Abstract
Background: Diabetic foot ulcers (DFU) are one of the most serious complications in diabetic health treatment. The treatment for DFUs is more challenging, especially in individuals with a weakened immune system. Furthermore, due to developing antibiotic resistance characteristics among harmful bacteria and fungi, existing antibiotics may not be helpful in combating microbial infections in the wound site.
Objective: This review will focus on the newest advances in antimicrobial treatments, such as dressings and topical therapies, as well as drugs and debridement methods.
Methods: The English-language publications published on DFU were collected from a variety of sources, including Scopus, Web of Science, Bentham Science, Science Direct, and Google Scholar.
Results: DFU therapy necessitates a multidisciplinary strategy including the use of appropriate diagnostic instruments, expertise, and experience. This begins with patient education and the use of new classifications to direct care in order to avoid amputations. To gain a deeper understanding of the microbiota in DFUs, new diagnostic approaches, such as the 16S ribosomal DNA sequence in bacteria, should become usable.
Conclusion: DFU is said to have a polymicrobial nature and, depending on its geographical area, some distinct characteristics, such as wound characteristics, antibiograms based on local epidemiology, individualized antimicrobial driven treatment, routine debridement, regular wound examination, and dressing changes. New biological and molecular therapies that have been shown to enhance infection prevention, the management of the local inflammatory profile, and the efficiency of the cicatrizing mechanism often help with the above characteristics.
Keywords: DFUs, diabetes mellitus, debridement techniques, antimicrobial peptides, diabetic neuropathy, biofilms.
[http://dx.doi.org/10.1007/978-0-387-09841-8]
[http://dx.doi.org/10.1155/2018/9317987] [PMID: 29853887]
[http://dx.doi.org/10.2147/DMSO.S225854] [PMID: 32021343]
[http://dx.doi.org/10.2174/1389450118666170704132523] [PMID: 28676002]
[http://dx.doi.org/10.1016/j.actbio.2013.03.033] [PMID: 23542233]
[http://dx.doi.org/10.3109/21691401.2012.716065] [PMID: 23316788]
[http://dx.doi.org/10.1001/jama.293.2.217] [PMID: 15644549]
[http://dx.doi.org/10.36502/2019/droa.6152]
[http://dx.doi.org/10.4239/wjd.v6.i1.37] [PMID: 25685277]
[http://dx.doi.org/10.1056/NEJMra1615439] [PMID: 28614678]
[http://dx.doi.org/10.1080/07853890.2016.1231932] [PMID: 27585063]
[http://dx.doi.org/10.2337/dc17-1836] [PMID: 29559450]
[http://dx.doi.org/10.2337/diacare.24.1.84] [PMID: 11194247]
[http://dx.doi.org/10.1016/j.diabres.2011.10.029] [PMID: 22079683]
[http://dx.doi.org/10.1111/j.1464-5491.2004.01358.x] [PMID: 15498081]
[http://dx.doi.org/10.1016/j.jaad.2013.07.048]
[http://dx.doi.org/10.11648/j.ijde.20180302.11]
[http://dx.doi.org/10.18203/2320-6012.ijrms20174548]
[http://dx.doi.org/10.1088/1755-1315/125/1/012161]
[http://dx.doi.org/10.1016/j.jaad.2013.06.055] [PMID: 24355275]
[http://dx.doi.org/10.1097/01.JAA.0000464276.44117.b1] [PMID: 25853673]
[http://dx.doi.org/10.18203/2394-6040.ijcmph20184249]
[PMID: 12449264]
[http://dx.doi.org/10.1016/j.dsx.2019.01.048] [PMID: 31336479]
[http://dx.doi.org/10.1016/j.acvd.2015.01.015] [PMID: 26184866]
[http://dx.doi.org/10.18203/2349-2902.isj20170937]
[http://dx.doi.org/10.1002/dmrr.464]
[http://dx.doi.org/10.1016/j.jid.2016.08.009] [PMID: 27566400]
[http://dx.doi.org/10.1136/bmjopen-2012-002370] [PMID: 23293263]
[http://dx.doi.org/10.1136/bmjopen-2017-019437] [PMID: 29391370]
[http://dx.doi.org/10.1111/iwj.13465] [PMID: 32779355]
[http://dx.doi.org/10.1016/j.humic.2017.09.002]
[http://dx.doi.org/10.3389/fmicb.2017.01791] [PMID: 28983285]
[http://dx.doi.org/10.1111/j.1742-481X.2007.00363.x] [PMID: 17953678]
[http://dx.doi.org/10.1016/j.pmr.2009.06.007] [PMID: 19781502]
[http://dx.doi.org/10.1099/jmm.0.076034-0] [PMID: 25038136]
[http://dx.doi.org/10.4103/ijem.IJEM_546_16] [PMID: 28989875]
[http://dx.doi.org/10.1016/j.jiph.2015.10.011] [PMID: 26617249]
[http://dx.doi.org/10.1186/s12866-016-0665-z] [PMID: 27005417]
[http://dx.doi.org/10.3390/microorganisms8101580] [PMID: 33066595]
[http://dx.doi.org/10.3201/eid0809.020063] [PMID: 12194761]
[http://dx.doi.org/10.1615/CritRevTherDrugCarrierSyst.v24.i5.10] [PMID: 18197780]
[http://dx.doi.org/10.2337/db15-0031] [PMID: 25901094]
[http://dx.doi.org/10.1186/s13756-019-0533-3] [PMID: 31131107]
[http://dx.doi.org/10.1177/1534734619873785] [PMID: 31535600]
[http://dx.doi.org/10.1111/iwj.12777] [PMID: 28643380]
[http://dx.doi.org/10.3389/fmicb.2015.01464] [PMID: 26779134]
[http://dx.doi.org/10.1177/1534734614521236] [PMID: 24520007]
[http://dx.doi.org/10.4102/ajlm.v10i1.1261] [PMID: 33824857]
[http://dx.doi.org/10.3390/jcm10091948] [PMID: 34062775]
[http://dx.doi.org/10.1002/1520-7560(200009/10)16:1+<::AIDDMRR139>3.0.CO;2-8]
[http://dx.doi.org/10.1016/S0732-8893(02)00377-2]
[http://dx.doi.org/10.12968/jowc.2015.24.Sup5b.20] [PMID: 26079164]
[http://dx.doi.org/10.1089/wound.2011.0333] [PMID: 24527292]
[http://dx.doi.org/10.1111/iwj.13509] [PMID: 33236843]
[http://dx.doi.org/10.2147/CWCMR.S127874]
[http://dx.doi.org/10.1016/j.engreg.2020.07.003]
[http://dx.doi.org/10.12968/jowc.2015.24.8.366] [PMID: 26562379]
[http://dx.doi.org/10.1080/13696998.2017.1423489] [PMID: 29295637]
[http://dx.doi.org/10.2217/cer-2017-0066] [PMID: 29076747]
[http://dx.doi.org/10.3390/pharmaceutics12090881] [PMID: 32957476]
[http://dx.doi.org/10.1111/1753-0407.12871] [PMID: 30324760]
[http://dx.doi.org/10.1002/14651858.CD009099.pub3] [PMID: 23922167]
[http://dx.doi.org/10.3947/ic.2018.50.1.11] [PMID: 29637748]
[http://dx.doi.org/10.4103/ijmr.IJMR_1436_14] [PMID: 28574021]
[http://dx.doi.org/10.1016/S0140-6736(05)67694-5] [PMID: 16291062]
[http://dx.doi.org/10.1053/j.semvascsurg.2012.04.010] [PMID: 22817856]
[http://dx.doi.org/10.1185/03007995.2015.1128888] [PMID: 26643047]
[http://dx.doi.org/10.1007/s13346-017-0445-9] [PMID: 29134555]
[http://dx.doi.org/10.12968/jowc.2013.22.3.130] [PMID: 23665731]
[http://dx.doi.org/10.1155/2017/3159798] [PMID: 29675430]
[http://dx.doi.org/10.1016/j.ejphar.2015.06.029] [PMID: 26101070]
[http://dx.doi.org/10.1016/j.semcdb.2012.09.014] [PMID: 23063664]
[http://dx.doi.org/10.1517/14728214.2013.802305] [PMID: 23687931]
[http://dx.doi.org/10.1016/j.ijscr.2021.105931] [PMID: 33962267]
[http://dx.doi.org/10.1016/j.dsx.2021.01.014] [PMID: 33524646]
[http://dx.doi.org/10.1016/j.mvr.2020.104100] [PMID: 33181169]
[http://dx.doi.org/10.1016/j.mehy.2021.110548] [PMID: 33690002]
[http://dx.doi.org/10.1016/j.tem.2020.10.003] [PMID: 33199085]
[PMID: 32826167]
[http://dx.doi.org/10.1016/j.diabres.2021.108743] [PMID: 33713718]
[http://dx.doi.org/10.1016/j.jpra.2021.04.012] [PMID: 34307819]
[http://dx.doi.org/10.1016/j.meegid.2021.104824] [PMID: 33774177]
[http://dx.doi.org/10.1016/j.msec.2021.111975] [PMID: 33812603]
[http://dx.doi.org/10.1016/j.dsx.2021.06.010] [PMID: 34186354]
[http://dx.doi.org/10.1016/j.jot.2021.04.006] [PMID: 34136348]
[http://dx.doi.org/10.1007/s40265-020-01415-8] [PMID: 33382445]
[http://dx.doi.org/10.1002/mabi.201900362] [PMID: 32077250]
[http://dx.doi.org/10.2147/IJGM.S278574] [PMID: 33293853]