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Wound Care > Research and Science > Diabetic foot: hydroactive wound dressings promote healing

Diabetic foot: blood sugar regulation and hydroactive wound dressings promote healing

03.08.2006 If the macro and micro circulation in the skin is disturbed, a chronic wound can develop. An article in the medical journal Lancet provided an overview of the biological and molecular wound healing process.

Without maintaining correct blood sugar levels the diabetic foot cannot heal.

After skin injury, a complex wound healing process starts where lost or damaged tissue is replaced and the skin renewed. If the macro or microcirculation of skin is compromised, a chronic wound may develop which is difficult to heal. Professor Vincent Falanga from Boston University summarized the current state of knowledge on biological and molecular wound healing in an overview and explained what must be observed for successful treatment of diabetic ulcers (Lancet 2005; 366: 1736-1743). Diabetic ulcers have – like all chronic wounds- lost the ability to synchronize the healing phases for closing the skin defect. In diabetic foot syndrome, this impairment of wound healing is due to a number of different factors. Falanga distinguishes between intrinsic (neuropathies, vascular problems and other systematic effects due to diabetes) and extrinsic factors (wound infection, formation of calluses, excessive pressure on the wound). “These pathological changes often build upon each other in a vicious circle“, Falanga writes.

Improve disturbed macro and microcirculation

In patients with chronic wounds, effective causal therapy of the underlying disease is as important as the local wound treatment. The aim is to improve the macro and microcirculation of the skin to promote healing. At the beginning of the treatment of a diabetic ulcer, blood sugar levels must be regulated, infections treated and perfusion dysfunction corrected. Depending on the wound condition, hydroactive dressings should be used which prevent maceration and accumulation of debris etc. and at the same time stimulate cell migration during the healing process.