The Role of Vitamin C in Wound Healing in Surgically Managed Diabetic Foot Disease

Background: Diabetic foot ulcers (DFUs) represent a significant cause of morbidity in diabetic patients, with surgical management frequently required in advanced cases. This study examines the association between preoperative vitamin C levels and wound-healing outcomes in patients with diabetic foot disease (DFD) requiring surgical debridement. Methods: A retrospective cohort study was conducted at a tertiary referral centre, with the study including diabetic patients who had undergone surgical debridement for forefoot and midfoot diabetic foot infections between January 2020 and July 2024. Patients with ISDA grades 3 and 4 ulcers and preoperative measurements of vitamin C, albumin, HbA1c, and BMI were included. The primary outcome was time to wound healing, defined as the duration from surgery to discharge from the orthopaedic diabetic foot clinic. Data were analysed using generalized linear models to assess the impact of preoperative vitamin C levels on healing time, controlling for confounding variables. Results: In the 61 patients included in the multivariable regression analysis, higher preoperative vitamin C levels were significantly associated with faster wound healing (p = 0.01). Other significant factors included albumin levels and ulcer location, with midfoot ulcers healing more slowly than forefoot ulcers. The mean time to healing was 3 months, with vitamin C levels showing a statistically significant effect on wound-healing outcomes. Conclusions: Our study demonstrates that higher preoperative vitamin C levels were associated with faster wound healing in surgically treated diabetic foot ulcers. Future prospective randomized controlled trials are needed to confirm these findings and assess the role of vitamin C supplementation in the management of surgically treated DFUs.