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.
- Diabetic Foot/drug therapy
- Endothelial Growth Factors/therapeutic use
- Epidermal Growth Factor/therapeutic use
- Fibroblast Growth Factor 7
- Fibroblast Growth Factors/therapeutic use
- Granulocyte Colony-Stimulating Factor/therapeutic use
- Growth Substances/therapeutic use
- Intercellular Signaling Peptides and Proteins/therapeutic use
- Lymphokines/therapeutic use
- Platelet-Derived Growth Factor
- Risk Factors
- Transforming Growth Factor beta/therapeutic use
- Vascular Endothelial Growth Factor A
- Vascular Endothelial Growth Factors
- Wound Healing/drug effects