Due to an epidemic of type-2 diabetes and increased incidences of type-1 diabetes, Diabetic Foot Ulcers (DFUs) are a growing problem.33
DFUs are divided into neuropathic, ischemic, and neuroischemic based on their neurological and vascular pathologies. The neuroischemic DFUs are the most common (50%) followed by neuropathic (35%) and ischemic (15%).34
Ischemia in diabetic patients, usually manifested as peripheral arterial occlusive disease (PAD), is 2-4 times more common in diabetic vs. non-diabetic patients35 and is associated with non-healing wounds.36
3C Patch® is appropriate for all types of DFUs.
- Neuroischemic 50%
- Neuropathic 35%
- Ischemic 15%
Chronic capillary ischemia
One important pathogenic mechanism for the non-healing DFU phenotype seems to be the inability of these patients to mobilize an adequate immune response at the wound site due to microvascular and neurological pathologies.36
Reduced vasodilation and reduced leukocyte infiltration of the wound area combined with lowered blood pressure in the extremities due to peripheral arterial occlusive disease (PAD) is often described as a state of “chronic capillary ischemia.”43
The microangiopathic changes together with continuous systemic inflammation impair the acute inflammatory response in diabetes; infections are not cleared properly, which delay wound healing.44
In diabetic patients, the neuropathy causes non-functional shunting and impaired microvascular flow.41
These microcirculatory vasomotor changes correlate with the severity of peripheral neuropathy in patients with type-2 diabetes. The consequence is reduced vasodilation and reduced leukocyte infiltration of the wound area.42
AV shunting is part of the normal healing response. Immune cells, platelets and growth factors reach the wound.
In neuropathic patients no shunting is seen, leading to a poor healing response.