Every 30 seconds, one lower limb amputation due to diabetes is performed in the world. This study was conducted on a 64-year-old woman with a diabetic foot on her left leg [Sci Rew1] . The patient had pain with a visual analog scale (VAS) score of 80 mm on 100 mm. This study aimed to evaluate the effect of a product derived from leeches in the treatment of DFUs. Wound grade 1 according to Wagner’s classification system was covered with leech cream. A decoction of Hirudo orientalis was prepared by lyophilizing leeches at -80°C, the proteins containing biologically active substances (BAS) were extracted with normal saline, and this BSA was formulated in the form of cream. In vitro control of this pharmaceutical product was estimated according to the activity of these BSA. The leech cream was applied twice a day from the knee to the tail of the left toe for a month. The patient used no antibiotics and only received hygiene. After treatment, the patient was followed up for two months. Pain decreased significantly in terms of VAS: 40 mm after two days. At the end of the 3rd day, the pain completely disappeared. The granulation tissue was apparent on the toes' ulcers after a week. The diameter of the wound was reduced by ~50% in three weeks. After four weeks, the ulcers were completely healed. After two months follow up there was no sign of wound recurrence. Topical leech cream enhanced the wound healing process and, therefore, may have curative effects on DFUs.
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