Complete ulcer healing was achieved in all three nonagenarian patients with Wagner grade 4 diabetic foot ulcers using TCM black plasters (Heiyu Gao A and B) within 27, 105, and 96 days, without requiring revascularization or surgical debridement.
Complete ulcer healing was achieved in all three patients treated with Heiyu Gao TCM black plasters.
All patients experienced significant pain reduction within three days of initiating treatment with the TCM black plasters.
The treatment demonstrated tissue-intelligent selective autolytic debridement targeting only necrotic tissue, with concurrent regenerative repair at wound margins.
No ulcer recurrence was observed in any patient during follow-up periods ranging from 95 to 580 days.
A significant therapeutic gap exists for patients with refractory diabetic foot ulcers who are deemed at prohibitively high surgical risk, for whom debridement surgery and revascularization are contraindicated.
This research reports on three extremely elderly patients (ages 94, 95, and 96) who had severe diabetic foot ulcers that had not responded to conventional treatments and who could not undergo surgery due to the high risk it would pose to their health. These patients were treated instead with two Traditional Chinese Medicine black plasters called Heiyu Gao A and B, which were applied externally to their wounds. All three patients achieved complete wound healing — within 27, 105, and 96 days respectively — without needing surgery or procedures to restore blood flow to the affected areas. The authors noted several notable features of the healing process: pain was significantly reduced in all patients within just three days of starting treatment, the plasters appeared to selectively break down only dead tissue while leaving healthy tissue intact, and healing occurred simultaneously at the wound edges. Importantly, the healed wounds showed no scarring and appeared to restore normal skin structure. None of the three patients experienced a return of their ulcers during follow-up periods that ranged from about three months to nearly two years. This research suggests that TCM black plasters based on century-old formulations may represent a potential treatment option for very high-risk patients with severe diabetic foot ulcers who currently have few options beyond palliative (comfort-focused) care. However, it is important to note that this study involved only three patients with no comparison group, so these findings are preliminary and cannot establish how broadly effective or safe this treatment might be. Larger, controlled studies would be needed to confirm these results.
Danyu Z, Chengxiang W, Yu W, Jingyu G. (2026). Healing effects of Traditional Chinese Medicine plaster Heiyu Gao on refractory diabetic foot ulcers: a case series of ultra-elderly patients with surgical contraindications.. Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan. https://doi.org/10.19852/j.cnki.jtcm.2026.04.021