**5.5 Diabetes ulcers**

Exposed non-healing wounds on the feet are considered "chronic ulcers". Chronic ulcers show up in sufferers with diabetes, atherosclerosis, and varicosity of the limbs (**Figure 5**). The healing processes of such chronic diabetic foot ulcers (DFU) depends on the coexisting infection of aerobic and anaerobic microorganisms' viz. *Staphylococcus* spp., *S. aureus*, *Proteobacteria*, and anaerobes *Anaerococcus*, *Bacteroides, Clostridium*, *Peptonihilus*, and *P. aeruginosa* [30, 31, 35–38, 110]. Antibacterial cure of ulcers infected with a variety of microbial organisms shall be difficult [32, 33, 35]. Long-term administration of antibiotics for healing the ulcers in diabetes mellitus sufferers may additionally be complicated and ineffective. In such complicated instances of infected diabetic foot ulcers, phage therapy could be an alternative or a supplementary treatment to antibiotics treatments. Phage therapy used to be the most incredible in ulcers with one bacterial agent (100%), however, a personalized phage therapeutic strategy can also lead to the removal of pathogens in instances with combined infections. There are quite a few studies that have described the efficacy and well-being of phage treatment of infected ulcers in humans. Previous antibiotic treatment was unsuccessful with a mixture of microbial infections of DFU unlike the results of the Phage therapy treatment of patients [38, 96]. The fundamental challenge in treating such infected wounds was once the inability to rapidly select phages towards all recognized bacterial diseases. Patients with DFU infected with methicillin-resistant and methicillin-sensitive *S. aureus* strains were effectively treated and cured with *Staphylococcus* phage Sb-1 [37, 111]. Commercially available phage cocktails can be chosen in every case following their specificity to particular infectious agents in an ulcer. When no such precise phage cocktail was once commercially available, a custom-made phage preparation can be prepared. Commercially available bacteriophage solution has been used against

infections of *Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus* occurring in Chronic Venous leg ulcers (VLU). No adverse events were reported for the study product and no significant differences were determined between the testing and control groups for the frequency of adverse events, the healing rate, or the frequency of healing [110].
