Stem Cell Therapy for Diabetic Foot Ulcers: Theory and Practice

Figure 2

Mechanism of wound healing and dysregulation of diabetic foot ulcers. The stages of wound healing and dysregulation of diabetic foot ulcers: Wound healing begins with hemostasis phase, where a platelet plug prevents blood loss and a preliminary fibrin matrix is formed. Inflammation phase ensues to avoid infection (phagocytosis), with the secretion of neutrophils, macrophages, cytokines, and growths factors to remove cell debris. During the proliferative phase, endothelial cells, macrophages, fibroblast, and keratinocytes cells accelerate angiogenesis by closing the wound gap and replacing the initial fibrin clot with granulation tissue. Finally, the remodeling phase causes overall wound contraction by secretion of myofibroblasts and macrophages maturation. In diabetic wounds, active diabetes interrupts routine wound-healing phases, leading to poor outcomes.