Figure 2.

This figure explains the altered microbiota in diabetic wound healing. In general, diabetic foot wounds are complicated by various factors contributing to impaired tissue regeneration. Several factors impairing wound healing and associated factors are hyperglycaemia, peripheral neuropathy, vascular disease, and a complex microbiome. It is challenging to identify microbial communities that assemble in wound tissue and have not necessarily been associated with cardinal signs of infection. A debridement elicited reduced diversity of bacteria, governed by decreased anaerobic bacterial abundance in the overall community. One subset of wounds achieved complete re-epithelialization within 12 weeks. Kalan et al. [111] investigated the role of colonizing microbiota in wound healing, clinical outcomes, and a response to therapy in patients with chronic diabetic wounds. Strains of the wound pathogen S. aureus were associated with poor outcomes, and sharp debridement therapy depleted anaerobic bacteria in wounds with favorable outcomes.