Recent Advances in the Treatment of Diabetic foot

Abstract

Diabetic foot is a very serious complication of diabetes and is defined as a foot affected by ulceration associated with diabetic neuropathy and/or peripheral arterial disease of the lower limb in a patient with diabetes. The prevalence of diabetic foot in diabetic population is 4-10% and condition is more frequent in older patients. Recent advances in the treatment of diabetic foot include the use of Becaplermin gel which is a platelet derived growth factor (PDGF) of recombinant human origin. PDGF stimulates angiogenesis, wound contraction and wound remodeling. Living skin equivalent (LSE) products are newest technological advances for diabetic foot ulcers. One LSE product consists of dermal fibroblasts cultured  in vitro and has histological characters similar  to dermal papillary of newborn skin. Extracellular Matrix Proteins are semisynthetic ester of hyaluronic acid which facilitates the growth and movement of fibroblasts and controls hydration.MMP Modulators contains matrix metalloproteinases which regulate the extracellular matrix components. Negative Pressure Wound Therapy involves the use of continuous subatmospheric pressure through a special pump covered with adhesive drape to maintain a closed environment, Hyperbaric Oxygen accelerates wound healing in diabetes. Foot problems in a person with diabetes can have disastrous consequences. Though recent advances in the management of these problems have increased the abilities to save the lower limb, the best management remains the control of diabetes and prevention of diabetic foot.