This open-access consensus (Advances in Wound Care, 2025) synthesizes practical, evidence-driven guidance for the bedside management of diabetic wounds—spanning pathophysiology, glycemic care, infection/biofilm control, vascular assessment and revascularization, offloading, surgery, pain, dressings, and emerging therapies.
Contributors (acknowledged individually)
• Henry C. Hsia
• Elof Eriksson
• Geoffrey C. Gurtner
• Aristidis Veves
• Osama Hamdy
• David J. Margolis
• David G. Armstrong
• Lawrence A. Lavery
• Elisabeth A. Grice
• Greg Schultz
• Michael S. Conte
• Robert S. Kirsner
• Christopher E. Attinger
• John S. Steinberg
• Karen K. Evans
• Dot Weir
• Paul J. Kim
• Dennis P. Orgill
• Kenneth W. Liechty
• J. Peter Rubin 
Selected take-home points
• Nonhealing diabetic wounds are linked to chronic low-grade inflammation; management must convert the wound toward a healing trajectory. 
• Effective care is multidisciplinary, pairing tight glucose management with offloading, infection/biofilm control, and vascular evaluation/revascularization (WIfI-guided). 
• Antibiotic resistance is widespread; routine debridement + biofilm-oriented topical strategies are central, with systemic antibiotics reserved for invasive infection. 
• Limb salvage focuses on function: the goal is ambulation and life quality/years, not tissue preservation at all costs. 
The React-Re-Cell is a fundamental and essential treatment. It helps prevent limb loss, the formation of endothelial plaques, and the development of microfissures. It also promotes faster wound healing and, by maintaining gland elasticity, supports optimal functionality in diabetic individuals, thereby improving their quality of life.”