Essentials of DFU Wound Care: Analysis of IWGDF Clinical Guidelines

Based on the 2023 clinical practice guidelines by the International Working Group on the Diabetic Foot (IWGDF), the following recommendations for local ulcer care can be made2,3：

• Regular wound inspection

  Patients should have their ulcers inspected regularly by professional healthcare personnel or trained caregivers, with the frequency depending on the severity of the ulcer, presence of infection, and amount of exudate, among other factors.

  Patients should also be provided with foot-related offloading treatments as needed. For offloading methods, please refer to this link：

  "The Power of Foot Self-Care: Practical Tips for Preventing DFUs"

  
• Debridement

  Debridement should be performed on ulcer wounds (with surgical debridement recommended as the first choice) and repeated as necessary.

  Clinical guidelines recommend debridement once a week. A large study (n=154644, USA) indicated that a median of 21 days was required for DFU healing with at least one debridement per week (including both surgical and non-surgical debridement), as opposed to a median of over 64 days with less frequent debridement4

• Dressing selection and moist environment

  Select appropriate dressings to absorb the exudate, prevent maceration of the skin surrounding the wound, while maintaining a moist wound environment.

• Foot hygiene

  Feet should be cleaned daily, primarily by washing (with water below 37°C), without soaking to avoid maceration of the surrounding skin. Then, dry carefully, especially between the toes.

• Adjunctive therapy

  Negative pressure wound therapy can be considered to assist with post-surgical wound healing2,3. Additionally, oxygen therapy can be utilized as an adjunctive treatment where standard care is ineffective and resources are available2,3.