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Review
. 2023;19(8):e031122210617.
doi: 10.2174/1573399819666221103141715.

Physiological and Pathophysiological Aspects of Diabetic Foot Ulcer and its Treatment Strategies

Vadivelan Ramachandran  1 , Tharani Mohanasundaram  1 , Darshan Karunakaran  1 , Monika Gunasekaran  1 , Ruchi Tiwari  2
Affiliations
Review

Physiological and Pathophysiological Aspects of Diabetic Foot Ulcer and its Treatment Strategies

Vadivelan Ramachandran et al. Curr Diabetes Rev. 2023.

Abstract

Background: Diabetes foot ulcers (DFU) are among the most common complications in diabetic patients, leading to amputation and psychological distress. This mini-review covers the general physiology of ulcer healing as well as the pathophysiology of DFU and its therapies. Only a few treatments have been sanctioned and numerous compounds from various pharmacological groups are now being tested at various stages for the prevention and treatment of DFUs.

Objective: The main objective of this mini-review is to give concise information on how diabetes mellitus impairs the healing of chronic ulcers by disrupting numerous biological systems of the normal healing process, resulting in diabetic foot ulceration, and the current therapeutic approaches.

Methods: A review of accessible material from systemic searches in the PubMed/Medline, Scopus, Cochrane Database of Systematic Reviews, published review articles, and Clinical Trials databases (US National Library of Medicine) with no period of limitation was conducted.

Results: The treatment of DFUs comprises wound dressings, use of matrix metalloproteinase inhibitors in wound dressing, antibiotics, skin substitutes, pressure off-loading growth factors and stem cells, gene therapy, topical oxygen therapy, etc. Conclusion: The majority of these treatments are aimed at treating diabetic foot ulcers and preventing diabetic wounds from becoming infected. Yet, there is no single therapy that can be advised for diabetic foot ulcer patients. Future treatment strategies should be considered an appropriate treatment option for persistent wounds.

Keywords: Diabetic foot ulcer; amputation; diabetes mellitus; gene therapy; matrix metalloproteinase; pressure off-loading growth factors; stem cells.

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