Clinical Triangulation, Effective Wound Healing, and Self-Care to Strengthen the Comprehensive Management of Neuropathic Ulcers

Abstract

Introduction: Neuropathic ulcers represent a global public health problem of high clinical complexity due to their high morbidity, risk of amputation, and impact on quality of life.

Objective: To analyze the impact of clinical triangulation, effective skin healing, and self-care on the comprehensive management of neuropathic ulcers.

Methods: A prospective, quasi-experimental, before-and-after study was conducted in individuals with diabetes mellitus and plantar neuropathic ulcers, with a follow-up period of 6 to 12 months. The evaluation was structured using three-dimensional triangulation: ulcer, systemic status, and self-care. Interventions included debridement, advanced dressings, adjuvant therapies, skin grafts, metabolic control, and a structured self-care education program. Variables related to healing, recurrence, self-care, and quality of life were analyzed.

Results: A reduction in lesion size and a mean healing time of 12.2 ± 3.1 weeks were observed. Improved metabolic control was evident, with a decrease in HbA1c and an increase in serum albumin. Additionally, increased self-efficacy and treatment adherence were recorded, along with an improvement in quality of life and a reduction in emotional distress.

Conclusions: The integrative model based on clinical triangulation, skin restoration, and self-care is effective in optimizing the management of neuropathic ulcers by promoting a multidimensional approach that integrates the local condition, systemic status, and the person’s active participation in their care process.