The effect of combination therapy of oral methylene blue and fibrin glue in the treatment of non-healing diabetic foot ulcer

INTERVENTION: Intervention group: The first intervention group includes diabetic patients with chronic foot ulcers who, despite common treatments, will be undergone oral methylene blue intervention for 4 weeks, and the second intervention group consists of diabetic patients with chronic foot ulcers will be undergone synergistic 4‐week treatment with oral methylene blue and fibrin glue.. CONDITION: E10‐E14 Non‐healing diabetic foot ulcer. ; Diabetes mellitus with peripheral circulatory complications. Diabetic ulcer PRIMARY OUTCOME: Wound area. Timepoint: Every week for a month after dressing. Method of measurement: Paper ruler, digital camera, lab data and clinical observation. SECONDARY OUTCOME: Need to amputation. Timepoint: Every week for a month after dressing. Method of measurement: Clinical observation, lab data. INCLUSION CRITERIA: Having a Diabetic ulcer grade II and IV based on Wagner's classification on the sole, medial, or lateral part of the foot (including all surfaces of the toes) Having a single ulcer on the feet and extremities (toes, soles, heels) with no significant reduction in ulcer size (<20%) despite the use of best treatment methods for at least four weeks If there is more than one non‐healing wound, choose the largest wound The size of the wound surface (length × width) between 2 cm2 and 20 cm2 No smoking, alcohol and drug addiction based on the patient's self‐report Not taking drugs that may interfere with wound healing, such as Corticosteroids, immunosuppressants, and cytotoxic agents Not having a concurrent chronic disease that may cause problems in wound healing, such as cancers, vasculitis, no history of known severe kidney, liver, and heart disease, such as liver cirrhosis, active hepatitis, dialysis, etc. Not taking antidepressants Insensitivity