Preparation of the Wound Bed of the Diabetic Foot Ulcer

One of the unfortunate results of diabetes is the formation of diabetic ulcers. These typically do not heal well and form chronic wounds which, despite recent advanced therapies, still fail to heal. This results in increased risk for infection, thus resulting in high amputation rates. Many factors contribute to poor healing. Hyperglycemia induces the majority of micro- and macrovascular complications associated with impaired wound healing. Wound bed preparation (WBP) is an essential step of diabetic wound management in order to accelerate healing and/or facilitate the effectiveness of other treatment modalities. The main purpose of WBP is to remove the barriers that impair wound healing, including the presence of necrotic tissue, senescent cells, altered extracellular matrix, hypoxia, high bacterial burden, and inflammatory enzymes within the wound bed. There are several steps for achieving WBP, including debridement. We provide an overview of the current concepts of WBP in the context of diabetic ulcers.