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The Diabetic Foot pp 127–149Cite as

Physiology and Pathophysiology of Wound Healing in Diabetes

Part of the Contemporary Diabetes book series (CDI)

Abstract

Wound healing is an evolutionary conserved process that aims to restore the damaged barrier. This complex process involves many cellular responses including inflammation, proliferation, migration, angiogenesis, and tissue remodeling. Immediately after the injury, blood components are released into the wound site, activating the clotting cascade. The resulting clot induces hemostasis and provides a matrix for the influx of inflammatory cells. Inflammation is characterized by leukocyte migration and arrival to the site of injury. Neutrophils arrive first to remove contaminating bacteria (Singer and Clark, N Engl J Med 341(10):738–746, 1999) and are followed by monocytes, which differentiate into macrophages. Macro­phages play an important role in augmenting the inflammatory response and tissue debridement. At the same time, many different cell types respond to initial inflammatory signals and start migrating to the wound site, including keratinocytes, endothelial cells, and circulating and local progenitor cells.

Keywords

  • Clotting cascade
  • Hemostasis
  • Cellular responses
  • Keratinocytes
  • Fibroblasts
  • Endothelial cells
  • Neutrophils
  • Macrophages
  • Stem and progenitor cells
  • Angiogenesis
  • Wound healing

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Fig. 7.1

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Authors and Affiliations

  1. Wound Healing and Regenerative Medicine Research Program, Department of Dermatology, University of Miami Miller School of Medicine, 1600 NW 10th Ave, RMSB 2023-A, Miami, FL, 33136, USA

    Olivera Stojadinovic, Irena Pastar, Katherine A. Gordon & Marjana Tomic-Canic

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  1. Olivera Stojadinovic
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  2. Irena Pastar
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  3. Katherine A. Gordon
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  4. Marjana Tomic-Canic
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Correspondence to Marjana Tomic-Canic .

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Editors and Affiliations

  1. Center, Department of Surgery, Beth Israel Deaconess Medical, 1 Deaconess Road, Boston, 02215, Massachusetts, USA

    Aristidis Veves

  2. , Division of Podiatry, Beth Israel Deaconess Medical Center, 1 Deaconess Road, Boston, 02215, Massachusetts, USA

    John M. Giurini

  3. Center, Department of Surgery, Beth Israel Deaconess Medical, 110 Francis Street, Boston, 02215, Massachusetts, USA

    Frank W. LoGerfo

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Stojadinovic, O., Pastar, I., Gordon, K.A., Tomic-Canic, M. (2012). Physiology and Pathophysiology of Wound Healing in Diabetes. In: Veves, A., Giurini, J., LoGerfo, F. (eds) The Diabetic Foot. Contemporary Diabetes. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-791-0_7

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