Non Pressure Chronic Ulcer R Heel

Patient is 70y/o male patient, with Past Medical H/O HTN, COP, heart arrhythmia, active smoker with chronic Ulcer R heel since 2020, currently being treated with Aquacel AG as primary dressing followed by ABD then Kerlix gauze, no improvement noted.

Treatments tried in past: Santyl Ointment, Hydrophera Blue, Calcium Ag, skintegrity, Prisma dressing all with no improvement!

Any recommendations will be appreciated.