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Journal of Traditional Chinese Medicine >

2026 , Vol. 46 >Issue 4: 1018 - 1025

DOI: https://doi.org/10.19852/j.cnki.jtcm.2026.04.021

Original Articles

Healing effects of Traditional Chinese Medicine plaster Heiyu Gao (黑玉膏) on refractory diabetic foot ulcers: a case series of ultra-elderly patients with surgical contraindications

  • ZHANG Danyu ,
  • WU Chengxiang ,
  • WU Yu ,
  • GU Jingyu
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  • 1 Department of Endocrinology and Metabolic Diseases, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China
    2 Department of Endocrinology, Nanjing Qixia District Hospital, Nanjing 210046, China
    3 Nanjing Gulou Jinling New Village Health Center, Nanjing 210015, China
    4 Department of Endocrinology, the First Affiliated Hospital with Nanjing Medical University, Jiangsu Province People's Hospital, Nanjing 210029, China
ZHANG Danyu and WU Chengxiang contributed equally to this article.

Received date: 2025-05-12

  Accepted date: 2025-10-20

  Online published: 2026-08-08

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Abstract

Debridement surgery and revascularization are essential procedures for treating refractory diabetic foot ulcers (DFUs). However, a significant therapeutic gap exists for patients deemed at prohibitively high surgical risk. We report a case series of three nonagenarian patients (aged 95, 94, and 96 years) with Wagner grade 4 DFUs in whom conventional treatments had failed and surgery was absolutely contraindicated. Two proprietary Traditional Chinese Medicine (TCM) black plasters, designated as Heiyu Gao (黑玉膏) A and B based on century-old formulations, were externally applied to the ulcers and surrounding skin. The uniqueness of these cases lies in their extraordinary clinical challenges and remarkable treatment outcomes. Complete ulcer healing was achieved in all patients within 27, 105, and 96 d, respectively, without requiring revascularization or surgical debridement. Treatment demonstrated two novel features: tissue-intelligent selective autolytic debridement targeting only necrotic tissue, and concurrent regenerative repair at wound margins. All patients experienced significant pain reduction within three days of initiating treatment. The healing was characterized by absence of scarring and restoration of normal skin architecture. The follow-up periods ranged from 95 to 580 d, with no recurrence observed. These findings suggest that TCM black plasters may offer an effective alternative for high-risk patients currently relegated to palliative care pathways.

Key words： diabetic foot; aged; debridement; tissue regeneration; non-invasive treatment; Heiyu Gao

Cite this article

ZHANG Danyu , WU Chengxiang , WU Yu , GU Jingyu . Healing effects of Traditional Chinese Medicine plaster Heiyu Gao (黑玉膏) on refractory diabetic foot ulcers: a case series of ultra-elderly patients with surgical contraindications[J]. Journal of Traditional Chinese Medicine, 2026 , 46(4) : 1018 -1025 . DOI: 10.19852/j.cnki.jtcm.2026.04.021

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