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August 14, 2020  
WOUND NEWS: Wound Technology

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  • Healing One Step at A Time


    March 10, 2001

    -A Wound Technology Story
    by Erin K. Blakeley, Wounds1 Staff

    Reviewed by Dr. Keith Harding

    Diabetic foot ulcers are a condition that diabetics have reason to fear. Treatment of these sores, which range from superficial to deep, can take months or years, and can cost a bundle in medical costs and days missed from work. With the help of medical research, treatments exist to help a patient heal; however the process remains time-consuming. With the help of genetic research, laboratories have succeeded in producing a human platelet-derived growth factor that can expedite the healing process of a diabetic foot ulcer, putting patients back on their feet faster than ever.

    Diabetic foot ulcers form for two main reasons. For one, diabetics tend to suffer from poor circulation, so the extremities of the hands and feet tend to receive less oxygenated blood than the rest of the body. As a result of poor circulation, the extremities have a diminished ability to heal. The second reason is due to a condition associated with diabetes called peripheral neuropathy, during which localized nerve damage causes a loss of sensation in the extremities. Peripheral neuropathy is also largely the result of inadequate circulation.

    The combination of poor circulation and peripheral neuropathy for diabetics may develop a scratch or blister on their foot, and be unable to feel it, due to the neuropathy. Meanwhile, poor circulation prevents their bodies from delivering the necessary cells to the wound. A minor wound left untreated can become a diabetic foot ulcer, and a threat to the patient’s overall health.

    Because of the difficulty the body has in delivering blood supply to the diabetic foot, finding a way to provide the wound with one of the biological components of healing can be an important factor in expediting the healing process.

    When a wound heals, it proceeds through three phases. In the first phase, called inflammation, blood clots form, white blood cells attack bacteria and the body summons certain cells to the wound site. Next the wound enters a phase called proliferation, in which cells necessary for wound closure proliferate, or grow in number at the wound site. These cells make new connective tissue and form blood vessels. Finally, during the remodeling phase, the wound heals and forms the initial scar tissue.

    Several kinds of cells participate in the wound healing process. Among them are a blood component called platelets. Platelets are disk-shaped cells integral to clotting, and are the first cells to invade the wound site. They initiate the healing process by releasing growth factors. Growth factors participate in all three phases of wound healing. They summon useful cells and proteins to the wound during the first phase of healing, while in the second and third phases, they stimulate the increased production of connective and vascular tissue, and promote remodeling.

    Researchers produce human platelet derived growth factors in a laboratory by inserting genetic material onto a strain of yeast and allowing it to grow. Researchers then form the genetically engineered growth factor into a topical gel that patients can apply to the wound site. Studies show that diabetic foot ulcers heal more rapidly with the topical application of human-derived growth factors than foot ulcers that are left on their own to heal.

    Physicians instruct patients on how to apply the human platelet-derived growth factor gel to their foot ulcer. The advantage is that patients can administer the gel themselves, and monitor the progress of their wound. The platelet-derived growth factor takes on the responsibility of the patient’s own growth factors, summoning the cells that are integral to the healing process.

    As tissue engineering takes hold in the medical community, more and more products will utilize new technology to model wound care products after human body tissue, and model the body’s own methods of healing. Human platelet-derived growth factors are one product that expedites the wound healing process for diabetic foot ulcers. As products like human tissue-derived skin substitute become widely available to patients, it becomes clear that the road ahead for healing diabetic foot ulcers looks promising.

    Related information
    For information on insulin delivery click here

    Last updated: 10-Mar-01

       
     
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