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 area around the wound to prevent contamination of the gloves/surgical material/L‐PRF membranes when touching this area during the following treatment
3. LU generally have hard callus formation around the wound periphery. Hence it is necessary to remove such hard callus with a surgical blade and make it get bleeding points if possible. Then one can perform a superficial debridement to remove necrotic material, eschar, devitalised 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. 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)
6. Only in deeper areas of the wound, several layers of membranes should be applied up to the level of the wound borders to speed up the refill of these areas with granulation/connective tissue
7. 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
8. Apply a dry dressing to capture the typical exudate of the wound that usually increases during the first application. The dry dressing can be changed when needed (e.g., to absorb additional exudate, to avoid bad odors) without disturbing the wound dressing underneath
LU	Patients should avoid pressure and movement on the wound site, especially the first 3 days, and should wear special shoes or completely avoid stepping on the affected foot for at least a week. Patients should protect other areas of the foot from dryness and apply suitable moisturizers (e.g., paraffin wax dermal ointment).