Recent advances in the adjunctive management of diabetic foot ulcer: Focus on noninvasive technologies

Abstract

Diabetic foot ulcer (DFU) is one of the most costly and serious complications of diabetes. Treatment of DFU is usually challenging and new approaches are required to improve the therapeutic efficiencies. This review aims to update new and upcoming adjunctive therapies with noninvasive characterization for DFU, focusing on bioactive dressings, bioengineered tissues, mesenchymal stem cell (MSC) based therapy, platelet and cytokine‐based therapy, topical oxygen therapy, and some repurposed drugs such as hypoglycemic agents, blood pressure medications, phenytoin, vitamins, and magnesium. Although the mentioned therapies may contribute to the improvement of DFU to a certain extent, most of the evidence come from clinical trials with small sample size and inconsistent selections of DFU patients. Further studies with high design quality and adequate sample sizes are necessitated. In addition, no single approach would completely correct the complex pathogenesis of DFU. Reasonable selection and combination of these techniques should be considered.

Integrating bioinformatics and multiple machine learning to identify mitophagy-related targets for the diagnosis and treatment of diabetic foot ulcers: evidence from transcriptome analysis and drug docking

“…However, the current clinical diagnosis and treatment of DFU also face challenges, with the clinical diagnosis of DFU being overly dependent on the clinical experience of clinicians and lacking effective treatments ( Armstrong et al, 2017 ; Matos et al, 2018 ; Purwanti et al, 2024 ; Wang F. et al, 2024 ; Wang K. et al, 2024 ). At the present stage, the treatment of DFU patients mainly includes debridement, wound dressing, anti-infection treatment, peripheral vasculopathy treatment, strict glycemic control, and amputation ( McIllhatton et al, 2021 ; Orlando et al, 2021 ; Ahmed et al, 2022 ; Slomski, 2022 ; Jeffcoate et al, 2024 ), but the therapeutic efficacy of these methods is still unsatisfactory and has not yet achieved a satisfactory clinical results, that is, they do not fully control the underlying metabolic lesions ( Bardill et al, 2022 ; Chen et al, 2024 ; Yi et al, 2024 ; Zhang G. et al, 2024 ; Zhang N. et al, 2024 ).…”