Tissue-Engineered Wound Dressings for Diabetic Foot Ulcers

As the prevalence of patients with diabetes is rising, the number of patients at risk of developing diabetic foot ulcers (DFUs) is increasing. DFU is one of the most debilitating complications of diabetes because of the high risk of infections and lower extremity amputations. The standard of care for DFU treatment is limited to non-specific diagnostics (wound size, depth) and therapeutic interventions (debridement, wet gauze, antibiotics if needed), and has moderate healing rates. In the past three decades, a number of FDA-approved therapies have been developed that take advantage of advances in biomaterials and tissue engineering to manufacture materials that provide a favorable physicochemical environment and pro-healing cues (e.g., extracellular matrix, growth factors). However, these treatments have not led to strongly increased healing rates. As our understanding of diabetic wound pathophysiology is deepening, new therapeutic targets have emerged, particularly around inflammatory processes in diabetic wounds. In the last decade, the emergence of these targets has led to the development of wound dressings that release diagnostic and therapeutic agents that specifically address these processes. While many of these therapies have yet to provide a clinical proof-of-concept, the variety of strategies raises hope that novel and more specific diagnostic and therapeutic options will be available in the next decade.