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. 2017 Sep 21;8:1791. doi: 10.3389/fmicb.2017.01791

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Copyright © 2017 Pereira, Moura, Carvalho and Empadinhas.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Visual representation of the major stakeholders that have an impact in DFUs emergence, evolution, and chronicity maintenance: the triggers, under patients control, the underlying conditions associated to diabetes; and the opportunistic microbes qualitative and quantitative shifts. Their combined influence in DFU is multifactorial and time-dependent, which further hinders the implementation of appropriate DFU therapies. Physicians, and scientists, should always keep in mind this trilogy when deciding their strategies.