ABSTRACT
Abstract ................................................................................................. 275 7.1 Introduction .................................................................................. 275 7.2 Classification of Diabetic Wounds ............................................... 278
7.2.1 Wagner System ................................................................ 278 7.2.2 Texas System ................................................................... 279
7.3 Wound Dressings ......................................................................... 281 7.3.1 Selection of a Wound Dressing Material ......................... 283 7.3.2 Specialized Wound Dressings .......................................... 286
7.4 Characteristics of a Wound Dressing Material for Diabetic Wounds ........................................................................................ 287
7.5 Types of Wound Dressings Suitable for Diabetic Wounds .......... 289 7.5.1 Non-adherent or Low-adherence Dressing ...................... 290 7.5.2 Hydrocolloids ................................................................... 291 7.5.3 Hydrogels ......................................................................... 292 7.5.4 Foams ............................................................................... 293 7.5.5 Alginates .......................................................................... 294
7.6 Bioactive Wound Dressings ......................................................... 295
7.6.1 Antimicrobial Dressings .................................................. 295 7.6.2 Iodine Preparations .......................................................... 296 7.6.3 Silver-Impregnated Dressings .......................................... 296 7.6.4 Honey Dressing on an Infected Diabetic Foot Ulcer ....... 297 7.6.5 Growth Factor Impregnated Wound Dressings ................ 298
7.7 Collagen Based Wound Dressings in Diabetic Wound Management ................................................................................. 299 7.7.1 Alkaline-treated Collagen and Atelocollagen Gels ......... 300 7.7.2 Chitosan-cross Linked Collagen Sponge ......................... 301 7.7.3 Collagen as Acellular Dermal Skin Substitute ................. 301 7.7.4 Protease Absorbent Collagen Dressing ........................... 302
7.8 Smart Wound Dressings for Diabetic Wounds ............................. 302 7.8.1 Smart Exudate Management ............................................ 303 7.8.2 Smart Antimicrobial Dressing ......................................... 304 7.8.3 Smart Wound Dressing to Control Moisture and Reduce
Pain ................................................................................... 305 7.9 Negative Pressure Wound Therapy (NPWT) ............................... 307
7.10 Foot Wound Dressings (Diabetic Foot Wounds, Toe Wounds) ............................................................................ 309
7.11 Conclusion ................................................................................. 309 Keywords .............................................................................................. 310 References ............................................................................................. 310
ABSTRACT
People with diabetes are at increased risk for complications of wound healing for several reasons. A greater understanding of the molecular mechanism of diabetes and advances in biomaterial research has led to significant advancements in the management of diabetic wounds. These advances have saved thousands of patients from lower extremity amputation. Most of these amputations could easily be prevented with good foot care and wound treatment. Thus it is crucial for health care professionals working across the acute community interface to manage diabetic wounds effectively. The future of diabetic wound healing lies in the development of more effective smart wound dressings. Development of these kinds of therapies will require multidisciplinary translational research teams. This chapter outlines how current advances in molecular biology, polymer technology, and biomaterials can be incorporated into a multidisciplinary translational research approach for formulating novel smart wound dressings for diabetic wound treatment. It also provides an overview of recent advances in biomaterial research for the management of diabetic wounds and the different kind of wound dressings available in the market aimed on diabetic wounds.
