1. Gently clean the wound through irrigation with a standard saline solution to remove all exudate. The cleaning can be finalized by irrigation with a non‐cytotoxic antimicrobial solution (preferably also containing a surfactant). One can also use gauze embedded in this solution to clean the wound gently
2. Disinfect the wound, and area around the wound to prevent contamination of the gloves/surgical material/L‐PRF membranes when touching this area during the following treatment
3. Perform a superficial debridement to remove necrotic material, eschar, devitalized tissue, or any other type of bioburden from the wound (provide some bleeding points), including wounds with tunnels and/or cavities, to promote wound healing. Profound debridement should be avoided because of its negative impact!
4. Slightly undermine the wound borders to create an envelope (±4 mm in width) into which the L‐PRF membranes can be slid to force and stimulate epithelium to adhere and migrate over the membranes instead of underneath. The migration of the epithelium does not occur immediately if the wound is profound
5. Inject small amounts of L‐PRF exudate (not to be confused with liquid fibrinogen) in the wound area and the wound periphery. Use a thin needle (>30 gauge). The exudate is rich in growth factors and has antibacterial properties, and its injection will increase bleeding spots to supply the covering membranes with blood
6. Apply L‐PRF membranes (not the clots) over the entire wound area, starting from the periphery towards the center of the wound (slid them into the envelope under the wound borders)
7. Only in deeper areas of the wound should several layers of membranes be applied up to the level of the wound borders to speed up the refill of these areas with granulation/connective tissue
8. Cover the wound with a non‐adhering knitted primary dressing (e.g. cellulose acetate impregnated with a petrolatum emulsion). It should (i) be conformable to the wound bed, (ii) have the ability to stay in situ over wear time, (iii) transmit wound exudate to the secondary dressing, and (iv) give minimal trauma on removal
9. Cover this dressing and seal the periphery of the wound with a plastic film to ensure, in combination with the previous dressing, a moist environment to protect the L‐PRF membranes from dehydration. Dehydration should indeed be avoided at all times! This film should provide a waterproof, sterile barrier to external contaminants including liquids, bacteria, and viruses
10. Apply a dry dressing to capture the typical exudate of the wound that usually increases during the first application. At the lower point of the wound, the plastic film will automatically peel off when wound exudate accumulates. The exudate will leak out at this point. The dry dressing can be changed when needed (e.g., to absorb additional exudate to avoid bad odors) without disturbing the wound dressing underneath
DFU CU PU	Patients should avoid pressure and movement on the wound site specially the first 3 days after treatment In case of foot deformities (e.g., Charcot's foot), the patient should wear special shoes or completely avoid stepping on the affected foot for at least a week
VLU	Always apply an elastic bandages as standard compressive therapy
PU	Patients should avoid pressure and movement on the wound site specially the first 3 days after treatment