Growth factors in the treatment of diabetic foot ulcers

Br J Surg. 2003 Feb;90(2):133-46. doi: 10.1002/bjs.4019.


Background: Chronic foot ulceration is a major source of morbidity in diabetic patients. Despite traditional comprehensive wound management, including vascular reconstruction, there remains a cohort of patients with non-responding wounds, often resulting in amputation. These wounds may benefit from molecular manipulation of growth factors to enhance the microcirculation.

Methods: A review of the current literature was performed using Pubmed, with secondary references obtained from key articles.

Results and conclusion: There has been a generally disappointing clinical outcome from growth factor trials, although topical platelet-derived growth factor has shown significant benefit and should be considered in non-healing, well perfused ulcers after failure of conventional wound care. The modulatory role of the extracellular matrix in the cellular response to growth factors and data from regenerative-type fetal wound healing are further areas of interest. The chemical induction of microvessel formation may become a future therapeutic option.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Diabetic Foot / drug therapy*
  • Endothelial Growth Factors / therapeutic use
  • Epidermal Growth Factor / therapeutic use
  • Fibroblast Growth Factor 7
  • Fibroblast Growth Factors / therapeutic use
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Growth Substances / therapeutic use*
  • Humans
  • Intercellular Signaling Peptides and Proteins / therapeutic use
  • Lymphokines / therapeutic use
  • Platelet-Derived Growth Factor
  • Risk Factors
  • Transforming Growth Factor beta / therapeutic use
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors
  • Wound Healing / drug effects*


  • Endothelial Growth Factors
  • FGF7 protein, human
  • Growth Substances
  • Intercellular Signaling Peptides and Proteins
  • Lymphokines
  • Platelet-Derived Growth Factor
  • Transforming Growth Factor beta
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factors
  • Fibroblast Growth Factor 7
  • Granulocyte Colony-Stimulating Factor
  • Fibroblast Growth Factors
  • Epidermal Growth Factor