Rules for the treatment of diabetic foot ulcer infection on the basis of current guidelines and reports

Diabetic foot ulceration affects one in four diabetics, and half of these wounds become infected. This leads to severe impairment of healing, loss of limb, and sometimes even death of the patient. The principles of treatment of infected diabetic foot ulcer are described in current guidelines of scientific societies, developed in accordance with the principles of evidence-based medicine. According to these documents, the canon of management is systemic targeted antibiotic therapy, operative surgical treatment, regularly repeated wound debridement and, if necessary, revascularisation. Other methods of treating infection have not found a foothold in the guidelines because of the low strength of evidence available to support their efficacy. Nevertheless, some of these methods, such as topical antimicrobial treatment with fluids, gels, or dressings containing active substances, are widely used in clinical practice. They should be considered as complementary treatments only after standard treatment has been applied.