Growth factors in the treatment of diabetic foot ulcers

Author:

Bennett S P12,Griffiths G D2,Schor A M1,Leese G P3,Schor S L1

Affiliation:

1. Unit of Cell and Molecular Biology, The Dental School, University of Dundee, Dundee, UK

2. Department of Vascular Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK

3. Department of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK

Abstract

Abstract Background Chronic foot ulceration is a major source of morbidity in diabetic patients. Despite traditional comprehensive wound management, including vascular reconstruction, there remains a cohort of patients with non-responding wounds, often resulting in amputation. These wounds may benefit from molecular manipulation of growth factors to enhance the microcirculation. Methods A review of the current literature was performed using Pubmed, with secondary references obtained from key articles. Results and conclusion There has been a generally disappointing clinical outcome from growth factor trials, although topical platelet-derived growth factor has shown significant benefit and should be considered in non-healing, well perfused ulcers after failure of conventional wound care. The modulatory role of the extracellular matrix in the cellular response to growth factors and data from regenerative-type fetal wound healing are further areas of interest. The chemical induction of microvessel formation may become a future therapeutic option.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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