Diabetic Foot Ulcers: Current Advances in Antimicrobial Therapies and Emerging Treatments

Abstract

Diabetic foot ulcers (DFUs) are very important diabetes-related lesions that can lead to serious physical consequences like amputations of limbs and equally severe social, psychological, and economic outcomes. It is reported that up to 25% of patients with diabetes develop a DFU in their lifetime, and more than half of them become infected. Therefore, it is essential to manage infection and ulcer recovery to prevent negatives outcomes. The available information plays a significant role in keeping both physicians and patients aware of the emerging therapies against DFUs. The purpose of this review is to compile the currently available approaches in the managing and treatment of DFUs, including molecular and regenerative medicine, antimicrobial and energy-based therapies, and the use of plant extracts, antimicrobial peptides, growth factors, ozone, devices, and nano-medicine, to offer an overview of the assessment of this condition.

Keywords: antimicrobial therapy; diabetic foot ulcer; regenerative medicine.

Figure 1

Risk factors and predisposing factors for the development of diabetic foot ulcers (DFUs). There are two main protagonists among the risk factors and/or predisposing factors of DFUs: angiopathy and neuropathy, whose presence, together with intrinsic (foot deformity) and/or extrinsic triggers, such as trauma (mechanical, chemical or thermal), causes the loss of skin integrity. Aggravating factors, such as ischemia, abnormal immunity, and neuropathy, favor the development of DFU infections.