Biological Mechanisms of Chronic Wound and Diabetic Foot Healing: The Role of Collagen

Abstract

The treatment of chronic wounds is a continuously developing research focus. The problems of excessive mechanical forces, infection, inflammation, reduced production of growth factors, and lack of collagen will affect the results of treatment. The purpose of this study was to analysse the elements that lead to long-term non-healing of chronic wounds and trophic ulcers, including diabetic foot syndrome, by determining the optimal treatment algorithm. The paper presents an analysis of the world literature on the etiopathogenesis and principles of chronic wound treatment in diabetic foot syndrome. The epidemiology of chronic wounds of different genesis is presented. The issues of physiological and metabolic disorders in chronic ulcers affecting the process of wound healing are discussed. Particular attention is paid to collagen, which is a protein that forms the basis of connective tissue; collagen ensures the strength and elasticity of the skin, which confirms the importance of its role not only in aesthetics but also in the process of wound healing. Different types of collagen and their roles in the mechanisms of chronic wound healing in diabetic foot syndrome are described. The results of clinical studies evaluating the effectiveness of medical products and preparations, consisting of collagen with preserved (native collagen) and fractionated structures, in treating chronic wounds of diabetic foot syndrome are analysed. It has been shown that the use of native collagen preparations is a promising treatment for chronic ulcers and wounds, including diabetic foot syndrome, which makes it possible to increase the effectiveness of treatment and reduce the economic costs of managing these patients.

Efficacy of A Novel Smart Polymeric Nanodrug in the Treatment of Experimental Wounds in Rats

“…This is due to the increasing number of surgeries in the world, as well as domestic and workplace injuries and combat wounds [10][11][12][13][14]. Furthermore, the increase in life expectancy is accompanied by an increase in the prevalence of chronic trophic ulcers of various origin, the healing of which is a clinical problem [15][16][17][18]. The problem of wound healing is especially important in cases when the patients cannot be continuously monitored by clinicians and in cases when there are special requirements for the surgical scar, e.g., in aesthetic surgery [19].…”

<p>Comparative Analysis of the Effectiveness of Some Biological Injected Wound Healing Stimulators and Criteria for Its Evaluation</p>

“…The experiment was performed according to the principles of laboratory animals handling and complied with the provisions of the "European Convention for the 17). Mesenchymal SCs used in the experiment were isolated from a human umbilical cord after a normal birth at 38-40 weeks of the gestation period with the informed consent of the donors.…”

“…All selected injectables were of biological origin and derived from mammals; their effectiveness in wound treatment has been previously proven in clinical and experimental studies. These include collagen (Collost ® ; which contains native unreconstructed collagen obtained from the skin of cattle), [15][16][17][18][19] deproteinized calf blood hemoderivative (DCBH; Actovegin ® ), [20][21][22] and mesenchymal stem cells (SCs). [23][24][25][26][27][28] An obvious advantage of the injectable drugs is the ability to accurately administer a certain volume and dose of the drug to the same location in all animals, providing identical wound treatment conditions.…”

Collost Bioplastic Collagen Material for the Treatment of Burns

“…Collagen-based biological coatings are able to effectively control the wound exudate, inactivate proteinases, protect endogenous and exogenous growth factors from degradation, and serve as a bioplastic matrix for the formation of patient's own connective tissue [2][3][4]. Such is the Collost coating based on native unreconstructed bovine type 1 collagen.…”