Ulcer classification and current appearance
Grade, depth, size, duration, drainage, necrosis, exposed tendon or bone and recent photo sequence are organized in one clinical timeline.
← Specialist review & coordination areas
Wound-care evaluation
Diabetic Foot Ulcer / Heberprot-P® Evaluation
A structured file review for complex diabetic foot ulcers, organized around wound depth, infection status, vascular supply, diabetes control, previous wound-care response and whether a Heberprot-P® discussion may be clinically appropriate.
Medical disclaimer: This page is for information and international coordination only. It does not diagnose, prescribe, guarantee suitability or replace urgent local medical care.
Clinical file logic
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The review starts with wound safety and limb-risk context.
Diabetic foot ulcer evaluation is not a simple photo review. The physician needs to understand whether the wound is ischemic, neuropathic, infected, surgically managed, improving, stalled or worsening. The file is prepared so the clinical question is realistic and the patient is not pushed toward international coordination before urgent local care is addressed.
Vascular supply and limb perfusion
Doppler, ABI, angiography, vascular surgery notes or revascularization history are reviewed because blood supply can determine whether advanced wound therapies are safe or realistic.
Infection and osteomyelitis status
Culture results, antibiotics, inflammatory markers, imaging for bone infection and debridement history are checked before any treatment or travel discussion.
Diabetes and systemic risk
HbA1c, insulin or medication use, kidney function, nutrition, neuropathy and comorbidities help frame healing capacity and safety.
Previous wound-care response
Dressings, off-loading, negative-pressure therapy, debridement, grafts, antibiotics and prior specialist opinions are summarized chronologically.
The precise specialist question
The file should ask whether additional physician review is meaningful, what is missing and whether a Heberprot-P® discussion is medically relevant.
Review framework
What changes the next step.
The page is intentionally structured around clinical decision factors, not around promotional claims. The aim is to make the file safer, clearer and easier to review.
Not every ulcer is ready for international review
Uncontrolled infection, critical ischemia or acute limb threat may require immediate local hospital care before coordination continues.
Treatment context is conditional
Heberprot-P® is treated as a physician-review topic for selected diabetic foot ulcer contexts, not as a universal solution or guaranteed outcome.
Photos need clinical structure
Images are most useful when paired with dates, measurements, wound-care notes and information about pain, discharge, odor and fever.
Written next steps protect the patient
The patient should receive a clear explanation of missing documents, review limits and practical next steps before payment or travel logistics.
Documents to prepare
A complete file creates a better written response.
A wound-care file must be complete enough to let the physician understand local risk, previous care and current urgency. These documents usually reduce unnecessary back-and-forth.
Recent wound photosMultiple angles, good lighting, date reference and scale when possible.
Diabetes historyHbA1c, medications, insulin use, neuropathy notes and relevant comorbidities.
Vascular recordsDoppler, ABI, angiography, revascularization or vascular surgery consultation notes.
Infection workupCultures, antibiotics, imaging for osteomyelitis, CBC/CRP and hospitalization history.
Wound-care historyDebridement, dressings, off-loading, negative-pressure therapy and response timeline.
General medical statusKidney function, albumin/nutrition markers, allergies and current medications.
Cuba context
How the treatment discussion is framed responsibly.
The page does not present a procedure or travel plan as automatically suitable. Any Cuba-related discussion remains conditional on physician review of the current file.
Local medical care remains the baseline
The patient should continue appropriate local care while the file is being organized, especially when symptoms are active or worsening.
Named options are not presented as guarantees
Treatment names may be part of the medical context, but suitability, contraindications, dosing and monitoring must be determined by physicians.
Travel is not the first decision
The first decision is whether the file is complete enough for a responsible written response. Logistics come only after clinical clarity.
Options discussed in Cuba
Heberprot-P: composition, administration and the limits of the evidence
This treatment does not replace standard wound care; it is added to it.
Heberprot-P was developed at the Center for Genetic Engineering and Biotechnology (CIGB) in Cuba and contains recombinant human epidermal growth factor (rhEGF). In people with diabetes, reduced growth-factor signalling and receptor density in wound tissue contribute to stalled healing. The aim of treatment is to deliver that signal directly into the wound bed and restart the repair process.
It is not a cream or a dressing: it is given as intralesional injections into the wound base and edges, in a clinical setting and by trained staff. Published protocols schedule three applications per week, stopping when granulation tissue is adequate, with total duration in most patients not exceeding eight weeks. The most frequently reported side effects are pain and burning at the injection site, shivering, fever and nausea.
The manufacturer and treating centres report high rates of amputation avoidance in large series. Those reports are valuable, but the size and design of independent randomised studies do not support a firm promise of avoiding amputation. Outcome is determined above all by adequate circulation, infection control, debridement, offloading and glycaemic management.
Vascular assessment
Where critical ischaemia exists, restoring blood flow comes first; granulation tissue will not form without adequate perfusion.
Infection and bone
Spreading infection or suspected osteomyelitis must be treated first; application during active infection does not change the outcome.
Offloading
Removing pressure from the wound with suitable footwear, a cast or a device is a basic condition for healing, independent of any drug.
When local care comes first
Do not wait for international review if urgent symptoms are present.
International coordination should never delay emergency or necessary local care. If any of the following are present, the patient should be assessed locally first.
- Fever, spreading cellulitis, foul drainage, sepsis concern or rapidly worsening wound.
- Black tissue, exposed bone, severe pain, acute ischemia signs or threatened limb.
- Uncontrolled glucose, severe dehydration, kidney failure or other unstable medical condition.
Coordination pathway
From records to written next steps.
- File intakeReports, photos, laboratory results and current symptoms are uploaded through the application flow.
- Quality checkThe coordination team checks readability, dates, translation needs and missing items before routing the case.
- Specialist routingThe case is prepared around a clear medical question and sent through the relevant review pathway.
- Written responseThe patient receives organized next steps before travel, payment or treatment logistics are considered.
Questions
Before starting the application.
Does this page mean Heberprot-P® is suitable for the patient?
No. This page explains how the file is prepared. Suitability can only be determined by licensed physicians after reviewing the complete wound, vascular, infection and diabetes context.
Can photos alone be enough?
Usually no. Photos are important, but wound history, infection status, vascular supply and diabetes control are essential for a meaningful review.
Should urgent wounds wait for international coordination?
No. Acute infection, ischemia, sepsis concern or rapidly worsening wounds must be assessed locally first.
What does Cuba Health Assist coordinate?
Cuba Health Assist organizes documents, translations where needed, communication with the review pathway and written next-step logistics.
Can travel be planned before review?
Travel should not be the first decision. The file should be reviewed first so expectations, safety and missing documents are clear.
Related evaluation pages
Other specialty files reviewed through the same clinical coordination approach.
Start with the file
Submit documents before making a travel or treatment decision.
A coordinator will organize the medical information and guide the next step according to specialist review. The process is designed to be transparent, clinically cautious and written.