## 1 Introduction  
Lower extremity changes present some of the most frequent pathologies present in patients with diabetes mellitus, including ulcers, which present a frequent and significant complication. Data from the U.K. show that at any given moment, 2.5% of the diabetes patient population has an active lower limb ulceration, while data from the U.S. estimate a lifetime prevalence of 25% [1, 2]. Lower limb ulcerations can present an entry point for pathogens to develop into infections involving the bone and joints, which are significant due to the advanced risk of amputation that they present--this risk is estimated to be up to four times larger than in the absence of bone involvement [3]. Such an infection presents the first step on the road to amputation. The treatment goal for a patient presenting with a diabetic foot pathology should be limb integrity and function preservation, as this is important for their functional status, self-image, and social actualization [4]. However, advanced pathologies and infections of the diabetic foot result in loss of quality of life as well as function and, eventually, loss of limb [5]. The complex pathogenic processes that occur in patients with diabetes mellitus include numerous changes in the vasculature and innervation of the foot, leading to a combination of enduring changes, such as the atrophy of foot musculature, fibrous changes, and repositioning of fat tissue pads. All these changes affect the biomechanics of walking and lead to specific predilection sites for ulcer formation [6]. In the case of reduced sensitivity, as the patient does not feel the consequences of increased pressure,deformations of the tissue can occur relatively unnoticed, and any potential affection of macro- or microvasculature inhibits the healing capacity of tissue. The formation of ulcers above joints enables pathogens' direct entry into bone and joint tissue [1; 6; 7]. Due to the biomechanics of walking and the typical changes in the context of diabetic foot pathology, the first metatarasophalangeal joint presents a common predilection site [1; 6; 7; 8]. Standard surgical therapy conventionally used in such cases is resection of the affected bone and joint, as well as extensive adjacent soft tissue necrectomy [9; 10; 11]. This approach presents risks of gait destabilization and shift of weight, which can lead to additional pathological changes and formation of ulcers at other sites. However, other sites of bone and joint infections can also arise, such as osteomyelitisis as a complication of previous injury or other pathologies particular to the diabetic foot, such as Charcot neuroarthopathy. Preservation surgery and salvage treatment of the diabetic foot follow the principle of tissue sparing, with the goal of avoiding further deformation, recurrence of similar pathological processes, and ultimately limb preservation and prevention or deferring amputation [4]. Materials ideal for the treatment of diabetic foot pathologies are required to have an antimicrobial effect, the ability to fill bone defect cavities, and to promote healing. To achieve the necessary effects, materials acting as bone substitutes are coming into use. An increasing number of reports are available in the literature concerning the use of third-generation biomaterials. Stratified in this category due to its properties enabling osteogenesiseration and osteostimulation is S53P4 Bioactive Glass (BAG). Bioactive glass was originally invented at the University of Florida in 1969 and has since been approved for use in the treatment of osteomyelitisis in specific regions around the world [12]. However, descriptions of its use in diabetic foot infections and specific pathologies etiologically related to diabetes mellitus are infrequent.