Biology and Treatment of Diabetic Foot Ulcers

Almost 5 years have passed since the last WOUNDS section dedicated to the Biology and Treatment of Diabetic Foot Ulcers was published. One major change since then is the awareness that diabetes, especially type 2, is becoming pandemic and poses significant social and economic challenges even among highly developed societies. Diabetic foot problems are also on the rise and it is expected that these problems will become more widespread as the number of patients with diabetes increases and their life expectancy is prolonged.
Unfortunately, no major therapeutic breakthroughs have been reported since the last section on diabetic foot biology and treatment appeared in WOUNDS. Thus, the excitement that was created with the introduction of new therapeutic approaches including growth factors and leaving skin equivalents during the 5 years preceding the last issue was not followed by the introduction of new modalities the last 5 years. Furthermore, the limitations of the new therapeutic approaches in treating diabetic foot problems have been realized.
Some positive developments have occurred in the last 5 years, and the urgent need for more basic and translational research that will elucidate the pathophysiology of diabetic foot problems and help develop new therapeutic approaches, has been realized. Furthermore, in the clinical arena, algorithms are being constructed that can help the practicing clinician develop reasonable plans regarding when and how to use new therapeutic approaches. Given the high cost of these modalities, the algorithms are crucial to ensure that patients who can benefit from such treatments are appropriately treated without unnecessarily increasing the already high costs associated with treating diabetic foot ulcers.
This section on the Biology and Treatment of Diabetic Foot Ulcers includes a combination of research that examines the etiology of diabetic foot problems and the development of new treatments. I hope that the information in this issue will help readers in managing their patients in addition to providing an account and status of current research regarding diabetic foot problems.
Thank you to all who contributed to this issue, and to the editor and WOUNDS management team for their support.