Impaired wound healing in diabetes: the rationale for clinical use of hyaluronic acid plus silver sulfadiazine.

TL;DRAbstract

Diabetes-related chronic cutaneous lesions are a serious and common problem, as well as a major cause for hospital admissions, although no general consensus has been reached on the best available treatment for this frequent pathological condition. The primary objective of this review is to analyze the most recent evidence supporting the clinical use of a formulation containing hyaluronic acid (HA) and silver sulfadiazine (SSD) in the diabetic patient. This formulation has been widely used in cutaneous lesions of various etiology, both acute and chronic. The mechanisms underlying tissue repair are altered in the diabetic patient with respect to a healthy individual, namely for a diminished response of the keratinocytes and a reduced capacity of the endothelial cells to form new vessels (neoangiogenesis). Since HA favours the tissue repair process through various mechanisms, among these an increased angiogenic response and an activation of the keratinocytes, its application in diabetic l

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