Bilayered skin-substitute technology for the treatment of diabetic foot ulcers: current insights

Abstract

The estimated prevalence of diabetes mellitus in New Zealand is 7%, and as in many other developed countries is a growing problem. One of the most common and costly complications, diabetic foot ulcers (DFUs) are chronic wounds that result when the phases of wound healing are disrupted or incomplete, resulting in wounds that persist for several months or even years. Despite standard-care therapy (ie, debridement, infection elimination, use of dressings, off-loading), the majority of DFUs remain unhealed, and it is thus appropriate to consider advanced therapies. One such therapy is a bioengineered bilayered living cellular construct (BLCC) comprised of living keratinocytes and fibroblasts. BLCC facilitates the delivery of a broad array of cytokines and growth factors often deficient in chronic nonhealing wounds, and in doing so reverses patients' wounds from a chronic wound to an acute normally healing wound. BLCC has an important body of evidence to support its use in DFUs, including randomized clinical trials, a real-world comparative-effectiveness analysis, and health-economics data.

The Insights of Microbes’ Roles in Wound Healing: A Comprehensive Review

“…Under normal conditions, the secretions ratio between MMPs and tissue inhibitors of metalloproteinases (TIMPs) are equal. However, the imbalance expressions of MMPs and TIMPs can cause degradation and inhibition of growth factors and ECM components thus, delaying the wound healing process [46][47][48]. Keratinocytes are the building blocks for the epidermis, which trigger the release of cytokines when in contact with an injury or wound [49].…”