Diabetic Foot: Treatment of Ulcers with Nitric Oxide Bandages

Worldwide, 425 million people live with diabetes and more than 15% develop foot ulcers, increasing the risk of death by 2.5 times. New nitric oxide (NO) release technology could reduce healing time for diabetic foot ulcers from 120 days to 21 days.

Reduction of healing time is possible due to nitric oxide. In diabetic patients, deterioration in NO production impairs the regenerative capacity of skin cells. However, simply pumping NO has no effect. The long-term plan of the Michigan Technological University researchers is to create nitric oxide-impregnated bandages that regulate chemical release based on cell conditions.

In the article estet-portal.com you can get acquainted with the treatment of diabetic foot using nitric oxide in a new format.

Nitric oxide mechanism in diabetic ulcer conditions

Nitric oxide plays a key role in promoting wound healing, so biomaterials with NO-releasing properties are gaining more attention as an ideal wound dressing.

A novel functional wound dressing is obtained by combining a poly(ε-caprolactone) (PCL) non-woven material with biomaterials based on NO-releasing chitosan (CS-NO). The prepared PCL/CS-NO composition releases NO, which is stable under physiological conditions and controlled by β-galactosidase catalysis.

The results showed that PCL/CS-NO wound dressings significantly accelerated the wound healing process by improving re-epithelialization and granulation formation and effectively improved the organization of regenerated tissues, including the epidermal-dermal junction, which could be explained by proangiogenesis, immunomodulation (increased macrophage activity ) and increased collagen synthesis (the result of activated fibroblasts), provided by the long-term release of NO. Macrophages synthesize the cytokine transforming growth factor beta (TGF-.beta.), which controls proliferation, cell differentiation and other functions at the site of alteration.

Exposure to an extreme pH environment (1.5 or 12) results in significant TGF-beta activation, while moderate acidity (pH 4.5) only achieves 20-30% of the activity.

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Nitric oxide dressing for diabetic foot

Severe skin damage caused by trauma, surgery, burns or chronic disease has become one of the most serious clinical problems.

There is a growing need every day for the perfect wound dressing that can improve wound healing.

By expanding the choice of dressings and applying NO treatment technology to patients, the team will continue to expand their database while deepening their knowledge of the mechanisms of action of nitric oxide. In a few years, they plan to create a prototype of a working bandage. A nitric oxide dressing can help heal one of the most problematic pathologies in festering surgery in less than a month.

PCL/CS-NO may be a promising candidate for wound dressings, especially for chronic ischemic wounds.

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