Efficacy of collagen based biomaterials in diabetic foot ulcer wound healing

Diabetic foot ulcer (DFU), a chronic wound with complex pathophysiology and immune cell imbalance is the major health concern as it takes longer healing time compared to normal wound healing. Collagen wound dressings have important role in DFU healing as these dressings improve angiogenesis, reduces inflammation time and aids in the regeneration of damaged tissue, maintains a moist wound environment by promoting optimal conditions for cell activity. These dressings are formulated with bovine, avian, porcine, marine, human based or recombinant sources such as plant based, insect based or microorganisms. Animal based biomaterials have concern of immunogenicity and purification while marine based and recombinant sources are better alternatives for these issues. Chemical modifications with other bioactive materials, reduces immunogenicity and the healing time, increase antioxidant activity, modulate inflammatory responses, improve wound microenvironment and promote broad spectrum antimicrobial property. Additionally, incorporation of mesenchymal stem cells and growth factors can generate various cells essential to wound healing, such as dermal fibroblasts (DFs), endothelial cells, and keratinocytes. This review summarizes the role of collagen wound dressing in DFU wound healing, to provide the conceptual understanding of the research and development of collagen as a potential biomaterial for diabetic wound healing.