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BioMed Research International
Volume 2013 (2013), Article ID 385641, 6 pages
http://dx.doi.org/10.1155/2013/385641
Review Article

Current Aspects in the Pathophysiology and Treatment of Chronic Wounds in Diabetes Mellitus

1Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III, Technical University Medical Center, 01307 Dresden, Germany
2Endokrinologikum Ruhr, 44866 Bochum, Germany

Received 28 October 2012; Accepted 6 March 2013

Academic Editor: David G. Armstrong

Copyright © 2013 Elena Tsourdi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Impaired wound healing is a frequent and very severe problem in patients with diabetes mellitus, yet little is known about the underlying pathomechanisms. In this paper we review the biology of wound healing with particular attention to the pathophysiology of chronic wounds in diabetic patients. The standard treatment of diabetic ulcers includes measures to optimize glycemic control as well as extensive debridement, infection elimination by antibiotic therapy based on wound pathogen cultures, the use of moisture dressings, and offloading high pressure from the wound bed. In this paper we discuss novel adjuvant therapies with particular reference to the use of autologous skin transplants for the treatment of diabetic foot ulcers which do not respond to standard care.