Advances in diabetic wound healing: from pathophysiology to emerging therapies

Diabetic wounds (DWs), particularly those affecting the lower extremities, represent a significant clinical challenge due to their chronic nature and high risk of complications, including infection and amputation. Despite advances in diabetes management, conventional wound care strategies often fail to achieve satisfactory healing outcomes, largely due to the complex pathophysiology of DWs, are involving impaired angiogenesis, chronic inflammation, and compromised immune responses. The data on the conventional and emerging therapies used in the management of DWs were searched using PubMed, Scopus, and Web of Science databases to locate literature published. Studies have shown that conventional wound care interventions like debridement, dressing, and infection control mostly provide symptomatic treatment without eliminating underlying cellular and molecular diabetic wound pathophysiology. Recent years have witnessed the emergence of novel therapeutic approaches, including stem cell therapy, gene therapy, nanotechnology-based interventions, and tissue engineering. These strategies improve angiogenesis, alter the polarization of macrophages, and stimulate tissue repair, which can offer new hope for enhancing wound healing in diabetic patients. This review synthesizes current literature on the pathophysiology of diabetic wound healing, evaluates the limitations of traditional therapies, and provides a comprehensive overview of cutting-edge treatments that holds an effective diabetic wound management.