Jayalal J A, Kumar Selwyn, Mohan Abhinand
General Surgery, Kanyakumari Government Medical College, Asaripallam, IND.
Cureus. 2025 Mar 20;17(3):e80929. doi: 10.7759/cureus.80929. eCollection 2025 Mar.
Diabetic foot ulcer (DFU) remains a serious complication of diabetes, with a significant prevalence of peripheral artery disease (PAD) in affected patients. PAD complicates DFU healing, reducing recovery rates significantly. In other settings, cilostazol, a phosphodiesterase-3 inhibitor, has shown promise in reducing the risk of arterial thrombosis more effectively than aspirin, despite the traditional recommendation of aspirin to mitigate the heightened cardiovascular risk associated with diabetes. This study retrospectively compared the effects of cilostazol and aspirin on wound healing and PAD symptoms in patients with DFU. We evaluated 60 patients with DFU and PAD treated with either cilostazol or aspirin retrospectively for wound healing progression, clinical improvement, and alleviation of PAD symptoms. As 10 patients' data were incomplete, it included 50 patients from two cohorts.There were 30 patients in the cilostazol cohort and 20 in the aspirin cohort. We assessed the wound using Wagner's classification and planimetric techniques and classified the PAD stages using the Fontaine classification. Results indicated that cilostazol treatment led to a significantly higher rate of complete wound healing (90%) compared to aspirin (55%) and a faster healing timeline. Cilostazol also demonstrated a more effective improvement in PAD symptoms, facilitating a better quality of life for patients. These findings suggest that cilostazol may offer a more effective treatment option for promoting wound healing and managing PAD in DFU patients than aspirin. We recommend further randomized and controlled studies to validate these results and refine DFU treatment protocols. Protocols that incorporate cilostazol could lead to significant advancements in patient care, ultimately reducing the burden of diabetic foot ulcers. As healthcare providers seek more effective therapies, understanding the mechanisms behind cilostazol's efficacy will be crucial for optimizing treatment strategies.
糖尿病足溃疡（DFU）仍然是糖尿病的一种严重并发症，在受影响的患者中，外周动脉疾病（PAD）的患病率很高。PAD使DFU愈合复杂化，显著降低了恢复率。在其他情况下，西洛他唑是一种磷酸二酯酶-3抑制剂，尽管传统上推荐使用阿司匹林来减轻与糖尿病相关的心血管风险升高，但它在降低动脉血栓形成风险方面比阿司匹林更有效。本研究回顾性比较了西洛他唑和阿司匹林对DFU患者伤口愈合和PAD症状的影响。我们回顾性评估了60例接受西洛他唑或阿司匹林治疗的DFU和PAD患者的伤口愈合进展、临床改善情况以及PAD症状的缓解情况。由于10例患者的数据不完整，研究纳入了来自两个队列的50例患者。西洛他唑队列中有30例患者，阿司匹林队列中有20例患者。我们使用瓦格纳分类法和平面测量技术评估伤口，并使用方丹分类法对PAD阶段进行分类。结果表明，与阿司匹林组（55%）相比，西洛他唑治疗导致完全伤口愈合率显著更高（90%），且愈合时间更短。西洛他唑在改善PAD症状方面也更有效，有助于提高患者的生活质量。这些发现表明，与阿司匹林相比，西洛他唑可能为促进DFU患者的伤口愈合和管理PAD提供更有效的治疗选择。我们建议进一步进行随机对照研究，以验证这些结果并完善DFU治疗方案。纳入西洛他唑的方案可能会在患者护理方面取得重大进展，最终减轻糖尿病足溃疡的负担。随着医疗保健提供者寻求更有效的治疗方法，了解西洛他唑疗效背后的机制对于优化治疗策略至关重要。
