Experimental treatments in clinical trials for diabetic foot ulcers: wound healers in the pipeline

ABSTRACT

Introduction

Diabetes affects 400 million people globally and patients and causes nephropathy, neuropathy, and vascular disease. Amongst these complications, diabetic foot ulcers remain a substantial problem for patients and clinicians. Aggressive wound care and antibiotics remain important for the healing of these chronic wounds, but even when treated these chronic ulcers can lead to infection and amputations

Areas covered

This paper reviews the pathophysiology of diabetic foot ulcers and the current management strategies. Then, it discusses novel therapeutics such as topical oxygen therapy as well as autologous patches and macrophage creams.

Expert opinion

Diabetic foot ulcers are a substantial problem for patients and clinicians. Early identification, aggressive wound care, and normoglycemia remain the standard of care, however when these fail it is important to adapt. Since each patient and wound vary drastically we believe they should be treated as such. For patient with intact perfusion, topical ON101 and sucrose octasulfate creams can help. While patient with peripheral arterial disease should consider topical oxygen therapy as an adjunct. However, as scientists gain a better understanding of the pathophysiology behind DFUs, the hope is that this new wave of therapeutics will emerge.

KEYWORDS:

• Diabetic foot ulcers
• wound care
• topical oxygen therapy
• macrophage therapy
• LeucoPatch

Article highlights

• Diabetes remains a worldwide problem that can lead to a myriad of complications such as renal failure, peripheral arterial disease and diabetic foot ulcers

• Management of diabetic foot ulcers requires a multidisciplinary approach between primary care providers, wound care specialists, endocrinologists and surgeons.

• Primary prevention, risk factor modification, and strict glucose control remain critical to prevent wounds

• While there are new therapeutics and technologies available to help improve diabetic wound healing, proper off loading, antibiotics, and aggressive wound care and debridement’s remain the first line

• When standard of care fails, patients can trial new types of therapeutics creams and technologies to help aid in proper healings.

Declarations of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.