## 3 Discussion  
The rising prevalence of diabetes represents a public health and socioeconomic burden [23]. Diabetic foot ulcers occur due to a combination of multiple factors: underlying peripheral vascular disease, impaired leukocyte function and cell proliferation, polynewropathy and increased plantar pressure, of which unfortunately about 75-85% of cases end in amputation. Because of the angiopathy and nerve damage, the majority of diabetic foot wounds are asymptomatic for a great period of time, leading to complications [23; 24; 25; 26]. The neuropathy allows ulceration to develop after unrecognized trauma, whereas poor blood supply (ischem) inhibits wound healing [27]. The evolution of the diabetic foot ulcer is divided into four stages: black (necrosis), yellow (inflammatory exudate), red (granulation formation), and pink (epithelial formation) and, regarding them, the treatment principles refer to T = tissue; I = infection/inflammation; M = moisture balance and E = wound edges [28; 29; 30]. Silver dressings are used to treat wounds in order to lower the microorganism load in acute or chronic ulcers and aid in creating an antibacterial barrier [23]. The most important bactericidal mechanism exhibited by silver-based antiseptic is the binding to the bacterial surface, which affects the membrane structure and function as well as the release of reactive oxygen species, which are active in both planktonic and biofilm-embedded cells [11; 13]. Although the VULCAN study highlighted the lack of therapeutic superiority of silver dressings in the treatment of venous ulcers compared to other dressings, and that they are also more expensive, other studies have demonstrate the cost-effectiveness of silver-containing dressings because by using them: the healing time of wounds is reduced [31; 32] and thus the duration of hospitalization drops [33; 34]; the frequency of changing dressings and the need for analgesics, as well as bacteremia secondary to MRSA-infected wounds are decreased [8; 35; 36; 37]. The most commonly used modern dressings in clinical practice are hydrogels, hydrocolloid, alginates, foams, and films [38]. Figure 6: Electropherogram of amplicons obtained by PCR for SilCAB and SilF genes. (**A**) Wells 2–25—amplicons of the analyzed strains; well no. 1, L-Molecular weight marker GeneRuler 10,000 bp (Thermo-Scientific, Waltham, MA, USA); Positive strains for the SilCAB gene: number 46—_S. xylosus_; 55751—MRSA. (**B**) Wells 2–24—amplicons of the analyzed strains; well no. 1, L-Molecular Weight Marker GeneRuler 10,000 bp (ThermoScientific); Positive strains for SilF gene: number 14532—_S. xylosus_; 5622—_E. coli._  
Figure 7: Electropherogram of amplicons obtained by PCR for SilE and SilRS genes. (**A**) Wells 2–28—amplicons of the analyzed strains; well no. 1, L-Molecular Weight Marker GeneRuler 10,000 bp (ThermoScientific); Positive strains for the SilA gene: number 112. Different studies have evaluated the efficiency of silver dressings. [PERSON] et al. designed a silver-ion dressing that is composed of a grid structure of sodium carboxymethyl cellulose and 1.2% silver ions, which has broad-spectrum antibacterial properties [8]. Due to these highly optimized properties, nano-silver dressings have more advantages in diabetic foot therapy [21]. Adding epidermal growth factor to the nano-silver material can lead to wound healing [39]. Another clinical study evaluated the combination of alginate fibers, prontosan gel, and silver ions. Alginate fibers can form a gel in combination with the wound moisture, thus ensuring a microacidic environment to promote wound healing. Prontosan gel is compatible with silver ions. The use of combination therapy is more effective at removing necrotic tissue, preventing biofilm formation, and removing exudate [40]. The silver-releasing foam dressing has proven to be more effective than silver sulfadiazine in the wound healing of diabetic foot ulcers [41].