*4.2.1 Debridement*

Debridement is one of the cornerstones of wound management, which could be surgical or non-surgical. It involves removal of necrotic tissue to aid wound healing. Debridement of open foot ulcers is required if unhealthy tissue is present, as this will aid in decreasing pressure points at callused sites on the foot [140, 141]. Removal of unhealthy tissue is linked to reducing colonizing a "clean" wound and allowing for examination of deep-lying tissues in the ulcer. Wound dressing is the cornerstone in diabetic foot care. As a convention, dressing changes and wound inspection and dressing should be done daily or as determined by the physician [142]. An ideal dressing should contribute to a moist wound environment, absorb excessive exudates, and not increase the risk for infections. Luckily, some non-surgical debriding agents have been incorporated with biologics such as transforming growth factor-β, vascular endothelial growth factor and epidermal growth factor [142–144]. Compared to conventional wound dressings, this modern wound dressing technique hastens the process of wound healing, as it stimulates angiogenesis, fibroblast proliferation, collagen synthesis and deposition, epithelization and remodeling of new extracellular matrix.
