Eleftheriadou Ioanna, Samakidou Georgia, Tentolouris Anastasios, Papanas Nikolaos, Tentolouris Nikolaos
First Department of Propaedeutic Internal Medicine and Diabetes Center, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital.
Democritus University of Thrace, Alexandroupolis, Greece.
Int J Low Extrem Wounds. 2021 Sep;20(3):188-197. doi: 10.1177/1534734620963561. Epub 2020 Oct 19.
Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes mellitus that is associated with increased morbidity and mortality, as well as substantial economic burden for the health care system. The standard of care for DFUs includes pressure off-loading, sharp debridement, and wound moisture balance, along with infection control and management of peripheral arterial disease. A variety of advanced modalities that target distinct pathophysiological aspects of impaired wound healing in diabetes are being studied as possible adjunct therapies for difficult to heal ulcers. These modalities include growth factors, stem cells, cultured fibroblasts and keratinocytes, bioengineered skin substitutes, acellular bioproducts, human amniotic membranes, oxygen therapy, negative pressure wound therapy, and energy therapies. Additionally, the use of advanced biomaterials and gene delivery systems is being investigated as a method of effective delivery of substances to the wound bed. In the present narrative review, we outline the latest advances in the nonpharmacological management of DFUs and summarize the efficacy of various standard and advanced treatment modalities.
糖尿病足溃疡（DFUs）是糖尿病常见且严重的并发症，与发病率和死亡率增加相关，还给医疗保健系统带来巨大经济负担。DFUs的护理标准包括减轻压力、锐性清创、伤口水分平衡，以及感染控制和外周动脉疾病的管理。针对糖尿病伤口愈合受损不同病理生理方面的多种先进治疗方法正在作为难愈合溃疡的可能辅助治疗进行研究。这些方法包括生长因子、干细胞、培养的成纤维细胞和角质形成细胞、生物工程皮肤替代物、无细胞生物制品、人羊膜、氧疗、负压伤口治疗和能量治疗。此外，正在研究使用先进生物材料和基因递送系统作为将物质有效递送至伤口床的方法。在本叙述性综述中，我们概述了DFUs非药物管理的最新进展，并总结了各种标准和先进治疗方法的疗效。
