Navigating the complexities of diabetic foot ulcers: From pathophysiology to advanced treatment strategies

Diabetic foot ulcers (DFUs) are the most prevalent and serious complication among diabetic patients, causing substantial health and economic burden due to low rate of healing and high recurrence. Current therapies for DFUs include surgical debridement, wound dressings, pressure offloading, revascularization, hyperbaric oxygen therapy, low-level laser therapy, and negative pressure wound therapy. In this review, we discussed conventional and emerging therapies using hydrogel and nanofiber-based treatments, stem cell approaches, 3D bioprinting, growth factors, matrix metalloproteinase (MMP) modulators, and bioengineered skin substitutes, which showed improved healing and reduced the risk of amputation. The current article attempts to give an in-depth overview of DFU management by examining established and innovative techniques. Further, this review emphasizes the necessity of multidisciplinary approaches to enhance patient compliance and lessen the burden of devastating pathological conditions.