New and experimental approaches to treatment of diabetic foot ulcers: a comprehensive review of emerging treatment strategies
Article first published online: 23 SEP 2004
Volume 21, Issue 11, pages 1161–1173, November 2004
How to Cite
Eldor, R., Raz, I., Ben Yehuda, A. and Boulton, A. J. M. (2004), New and experimental approaches to treatment of diabetic foot ulcers: a comprehensive review of emerging treatment strategies. Diabetic Medicine, 21: 1161–1173. doi: 10.1111/j.1464-5491.2004.01358.x
- Issue published online: 20 OCT 2004
- Article first published online: 23 SEP 2004
- Accepted 26 January 2004
- diabetic foot;
- diabetic neuropathy;
- foot ulceration
Diabetic foot ulcers occur in up to 15% of all diabetic patients and are a leading cause of nontraumatic amputation worldwide. Neuropathy, abnormal foot biomechanics, peripheral vascular disease and external trauma are the major contributors to the development of a foot ulcer in the diabetic patient. Therapy today includes repeated debridement, offloading, and dressings, for lower grade ulcers, and broad spectrum antibiotics and occasionally limited or complete amputation for higher grades, requiring a team effort of health care workers from various specialties.
The large population affected by diabetic foot ulcers and the high rates of failure ending with amputation even with the best therapeutic regimens, have resulted in the development of new therapies and are the focus of this review. These include new off loading techniques, dressings from various materials, methods to promote wound closure using artificial skin grafts, different growth factors or wound bed modulators and methods of debridement.
These new techniques are promising but still mostly unproven and traditional approaches cannot be replaced. New and generally more expensive therapies should be seen as adding to traditional approaches.