Diabetic foot ulcer: A comprehensive review of pathophysiology and management modalities

Raja, Joel; Maturana, Miguel; Kayali, Sharif; Khouzam, Amir R.; Efeovbokhan, Nephertiti

doi:10.12998/wjcc.v11.i8.1684

Cited by 37 publications

(17 citation statements)

References 57 publications

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“…Debridement plays a crucial role in the treatment of diabetic foot ulcers (DFUs), particularly when necrotic tissue is present. Following debridement, additional reconstructive measures such as flaps or skin grafts are often necessary for wound closure [12]. However, reconstruction may not always be feasible, particularly in patients with multiple comorbidities and extensive defects.…”

Section: Discussionmentioning

confidence: 99%

“…Following debridement, additional reconstructive measures such as flaps or skin grafts are often necessary for wound closure. 12 However, reconstruction may not always be feasible, particularly in patients with multiple comorbidities and extensive defects. In cases where reconstruction is not possible, amputation may be considered to prevent further deterioration of the condition.…”

Section: Discussionmentioning

confidence: 99%

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Using 3D Bioprinted Autologous Minimally Manipulated Homologous Adipose Tissue for Limb Salvage in Treating Diabetic Foot Ulcer

Yoon,

Song

2024

Arch Plast Surg

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Reconstructive surgeons face challenges when considering limb salvage methods for the treatment of diabetic foot ulcers (DFUs). In this article, we present our experience with autologous fat grafting as a viable alternative in cases where flap reconstruction is difficult. We encountered a 78-year-old female patient with a non-healing DFU who had multiple comorbidities, including renal failure and severe peripheral arterial disease (PAD). During the initial multidisciplinary meeting, due to extensive necrosis and osteomyelitis, amputation was recommended. However, the patient expressed a strong preference for a salvage procedure and refused amputation. After careful consideration, we opted to reconstruct the patient's foot using 3D-bioprinted autologous minimally manipulated homologous adipose tissue (3D-AMHAT). The AMHAT was engrafted well without complications such as autolysis, graft failure or infection. After the operation, the large defect with partial bone exposure was covered with healthy granulation tissue. The size of the wound decreased to less than half its original size after 6 weeks of surgery, and it decreased to less than 25% after 12 weeks of surgery. The AMHAT may be an appealing treatment option for diabetic foot patients who are unsuitable for flap reconstruction due to comorbidities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Using 3D Bioprinted Autologous Minimally Manipulated Homologous Adipose Tissue for Limb Salvage in Treating Diabetic Foot Ulcer

Yoon,

Song

2024

Arch Plast Surg

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“…53 Narrow-spectrum antibiotics may be used in mild or moderate wound infection, on the other hand, broad-spectrum parenteral antibiotics may be used in severe wound infection. 54,55 Peripheral artery disease (PAD) is one of the best indicators for the development of chronic wounds and an elevated risk of death from cardiovascular disease. 56,57 According to reports, 40% of people with DFUs develop PAD.…”

Section: Gradementioning

confidence: 99%

“…Aerobic Gram‐positive cocci and staphylococci are the most frequently identified microorganisms that are responsible for most DFUs 53 . Narrow‐spectrum antibiotics may be used in mild or moderate wound infection, on the other hand, broad‐spectrum parenteral antibiotics may be used in severe wound infection 54,55 …”

Section: Conventional Treatment Of Dfumentioning

confidence: 99%

Mesenchymal stem cell therapy in diabetic foot ulcer: An updated comprehensive review

Hetta,

Elsaghir,

Sijercic

et al. 2024

Health Science Reports

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BackgroundDiabetes has evolved into a worldwide public health issue. One of the most serious complications of diabetes is diabetic foot ulcer (DFU), which frequently creates a significant financial strain on patients and lowers their quality of life. Up until now, there has been no curative therapy for DFU, only symptomatic relief or an interruption in the disease's progression. Recent studies have focused attention on mesenchymal stem cells (MSCs), which provide innovative and potential treatment candidates for several illnesses as they can differentiate into various cell types. They are mostly extracted from the placenta, adipose tissue, umbilical cord (UC), and bone marrow (BM). Regardless of their origin, they show comparable features and small deviations. Our goal is to investigate MSCs' therapeutic effects, application obstacles, and patient benefit strategies for DFU therapy.MethodologyA comprehensive search was conducted using specific keywords relating to DFU, MSCs, and connected topics in the databases of Medline, Scopus, Web of Science, and PubMed. The main focus of the selection criteria was on English‐language literature that explored the relationship between DFU, MSCs, and related factors.Results and DiscussionNumerous studies are being conducted and have demonstrated that MSCs can induce re‐epithelialization and angiogenesis, decrease inflammation, contribute to immunological modulation, and subsequently promote DFU healing, making them a promising approach to treating DFU. This review article provides a general snapshot of DFU (including clinical presentation, risk factors and etiopathogenesis, and conventional treatment) and discusses the clinical progress of MSCs in the management of DFU, taking into consideration the side effects and challenges during the application of MSCs and how to overcome these challenges to achieve maximum benefits.ConclusionThe incorporation of MSCs in the management of DFU highlights their potential as a feasible therapeutic strategy. Establishing a comprehensive understanding of the complex relationship between DFU pathophysiology, MSC therapies, and related obstacles is essential for optimizing therapy outcomes and maximizing patient benefits.

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“…Diabetes mellitus is a chronic non-communicable disease which has affected around 422 million people globally and is projected to affect 629 million people by the year 2045 [1,2]. One of the most common complications of diabetes is diabetic foot which is very distressing in nature [3].…”

Section: Introductionmentioning

confidence: 99%

A Journey from Clinical Pharmacist to a Diabetic Foot Wound Care Pharmacist from India: An Experience from Amit Jain’s Institute of Diabetic Foot

Apoorva

2023

AJRIMPS

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Diabetes is a growing problem and so are its complications with diabetic foot being one of the commonest known complications. Diabetic foot is often associated with amputation that increases the morbidity and mortality. Often, multidisciplinary management consisting of prevention, education, examination, treatment etc and multidisciplinary team approach can provide favorable outcomes. One of the members among this multidisciplinary team has been a pharmacist in few of the expert diabetic foot Centre’s around the world. It is observed that, though spoken of their role in clinical practice, either such roles are limited or undervalued. Further, there are sparse publications that provides a clear-cut role, training, responsibility, and their experience in a diabetic foot team. This article provides an essential insight on the journey of one of the first diabetic foot wound care Pharmacist from India.

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Diabetic foot ulcer: A comprehensive review of pathophysiology and management modalities

Cited by 37 publications

References 57 publications

Using 3D Bioprinted Autologous Minimally Manipulated Homologous Adipose Tissue for Limb Salvage in Treating Diabetic Foot Ulcer

Using 3D Bioprinted Autologous Minimally Manipulated Homologous Adipose Tissue for Limb Salvage in Treating Diabetic Foot Ulcer

Mesenchymal stem cell therapy in diabetic foot ulcer: An updated comprehensive review

A Journey from Clinical Pharmacist to a Diabetic Foot Wound Care Pharmacist from India: An Experience from Amit Jain’s Institute of Diabetic Foot

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