Role of an acidic environment in the treatment of diabetic foot infections: A review

Table 1 Important roles of various acids in treating diabetic foot ulcers

Order of efficacy	Name of acid	Roles
1	Citric acid	Antibacterial activity[13,51]; Decrease in pH-preventing growth and multiplication[13,76,79]; Fibroblastic growth, neovascularization and epithelialization[13,51,76,77]; Notable clinical changes[76,77,79]
2	Acetic acid	Mainly antipseudomonal activity[55-57]; Anti biofilm activity[81-83]
3	Hyaluronic acid	Reduces inflammatory response[22,84,85]; Increases angiogenesis and promotes granulation[22,84,85]; Proliferation of keratin cells[22,84,85]; Contributes to scarring[22,84,85]; Scavenger of free radicals and tissue degrading enzymes[85,86]; Controls tissue hydration[87]
4	Hypochlorous acid	Antimicrobial activity[70]; Wound debridement[70]; Anti-biofilm activity[70]; Promotes granulation[66]