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World J Diabetes. Sep 15, 2021; 12(9): 1539-1549
Published online Sep 15, 2021. doi: 10.4239/wjd.v12.i9.1539
Role of an acidic environment in the treatment of diabetic foot infections: A review
Basavraj Nagoba, Ajay Gavkare, Abhijit Rayate, Sachin Mumbre, Arunkumar Rao, Basavraj Warad, Neeta Nanaware, Nawab Jamadar
Basavraj Nagoba, Department of Microbiology, MIMSR Medical College, Latur 413512, Maharashtra, India
Ajay Gavkare, Department of Physiology, MIMSR Medical College, Latur 413512, Maharashtra, India
Abhijit Rayate, Basavraj Warad, Department of Surgery, MIMSR Medical College, Latur 413512, Maharashtra, India
Sachin Mumbre, Department of Community Medicine, Ashwini Rural Medical College, Solapur 413001, Maharashtra, India
Arunkumar Rao, Department of Orthopedics, MIMSR Medical College, Latur 413512, India
Neeta Nanaware, Department of Physiology, Government Medical College, Latur 413512, Maharashtra, India
Nawab Jamadar, Department of Anesthesiology, MIMSR Medical College, Latur 413512, Maharashtra, India
Author contributions: Nagoba B contributed to the idea behind the manuscript, writing the paper, modification of content and final approval of the draft; Gavkare A, Rayate A and Nanaware N contributed to the literature search, collection of the data and writing the paper; Mumbre S, Rao A, Warad B and Jamadar N contributed to the writing the paper, modification of content and final approval of the draft.
Conflict-of-interest statement: Authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Basavraj Nagoba, PhD, Assistant Dean, Research, Professor, Department of Microbiology, MIMSR Medical College, Vishwanathpuram, Ambejogai Road, Latur 413512, Maharashtra, India. dr_bsnagoba@yahoo.com
Received: January 28, 2021
Peer-review started: January 29, 2021
First decision: June 16, 2021
Revised: June 21, 2021
Accepted: August 5, 2021
Article in press: August 5, 2021
Published online: September 15, 2021
Processing time: 221 Days and 23.3 Hours
Abstract

Management of diabetic foot ulcers is the biggest challenge to the clinician, as conventional antibiotic therapies and local wound care have their own limitations. They are not effective for control of infections and promotion of healing because of cytotoxic effects. In view of cytotoxicity of routinely used topical antiseptic agents, this article focuses on the search of an ideal topical antiseptic agent that is safe and effective in controlling infectious agents and also in promoting the healing process. This review focuses on the use of various acids such as citric, acetic, hyaluronic, and hypochlorous acids as topical agents in diabetic foot infections. This article also focuses on the different roles of acids in the treatment of diabetic foot infections.

Keywords: Diabetic foot ulcer; Infection; Management; Topical agents; Acids; Role of acids

Core Tip: Diabetic foot ulcer is the most serious complication of diabetes mellitus. The biggest challenge is to find an ideal topical antiseptic agent that is safe and effective in controlling infectious agents and promoting the healing process. This article focuses on the use of acids as topical agents to control diabetic foot infections, with special emphasis on the different roles of citric, acetic, hyaluronic, and hypochlorous acids in the effective management of diabetic foot ulcers.