Diabetic foot ulcers: A devastating complication of diabetes mellitus continues non-stop in spite of new medical treatment modalities

Table 4 Standard care of diabetic foot ulcer

Treatment	Description
Debridement	Surgical debridement	Necrotic or non-viable tissue should be removed, regular (weekly) debridement is associated with rapid healing of ulcers
Dressing	Films, foams, hydrocolloids, hydrogel	Proper using of dressing materials could facilitate moist environment
Wound off-loading	Rock or bottom outsoles, custom-made insoles, some shoe inserts	Plantar shear stress should be removed
Vascular assessment	PTA or endovascular recanalization followed by PTA or by-pass grafting	Arterial insufficiency should be treated for improving wound healing
Control of infection	Appropriate antibiotic therapy according to pathogens	Deep tissue cultures should be obtained before antibiotic therapy, for mild infection treatment duration could be 1-2 wk but for moderate to severe infection, it should be 3-4 wk
Glycemic control		For better glycemic control, insulin treatment has been preferred in hospitalized patients with diabetic foot ulcers

PTA: Percutaneous transluminal angioplasty.