Reviewing Advances in Skin Grafting for Diabetic Foot Ulcers
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Abstract
Diabetic foot ulcers (DFUs) represent a significant health concern linked to poorly managed diabetes, affecting 19% to 34% of diabetic individuals and resulting in impaired functionality, infections, hospitalization, and the potential for amputations or mortality. Effective management involves addressing hyperglycemia, risk factors, and utilizing classification systems like SINBAD and IDSA/IWGDF for treatment. Skin grafting techniques such as split-thickness (STSG) and full-thickness (FTSG) grafts offer effective wound closure options. We acknowledged management for diabetic foot ulcers (DFUs) include autografts, cadaveric allografts, xenografts, and synthetic skin substitutes with natural polymers. Advanced techniques encompass biomaterials, nanobiomaterials, endothelial progenitor cells, and tissue engineering, while cellular therapies like mesenchymal stem cells (MSCs) show promise when properly activated. Innovations in DFU management encompass 3D bioprinting, nanotechnology, gene therapy, and photobiomodulation therapy. Positive clinical outcomes from skin grafting, including acellular fish skin (AFS) grafts, are observed, although challenges like graft rejection and limited technology awareness persist. Further research is essential to seamlessly integrate these advancements into DFU management for enhanced outcomes.
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