DIABETIC FOOT SYNDROME (DFS)

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DFS is a major complication for patients with diabetes mellitus. About 25 % of patients with diabetes will suffer from diabetic foot syndrome at some point during the course of their disease.

Diabetic neuropathy and peripheral vascular disease are the main causative factors in the pathogenesis of chronic wounds in patients with DFS. The mortality rate of these patients is more than twice as high as that of the average population.

 

Diabetic Foot Ulcers
A diabetic foot ulcer is an open wound that most commonly occurs on the foot in approximately 15 % of patients with diabetes.

25 % of costs incurred by patients with diabetes are spent on diabetic foot ulcers, and 50 % of hospital days are attributed to the treatment of the DFS. It is also the most common cause of non-traumatic amputations. Both the risk of ampu-tation and mortality are much increased in case of peripheral vascular disease.

Chronic diabetic foot ulcers are caused by small-vessel occlusion, frequently compounded by neuropathy and infection. They usually are caused by several factors: Neuropathy, altered biomechanics, peripheral vascular disease (PAD) and inadequate foot wear are among the major factors. The course of the disease may be complicated by infection.

It occurs as a result of various factors, such as mechanical changes in conformation of the bony architecture of the foot, athero-sclerotic peripheral arterial disease and peripheral neuropathy, all of which occur with higher frequency and intensity in the diabetic population. Diabetic foot lesions are responsible for more hospitalizations than any other complication of diabetes, having a major impact on the patient as well as on the health care system.

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Current standard of care for DFS related complications

The existing therapy approaches for complications caused by DFS are almost exclusively concentrating on prevention.
Current standards of care consist of:

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• Prevention: optimized insulin adjustment, professional foot care and orthopedic foot wear, patient education

• Early diagnosis combined with qualified treatment

• Modern dressings such as moist dressings

• Hyperbaric Oxygen Therapy (HBO)

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An early diagnosis combined with qualified treatment of disturbed wound healing is considered crucial for successful healing of diabetic foot ulcers too. However, therapy outcomes are often irregular and inconsistent.

Management of chronic ulcers in the lower extremity remains a challenge for patients and health providers. Therefore a therapy method with a cellular regeneration mechanism for the affected tissue is urgently required.