Natural Products in the Treatment of Unremitting Wounds Secondary to Diabetes or Peripheral Vascular Disease

Non-healing cutaneous wounds secondary to diabetes and peripheral vascular disease can be a devastating problem. The normal wound healing continuum is affected at all stages by hyperglycemia and peripheral vascular disease. It is a complex process that involves microvascular and cellular changes. The development of diabetic foot ulcers complicated by vascular diseases may have significant complications for a patient, leading to amputation and increased mortality. Current strategies utilize offloading, means to facilitate angiogenesis and topical applications to manage the wound itself. Natural products have been utilized globally for centuries for cutaneous wound healing. The use of some natural products may stimulate the body's cellular healing and provide anti-inflammatory, antimicrobial and antioxidant effects. Honey-based dressings are widely used and commercially available today. Multiple phyto-derived compounds have been studied in diabetic models. However, studies using many of these compounds are limited. Further studies are needed to increase the efficacy of natural products in the use of wound healing with diabetic or peripheral vascular wounds.