Avances en el tratamiento de las úlceras crónicas en la enfermedad de pie diabético: Una actualización basada en metaanálisis
- Autores: Francisco Javier Martinez Barrios
- Directores de la Tesis: María Ruiz Muñoz (dir. tes.), Ana Marchena Rodríguez (codir. tes.)
- Lectura: En la Universidad de Málaga ( España ) en 2025
- Idioma: español
- Tribunal Calificador de la Tesis: Jerónimo Carmelo García Romero (presid.), María José Vallejo Herrera (secret.), Tereza Nováková (voc.)
- Programa de doctorado: Programa Oficial de Doctorado en Ciencias de la Salud (Enfermería y Fisioterapia)
- Materias:
- Enlaces
- Resumen
Diabetic foot ulcers (DFUs) represent a severe and pervasive complication of diabetes mellitus (DM), significantly impacting patients' quality of life and serving as a critical risk factor for lower extremity amputations and other grave complications. Despite ongoing advancements in medical science, the management of these chronic wounds remains notably complex, with healing outcomes often varying considerably depending on the therapeutic approach employed. Standard therapeutic options for DFUs traditionally encompass meticulous wound cleaning, the application of specialized dressings, and stringent control of diabetes. However, these conventional strategies frequently fail to achieve complete ulcer closure, thereby escalating the risk of severe adverse events, including infections and major amputations. This persistent challenge underscores the critical need for continued research into novel therapies aimed at enhancing the healing trajectory of chronic ulcers in patients afflicted with DFUs. In recent years, several experimental therapies have emerged, demonstrating promising results in facilitating the healing of chronic wounds, particularly biomaterials derived from placenta, Fish Skin Grafts (FSG), and autologous Platelet-Rich Plasma (aPRP). Nevertheless, despite considerable investigation into these therapies, a significant lack of consensus persists regarding their definitive efficacy when compared to conventional treatments. This notable gap in the scientific evidence necessitates a comprehensive quantitative evaluation of these innovative therapeutic modalities. Such an investigation holds relevance given the profound impact that chronic ulcers exert on the quality of life of affected patients, coupled with the high rates of associated complications, including amputations and premature mortality. This thesis, therefore, undertakes a rigorous quantitative analysis of the three advanced therapies-placental biomaterials, FSG, and aPRP-to independently assess their effectiveness in promoting the closure rate of chronic ulcers in patients diagnosed with DFUs, relative to conventional treatment. By addressing the current lack of consensus in the literature and offering a robust quantitative comparison of these novel therapies against the established standard of care, this thesis aims to contribute significantly to the development of enhanced therapeutic alternatives that hold the potential to markedly improve healing outcomes for patients grappling with DFUs.
Keywords: Diabetic Foot Ulcer, DFU, Chronic Ulcers, Advanced Therapies, Biomaterials, Placenta, Fish Skin Graft, Platelet-Rich Plasma, aPRP, Meta-analysis, Wound Healing.