DFU CHALLENGE

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

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

The International Working Group on the Diabetic Foot, IWGDF, now recommends the use of Reapplix´s technology.⁴⁹