Recurrent diabetic foot ulcer: a comprehensive analysis of epidemiological features and pathophysiological mechanisms
10.3760/cma.j.cn114453-20250115-00015
- VernacularTitle:复发性糖尿病足溃疡的流行病学特征与病理生理机制
- Author:
Xuejun NI
1
;
Xiaofen WAN
;
Lu CHEN
;
Biao WANG
;
Xiuying SHAN
Author Information
1. 福建医科大学附属第一医院整形外科，福州 350005
- Publication Type:Journal Article
- Keywords:
Recurrent diabetic foot ulcer;
Epidemiology;
Pathophysiology;
Epigenetics;
Metabolic memory
- From:
Chinese Journal of Plastic Surgery
2025;41(5):515-523
- CountryChina
- Language:Chinese
-
Abstract:
Diabetic foot ulcer (DFU) have emerged as a serious global health issue due to its high rates of occurrence, disability, and mortality. DFU exhibit an exceptionally high recurrence rate, driven by a combination of behavioral and biological factors, leading to the recognition of fully epithelialized ulcers as being in "remission" rather than cured. However, the pathogenic factors underlying recurrent DFU (RDFU) remain poorly understood. This review examines the epidemiological characteristics and pathophysiological mechanisms of RDFU. Key mechanisms include neuropathy, angiopathy, epigenetic modifications, and metabolic memory. Research demonstrates that RDFU development results from the interplay of multiple factors: hyperglycemia-induced metabolic abnormalities, chronic inflammatory responses, vascular and neurological damage, as well as dysregulated epigenetic control. These factors interact synergistically, creating a vicious cycle that increases the risk of recurrence and delays recovery. By synthesizing current knowledge, this review aims to provide a foundation for future research and clinical management of RDFU. The insights presented support the development of personalized treatment strategies and effective preventive measures to reduce recurrence and improve patient outcomes.
