3D scaffolds in the treatment of diabetic foot ulcers: New trends vs conventional approaches

Diabetic Wound-Healing Science

“…Due to the above-referenced multifactorial pathophysiology of diabetic wounds, DFUs remain a clinical challenge. Wound-healing strategies can fall under standard of care therapies and advanced therapies, with the standard of care treatment involving wound debridement, offloading, and glycemic and infection control, whereas advanced therapies include hyperbaric oxygen therapy (HBOT), wound dressings, negative pressure wound therapy (NPWT), and growth factor therapies including platelet-rich plasma, stem cells, and cell- and tissue-based products [ 2 , 4 ] ( Table 1 ). Considering the clinical need, stimuli-responsive and multifunctional treatment strategies that can accelerate diabetic wound healing are likely to be an important part of future diabetic wound management [ 1 ].…”

“…Currently, close to 500 million people are estimated to be suffering from diabetes mellitus (DM), with a predicted startling increase in the upcoming years. In the US alone, over $300 billion is spent annually on both medical costs and as a result of lost workdays due to DM [ 1 , 2 ]. Moreover, one estimate suggests that between one in three to one in every five patients with DM will develop a chronic non-healing wound in their lifetime, such as a diabetic foot ulcer (DFU), with an alarming recurrence rate (40% within one year and 65% within five years) and no reliable methods available to predict its occurrence [ 3 , 4 ].…”

“…Considering additional factors identified by Armstrong et al, the overall lifetime incidence of foot ulcers in diabetic patients could be as high as 19–34% [ 5 ]. Thus, it is not surprising that a large proportion requires lower limb amputations, affecting patients’ quality of life and requiring costly treatments; it is estimated that the DFU market alone is set to increase from 7.03 billion USD in 2019 to 11.05 billion USD by 2027, making it imperative that more effective diagnostic and treatment strategies are developed to combat this debilitating disease [ 2 , 4 ]. The diabetic foot ulcer has an exceptionally complex pathology due to persistent hyperglycemia and associated diabetic complications, including (1) barrier disruption and infection, (2) high oxidative stress, (3) neuropathy, (4) microvascular complications, and (5) suboptimal chronic inflammatory response, in addition to psychological problems, including a patient’s mental health, self-esteem, and family cohesion (among others) ( Figure 1 ).…”

3D bioprinted scaffolds for diabetic wound-healing applications

“…These outcomes have significant implications for patient quality of life, as well as increasing the costs and clinical burden in treating DFU. For further information, readers can refer to a recent review manuscript from the authors for more details on DFU pathology and treatment strategies that are commonly implemented [3].…”

Construction of multifunctional wound dressings with their application in chronic wound treatment

“…3D bioprinting is an additive manufacturing technology that deposits bioinks loaded with cells or biologically active substances in a layer-by-layer fashion based on a computer-aided design of structures. 3,110 There are currently four main bioprinting technologies: inkjet bioprinting, extrusion bioprinting, laser-assisted printing, and dynamic optical projection stereolithography. 3 Compared with other wound dressings, 3D bioprinted scaffolds have better flexibility in the manufacturing process and can quickly produce reproducible 3D structures, thereby reducing patient waiting time.…”