Bioengineered Skin for Diabetic Foot Ulcers: A Scoping Review

Area of Science:

• Regenerative Medicine
• Wound Healing
• Diabetes Mellitus Research

Background:

• Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus (DM), leading to significant morbidity and potential lower limb amputation.
• Bioengineered skin substitutes (BSS) offer a potential alternative to traditional treatments for DFUs.
• The comparative efficacy of BSS against standard wound care (SWC) and other regenerative options like allografts is not well-established.

Purpose of the Study:

• To conduct a scoping review of human studies evaluating the efficacy of BSS in DFU treatment.
• To compare BSS with SWC and other treatment modalities, including allografts.
• To identify current approaches and knowledge gaps in BSS application for DFUs.

Main Methods:

• Systematic literature searches were performed in PubMed, Cochrane Library, and Web of Science for comparative studies.
• Studies published between December 1, 2012, and December 1, 2022, with at least 10 patients were included.
• PRISMA-ScR guidelines were followed, focusing on wound healing outcomes (closure, time-to-healing, area reduction).

Main Results:

• Out of 1312 initially identified articles, 24 were included in the qualitative analysis.
• Bioengineered skin substitutes (BSS) demonstrated superior performance compared to standard wound care (SWC) across all evaluated wound healing metrics.
• Eight studies compared BSS with human amniotic membrane allografts (hAMA), yielding conflicting results.

Conclusions:

• Bioengineered skin substitutes (BSS) appear to be a more effective treatment for diabetic foot ulcers (DFUs) than standard wound care (SWC).
• The comparative effectiveness of BSS versus human amniotic membrane allografts (hAMA) for DFU treatment remains inconclusive.
• Further research is warranted to clarify the role of BSS and hAMA in the management of diabetic foot ulcers.