Diabetic foot ulcers are a major cause of morbidity and mortality among diabetics despite several care options. A paper published in the American Journal of Clinical Dermatology shares new trends in managing diabetic foot ulcers and the use of adjunctive therapies.
Pressure relief, debridement, infection management, and revascularization are some of the standard care for diabetic foot ulcers. They have their potential benefits but this regimen alone may not be sufficient for prevention and management of foot ulcers in patients with diabetes. Some new trends are improving treatment beyond the standard care.
For ulcers persisting beyond 4-week standard of care treatment, adjunctive approaches may be an option.
Negative pressure wound therapy may assist in promoting wound healing via the application of intermittent or continuous negative pressure to a wound.
Hyperbaric oxygen therapy has been suggested for diabetic foot ulcers. But its efficacy has been questioned according to the published literature.
Bioengineered skin substitutes as adjunct therapy for treating and closing diabetic foot ulcer wounds is getting popular. Skin substitutes for diabetic foot ulcers include dermal substitutes consisting of either acellular or cellular extracellular matrix and composite substitutes of dermal and epidermal components.
There is also a growing trend in the use of topical growth factors for diabetic foot ulcers. Topical recombinant human platelet-derived growth factor is approved by US Food and Drug Administration for diabetic foot ulcers.
Electrical stimulation is another emerging approach to treat foot ulcer wounds.
Most of the emerging approaches are novel and lack sufficient evidence to support its clinical efficacy. The investigators conclude that new standard of care for managing diabetic foot ulcers should be combined with a multimodal approach that addresses many factors that contribute to ulcer development and those that promote healing.