Unravelling the pathophysiology of diabetic foot ulcer: insights into a complex wound healing process

Abstract

Diabetic foot ulcer (DFU) is a common and debilitating complication of diabetes mellitus, representing a significant clinical challenge. This article delves into the intricate pathophysiology underlying DFU, aiming to enhance our understanding of this complex wound healing process. We explore the interplay of multifactorial aspects, including peripheral neuropathy, vascular insufficiency, and impaired immune response, which contribute to the development and progression of DFU. Moreover, the dysregulation of key cellular and molecular mechanisms involved in inflammation, angiogenesis, extracellular matrix remodeling, and infection are examined. A comprehensive understanding of the pathophysiology of DFU including oxidative stress, neuropathy, dysregulated angiogenesis, impaired immune response, and key molecular pathways supports the development of targeted therapeutic strategies beyond current treatments to improve wound healing, reduce complications, and enhance patient quality of care.