding to a higher number of treatment sessions. The hallux was the most frequent site of osteomyelitis. Healing time appeared comparable between insulin-dependent and non-insulin-dependent diabetes, with numerically shorter duration in the latter.

These findings suggest that adjunctive photodynamic therapy may improve wound healing and limb preservation in diabetic foot osteomyelitis, warranting further study in larger controlled trials.