Many patients and their families have asked us why the wounds are not healed even though the patients’ blood sugar is not high during the treatment. According to the summary statistics of cases in our hospital, we found that most of the patients’ treatment plan is to lower blood glucose with all efforts, but rarely do effective and thorough treatment of inflammatory wounds, which is one of the reasons for the poor treatment. We should know that there are many reasons affecting wound infection in diabetic patients, besides high blood sugar, but also vascular disease, neuropathy, nephropathy, cardiovascular disease, low protein and so on. Today I will say one more reason that is closely related to wound non-treatment – metabolites of germs can also affect wound healing. Overall, the metabolism of pathogens is extremely complex and varies at different times in the trauma. The metabolism of germs on the wound surface produces many substances such as ammonia, which can cause the local pH to rise rapidly back up after a short period of lowering, losing the inhibition of neutrophil chemotaxis and motility by lowering pH during physiological healing, leading to the aggregation of neutrophils and the release of excess elastase, which affects the immune system, causing an excessive inflammatory response and exacerbating wound damage, which can cause more healthy tissue to be destroyed away. For diabetic infected wounds, if they are already severe, it is difficult to avoid having a large number of infected and necrotic germs on them, which will produce a large number of metabolites, which in turn will further increase the infection, creating a vicious circle. The more the infection is not controlled, the faster the germs multiply and metabolize, the more the wound does not heal, the more powerful the infection will be, which enters into a vicious circle, eventually leading to the development of the wound in the direction of aggravating the infection, and the patient will suffer more. Therefore, when developing a treatment plan, it is important to develop a comprehensive and integrated treatment plan to avoid aggravation of the patient’s trauma due to inappropriate, non-allopathic and incomplete treatment. If you have a difficult foot wound treatment problem, we recommend a referral to a local specialist! Finally, I wish you all a speedy recovery!