The management of neuropathic ulcers of the foot in diabetes by shock wave therapy

INTERVENTION: Shock waves and Silvercel dressing versus Silvercel dressing alone. Follow‐up in all arms and treatments is for 20 weeks with standard dressing every 3 ‐ 4 days. CONDITION: Neuropathic Diabetic Foot Ulcers ; Nutritional, Metabolic, Endocrine ; Insulin‐dependent diabetes mellitus PRIMARY OUTCOME: 1. Wound area reductions, measured with the Rhinoceros program; 2. Time to complete ulcer healing, measured as the number of days from the start of treatment to the date that a patient achieved complete wound healing. If the healing wasn't within the 20 weeks of the study, the patient was considered as non‐healing and the time wasn't registered.; 3. Time to complete healing; 4. Index of re‐epithelisation of the wound area; ; The outcomes were measured every 10 days. SECONDARY OUTCOME: No secondary outcome measures INCLUSION CRITERIA: 1. A neuropathic foot plantar ulcer below the malleoli for a period of at least 15 to 30 days with an area wider than 1 cm^2 2. 30 ‐ 70 years old, either sex 3. Diameter of the lesion between 0.5 to 5 cm 4. Diabetes mellitus type I; in insulin treatment since at least 5 years ago