Potential of stem cells for treating infected Diabetic Foot Wounds and Ulcers: a systematic review

Infected diabetic foot ulcers (iDFUs) cause great concern, as they generally heal poorly and are precursive of diabetic-related foot amputation and even death. Scientists have tested various techniques in attempts to ascertain the best treatment for iDFUs; however, the results have remained inconclusive. Stem cell therapy (SCT) appears to improve iDFU through its antimicrobial impacts, yet cogent information regarding the repair of iDFUs with SCT is lacking. Herein, published articles are evaluated to report coherent information about the antimicrobial effects of SCT on the repair of iDFUs in diabetic animals and humans. In this systematic review, we searched the Scopus, Medline, Google Scholar, and Web of Science databases for relevant full-text English language articles published from 2000 to 2022 that described stem cell antimicrobial treatments, infected diabetic wounds, or ulcers. Ultimately, six preclinical and five clinical studies pertaining to the effectiveness of SCT on healing infected diabetic wounds or ulcers were selected. Some of the human studies confirmed that SCT is a promising therapy for diabetic wounds and ulcers. Notably, more controlled studies performed on animal models revealed that stem cells combined with a biostimulator such as photobiomodulation decreased colony forming units and hastened healing in infected diabetic wounds. Moreover, stem cells alone had lower therapeutic impact than when combined with a biostimulant.