1. Deficits in molecular, physical and biological parameters of healing in the diabetic foot: a literature review.
- Author
-
Sikri, Isha, O'Brien, Timothy, and McIntosh, Caroline
- Subjects
DIABETES complications ,WOUND healing ,EVALUATION of medical care ,DIABETIC foot ,GENE expression ,AMPUTATION - Abstract
Background Diabetic foot ulcers (DFU) are complex, multifactorial and often complicated by delayed, impaired and uncoordinated wound healing. DFU are associated with devastating outcomes including infection, amputation and premature death. Aim The aim of this narrative literature review is to obtain a broad perspective on the pathophysiological mechanisms that contribute to delayed and impaired healing in the diabetic foot. Methods We undertook a review of the literature to critique and synthesise the evidence for pathophysiological factors that contribute to delayed and impaired healing in the diabetic foot. Findings It is evident from the literature that molecular mechanisms that give rise to impaired inflammation will impact upon healing, whilst physical parameters such as tissue hypoxia, pressure foot-loading, wound PH, temperature and biofilm can all contribute to delayed healing in the diabetic foot. Conclusions An understanding of the pathophysiology of impaired healing and a focus on controlling these disturbances can facilitate successful healing. To enhance the management of foot disease in diabetic patients, primary care professionals must be made aware of the significance of early referral to a specialised unit. When DFU do not heal adequately after 4 weeks of standard treatment, the underlying pathology should be re-evaluated, and the need for advanced therapy should be considered. Implications for clinical practice It is important that clinicians involved in treating DFU have an understanding of the pathophysiological mechanisms that cause delayed and impaired healing in the diabetic foot. When a DFU fails to respond to standard care within a 4-week period, the pathophysiology of the wound should be re-evaluated and advanced therapies should be considered. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF