Mechanisms and Interventions of Diabetic Wound Healing.

Abstract

Diabetic wounds constitute a significant global health challenge, affecting millions of individuals worldwide and imposing a substantial burden on healthcare systems. This review explores the complex pathophysiology of diabetic wound healing and discusses innovative interventions aimed at addressing this critical clinical problem. The impaired healing process in diabetic wounds is characterized by a multitude of interrelated factors, including cellular dysfunction, altered inflammatory responses, oxidative stress, the formation of advanced glycation end-products, and neurovascular abnormalities. Fibroblasts, keratinocytes, and endothelial cells demonstrate diminished proliferation and migration capabilities, while immune cells exhibit dysregulated responses, which contribute to a persistent inflammatory state. Complications associated with diabetes, such as neuropathy and vascular insufficiency, further exacerbate the wound healing process. Recent advancements in wound care strategies have opened new avenues for enhancing diabetic wound healing. These advancements encompass the development of advanced dressings and biomaterials, growth factor therapies, cell-based interventions, and gene therapy approaches. The integration of diverse treatment modalities, coupled with the management of systemic metabolic abnormalities, offers significant promise for improving outcomes in diabetic wound care. Future research should focus on optimizing combination therapies, developing personalized treatment algorithms, and conducting large-scale clinical trials to establish the most effective and safest interventions for diabetic wound healing.