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Review Open Access

Developments in the management of diabetic foot ulcers (Review)

  • Authors:
    • Anastasios Tentolouris
    • Ioanna Eleftheriadou
    • Georgia Samakidou
    • Nikolaos Tentolouris
  • View Affiliations / Copyright

    Affiliations: First Department of Propaedeutic Internal Medicine and Diabetes Center, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece
    Copyright: © Tentolouris et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 46
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    Published online on: March 18, 2025
       https://doi.org/10.3892/wasj.2025.334
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Abstract

Diabetic foot ulcers (DFUs) represent a severe complication of diabetes mellitus (DM), contributing to increased morbidity and mortality rates, and to a reduced quality of life. The impaired wound healing observed in DFUs is attributed to the dysregulation of multiple biological mechanisms essential for tissue repair. Several advanced treatment modalities have been explored as potential adjunct therapies for difficult‑to‑heal DFUs, targeting specific pathophysiological processes involved in wound healing. These modalities include treatments recommended by the International Working Group on the Diabetic Foot (IWGDF), such as sucrose octasulfate, which modulates matrix metalloproteinase activity, and LeucoPatch, an autologous preparation of leukocytes, platelets and fibrin applied to the wound surface. Additionally, several emerging therapies that have not yet been endorsed by the IWGDF have shown promise in the management of DFUs. These include regenerating agents that modify the extracellular matrix, the EDX110 nitric oxide‑generating dressing with vasodilatory and antimicrobial properties and ON101 cream, which regulates the pro‑inflammatory M1 to anti‑inflammatory M2 macrophage transition to improve the wound microenvironment. Furthermore, desferrioxamine that stimulates angiogenesis and maggot therapy, a bio‑debridement method, are being examined for their potential benefits. Despite these advancements, further high‑quality clinical studies are required to establish the efficacy, safety and cost‑effectiveness of these therapies in routine DFU management. The present review provides an updated overview of recent advancements in the treatment of DFUs, discussing their mechanisms of action, clinical evidence and implementation challenges.
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Spandidos Publications style
Tentolouris A, Eleftheriadou I, Samakidou G and Tentolouris N: Developments in the management of diabetic foot ulcers (Review). World Acad Sci J 7: 46, 2025.
APA
Tentolouris, A., Eleftheriadou, I., Samakidou, G., & Tentolouris, N. (2025). Developments in the management of diabetic foot ulcers (Review). World Academy of Sciences Journal, 7, 46. https://doi.org/10.3892/wasj.2025.334
MLA
Tentolouris, A., Eleftheriadou, I., Samakidou, G., Tentolouris, N."Developments in the management of diabetic foot ulcers (Review)". World Academy of Sciences Journal 7.3 (2025): 46.
Chicago
Tentolouris, A., Eleftheriadou, I., Samakidou, G., Tentolouris, N."Developments in the management of diabetic foot ulcers (Review)". World Academy of Sciences Journal 7, no. 3 (2025): 46. https://doi.org/10.3892/wasj.2025.334
Copy and paste a formatted citation
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Spandidos Publications style
Tentolouris A, Eleftheriadou I, Samakidou G and Tentolouris N: Developments in the management of diabetic foot ulcers (Review). World Acad Sci J 7: 46, 2025.
APA
Tentolouris, A., Eleftheriadou, I., Samakidou, G., & Tentolouris, N. (2025). Developments in the management of diabetic foot ulcers (Review). World Academy of Sciences Journal, 7, 46. https://doi.org/10.3892/wasj.2025.334
MLA
Tentolouris, A., Eleftheriadou, I., Samakidou, G., Tentolouris, N."Developments in the management of diabetic foot ulcers (Review)". World Academy of Sciences Journal 7.3 (2025): 46.
Chicago
Tentolouris, A., Eleftheriadou, I., Samakidou, G., Tentolouris, N."Developments in the management of diabetic foot ulcers (Review)". World Academy of Sciences Journal 7, no. 3 (2025): 46. https://doi.org/10.3892/wasj.2025.334
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