Clinically Unmet Needs of Conventional Diabetic Foot Ulcer Dressings

Diabetic foot ulcers (DFUs) represent one of the most complex and challenging chronic wounds to manage, carrying a high risk of limb amputation due to the multifactorial comorbidities of hyperglycemia, including peripheral neuropathy, arterial occlusive disease, and immune dysfunction. The current clinical gold standard treatment for DFUs involves surgical debridement, followed by the application of appropriate wound dressings. Although numerous commercial products are available and advanced dressings are currently in research development and clinical trials, most still fail to meet the clinical criteria for an ideal dressing. This Perspective highlights the current focus of DFU wound dressing research and identifies key translational gaps. These include the reliance on oversimplified validation models, the tendency to address only one or two pathological features (e.g., infection or angiogenesis), and limited consideration of dressing and other management needs in post-amputation care. We thenpropose the ideal properties required for the development of proactive, multifunctional, and smart wound dressings that can address a broader spectrum of DFU pathophysiologies. Furthermore, we emphasize that such designs should also prioritize simplicity and manufacturability to meet regulatory requirements and facilitate clinical translation.