Challenges and Advancements in Formulations for Diabetic Wound Healing - A Review

Abstract: Diabetic wounds represent a severe complication of diabetes mellitus, often resulting in delayed healing due to persistent hyperglycemia, impaired blood flow, oxidative stress, and a heightened risk of microbial infection. These factors disrupt normal wound healing processes, such as re-epithelialization, collagen synthesis, and angiogenesis. Conventional formulations like creams and ointments commonly face challenges, including rapid washout, low drug penetration, poor bioavailability, and short-duration release, making them inadequate for chronic wound treatment. This review explores the application of nanoformulations in diabetic wound healing, with data compiled from scientific databases, such as PubMed, ScienceDirect, and Google Scholar (2000-2024). Nanoformulations, including nanoparticles, liposomes, nanofibers, hydrogels, transferosomes, and ethosomes, demonstrate superior outcomes in terms of bioavailability, sustained drug release, skin permeation, and targeted therapeutic action. Herbal nanoformulations (e.g., curcumin, ellagic acid, Ocimum tenuiflorum) and synthetic drug-based systems (e.g., pioglitazone, vildagliptin) have shown enhanced antioxidant, anti-inflammatory, and tissue regeneration properties in both in vitro and in vivo models. Notably, patented technologies from recent years illustrate innovative formulations that accelerate healing and reduce recurrence. These nano-carrier systems mitigate the limitations of traditional formulations, providing long-acting, biocompatible solutions that support angiogenesis, fibroblast proliferation, and collagen deposition. The review underscores the necessity for further clinical translation to validate efficacy and safety in large patient populations.