Abstract
With the global prevalence of type 2 diabetes mellitus steeply rising, instances of chronic, hard-healing, or non-healing diabetic wounds and ulcers are predicted to increase. The growing understanding of healing and regenerative mechanisms has elucidated critical regulators of this process, including key cellular and humoral components. Despite this, the management and successful treatment of diabetic wounds represents a significant therapeutic challenge. To this end, the development of novel therapies and biological dressings has gained increased interest. Here we review key differences between normal and chronic non-healing diabetic wounds, and elaborate on recent advances in wound healing treatments with a particular focus on biological dressings and their effect on key wound healing pathways.
Highlights
Published: 15 March 2021The global impact of diabetes, including type 2 diabetes mellitus (T2DM), is severe, costing over 760 billion dollars—constituting 10% of adults’ annual health expenditure.More importantly, diabetes is projected to affect over 700 million individuals by 2045 (7.8%of the global population) [1,2]
15% of patients suffering from T2DM develop ulcers localized on the lower limbs, referred to as diabetic foot ulcers (DFUs)
Hereafter we will focus on scaffolds which possess a dermal element—in particular fully acellular dermal matrices—due to dermal element (1) prevalence in DFU
Summary
The global impact of diabetes, including type 2 diabetes mellitus (T2DM), is severe, costing over 760 billion dollars—constituting 10% of adults’ annual health expenditure. In 2019 alone, more than 4 million adults died from direct and associated complications of diabetes This prevalence and burden clearly outline diabetes and its associated complications as pressing global concerns. 15% of patients suffering from T2DM develop ulcers localized on the lower limbs, referred to as diabetic foot ulcers (DFUs). Wound healing is defined as a natural physiological process occurring as the reaction to structural damage of tissues, including skin. These mechanisms involve sophisticated complimentary interactions between different cell types, acting through networks of soluble. Diabetic hyperglycemia contributes to a variety of systemic complications, causing an array of local pathologies manifesting within the wound microenvironment, including chronic inflammation, dysregulated angiogenesis, hypoxia-induced oxidative stress, neuropathy, advanced glycation end-products, and impaired neuropeptide signaling [4]. We discuss strategies for diabetic wound treatment concentrated on the use of skin substitutes and biological dressings
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