How are chronic wounds of the international diabetic foot managed?

  The 2015 edition of the International Working Group on the Diabetic Foot (IWGDF) was published, and the guideline recommendations include 9 areas as follows Recommendation 1: Clean the wound with clean water or saline, debride if necessary to remove tissue debris from the wound, apply sterile inert Apply sterile inert dressings to wrap the wound to absorb excess secretions and keep the wound warm and moist to promote healing. (Strength of recommendation: strong; Strength of evidence: low) Recommendation 2: First apply sharp instruments to remove decaying necrotic tissue and periwound scabs from the wound. (Recommended intensity: strong; Evidence intensity: low) Recommendation 3: Dressing selection is based mainly on exudate control, comfort and cost. (Strength of recommendation: strong; Strength of evidence: weak) Recommendation 4: Do not use dressings containing antibiotics to improve wound healing or prevent secondary wound infection. (Strength of recommendation: strong; strength of evidence: moderate) Recommendation 5: For classical hyperbaric oxygen therapy, further blinded randomized controlled studies need to be applied to confirm its effectiveness and cost effectiveness. (Strength of recommendation: weak; strength of evidence: moderate) Recommendation 6: Classical negative pressure wound management techniques have been shown to be effective and cost-effective when applied to surgically treated wounds. (Strength of Recommendation: Weak; Strength of Evidence: Moderate) Recommendation 7: Do not use methods reported by some institutions that alter the biological environment of the wound to obtain better wound healing, including growth factors, bioengineered skin products and gels, suggesting that conventional treatments are more effective. (Strength of Recommendation: Strong; Strength of Evidence: Low) Recommendation 8: Do not choose methods recommended by some institutions regarding altering the physical environment of chronic wounds to obtain healing, including: protocols regarding electrons, magnetism, ultrasound, and shock waves, suggesting that the application of conventional treatments is more effective. (Strength of recommendation: strong; Strength of evidence: low) Recommendation 9: Do not choose systemic treatments to improve chronic ulcer healing, including pharmacological and herbal treatments, and recommend giving preference to standard conventional treatments. (Strength of recommendation: strong; strength of evidence: low)