Management of Diabetic Wounds: Expert Panel Consensus Statement

Henry C Hsia¹, Elof Eriksson², Geoffrey C Gurtner³, Aristidis Veves⁴, Osama Hamdy⁵, David J Margolis⁶, David G Armstrong⁷, Lawrence A Lavery⁸, Elisabeth A Grice⁹, Greg Schultz¹⁰, Michael S Conte¹¹, Robert S Kirsner¹², Christopher E Attinger¹³, John S Steinberg¹³, Karen K Evans¹³, Dot Weir¹⁴, Paul J Kim^{8

15}, Dennis P Orgill¹⁶, Kenneth W Liechty³, J Peter Rubin¹⁷

Affiliations

¹ Departments of Surgery and Biomedical Engineering, Yale University, New Haven, Connecticut, USA.
² Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Surgery, University of Arizona, Tucson, Arizona, USA.
⁴ Joslin-Beth Israel Deaconess Foot Center and The Rongxiang Xu, MD, Center for Regenerative Therapeutics, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
⁵ Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.
⁶ Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
⁷ From the Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
⁸ Department of Plastic Surgery, University of Texas Southwestern, Dallas, Texas, USA.
⁹ Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
¹⁰ University of Florida, Gainesville, Florida, USA.
¹¹ Division of Vascular and Endovascular Surgery, University of California San Francisco, San Francisco, California, USA.
¹² University of Miami Hospital and Clinics Wound Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
¹³ Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
¹⁴ Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, Kissimmee, Florida, USA.
¹⁵ Department of Orthopedic Surgery, University of Texas Southwestern, Dallas, Texas, USA.
¹⁶ Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹⁷ Departments of Plastic Surgery and Bioengineering, and McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

PMID: 40833358
DOI: 10.1177/21621918251366586

Review

Management of Diabetic Wounds: Expert Panel Consensus Statement

Henry C Hsia et al. Adv Wound Care (New Rochelle). 2025.

. 2025 Aug 20.

doi: 10.1177/21621918251366586. Online ahead of print.

Authors

Affiliations

¹ Departments of Surgery and Biomedical Engineering, Yale University, New Haven, Connecticut, USA.
² Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Surgery, University of Arizona, Tucson, Arizona, USA.
⁴ Joslin-Beth Israel Deaconess Foot Center and The Rongxiang Xu, MD, Center for Regenerative Therapeutics, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
⁵ Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.
⁶ Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
⁷ From the Southwestern Academic Limb Salvage Alliance (SALSA), Department of Surgery, Keck School of Medicine of USC, Los Angeles, California, USA.
⁸ Department of Plastic Surgery, University of Texas Southwestern, Dallas, Texas, USA.
⁹ Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
¹⁰ University of Florida, Gainesville, Florida, USA.
¹¹ Division of Vascular and Endovascular Surgery, University of California San Francisco, San Francisco, California, USA.
¹² University of Miami Hospital and Clinics Wound Center, University of Miami Miller School of Medicine, Miami, Florida, USA.
¹³ Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
¹⁴ Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, Kissimmee, Florida, USA.
¹⁵ Department of Orthopedic Surgery, University of Texas Southwestern, Dallas, Texas, USA.
¹⁶ Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹⁷ Departments of Plastic Surgery and Bioengineering, and McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

PMID: 40833358
DOI: 10.1177/21621918251366586

Abstract

Significance: The Wound Healing Foundation recognized the need for consensus-based unbiased recommendations for the treatment of wounds. Consensus statements on the treatment of chronic wounds and acute wounds have been developed and published previously. The current publication on diabetic wounds represents the next step in this process. Diabetic wounds constitute a major problem. Population-based and meta-analytic studies indicate that the presence of foot wounds in patients with diabetes increases their mortality risk by more than twofold. The management of diabetic wounds requires consistent and evidence-driven intervention to achieve optimal clinical outcomes. This consensus statement provides the clinician with the necessary foundational approaches to the causes, diagnosis, and therapeutic management of diabetic wounds. Presented in a structured format, this is a useful guide for clinicians and learners in all patient care settings. Recent Advances: Continuous glucose monitoring and other new tools have facilitated better diabetes management and the management of associated wounds. Diabetic limb salvage should focus on achieving and optimizing function for the patient with diabetes rather than preserving limb tissue at all costs. Critical Issues: Successful management of diabetic wounds requires a multidisciplinary approach encompassing comprehensive assessment, timely intervention, and collaborative care by the wound clinician with providers who can address critical aspects to achieve healing, including careful management of blood glucose levels, optimization of off-loading and physical therapy, assessment and treatment of limb ischemia, control and prevention of wound infection, and optimal pain management. Future Directions: Emerging treatments offer hope and promise, but the heterogenicity of diabetic wounds poses a challenge to performing good studies, which will be necessary to advance new treatments for diabetic wounds.

Keywords: comprehensive; diabetic wound; expert; management.

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Management of Diabetic Wounds: Expert Panel Consensus Statement

Affiliations

Management of Diabetic Wounds: Expert Panel Consensus Statement

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Abstract

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