Research progress on the application of negative pressure wound therapy combined with bioactive dressings in diabetic foot ulcers

doi:10.3877/cma.j.issn.1673-9450.2026.04.012

Abstract

Abstract:

Diabetic foot ulcer （DFU） is one of the chronic complications with the highest disability rate among diabetic patients. Clinical treatment and nursing care are notably challenging，and traditional dressing change regimens are often inadequate for meeting the repair requirements of complex wounds. As a novel collaborative nursing model，negative pressure wound therapy （NPWT） combined with bioactive dressings can effectively improve the wound microenvironment and promote tissue regeneration through the dual effects of physical-mechanical intervention and bio-biochemical regulation，and has become a core approach in the clinical nursing of DFU. From the perspective of clinical nursing，this article systematically reviews the clinical application basis，standardized nursing operation procedures，complication prevention，and comfort care measures of this combined model，analyzes the difficulties in clinical nursing management and proposes targeted solutions，and also looks into its development trend towards intelligent nursing. This review aims to provide standardized and refined practical references for clinical nursing staff，so as to enhance the quality of DFU nursing and reduce the risk of amputation in patients.

Key words: Diabetic foot ulcer, Negative pressure wound therapy, Bioactive dressings, Nursing administration research

Ying Feng, Hongjuan Zhu, Qian Wang, Mengmeng Gao, Jianing Guo, Yan Ma. Research progress on the application of negative pressure wound therapy combined with bioactive dressings in diabetic foot ulcers[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2026, 21(04): 309-314.

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References 48

［1］	Lavery LA，Suludere MA，Attinger CE，et al. WHS （Wound Healing Society） guidelines update： diabetic foot ulcer treatment guidelines ［J］. Wound Repair Regen，2024，32（1）：34-46. DOI：10.1111/wrr.13133.
［2］	Shakir K，Sarlak H，Bus SA，et al. Advancing diabetic foot ulcer care： focus on the post-healing transition phase ［J］. J Diabetes，2025，17（12）：e70173. DOI：10.1111/1753-0407.70173.
［3］	董润，何思懿，李明东. 糖尿病足溃疡的研究进展［J］. 中国临床研究，2026，39（1）：22-27. DOI：10.13429/j.cnki.cjcr.2026.01.004.
［4］	Wang F，Zhang X，Zhang J，et al. Recent advances in the adjunctive management of diabetic foot ulcer： focus on noninvasive technologies ［J］. Med Res Rev，2024，44（4）：1501-1544. DOI：10.1002/med.22020.
［5］	Bernatchez SF. Current state of science in negative pressure wound therapy ［J］. Adv Wound Care （New Rochelle），2025，14（6）：273-278. DOI：10.1089/wound.2024.0180.
［6］	Yao Y，Huang M，Li Y，et al. Emerging biomedical engineering therapies for infected diabetic foot ulcers： toward antibacterial functionalization and pathology-responsive regulation ［J］. Small Sci，2025，6（1）：e202500482. DOI：10.1002/smsc.202500482.
［7］	Raghav SS，Kumar B，Sethiya NK，et al. Diabetic foot ulcer management and treatment： an overview of published patents ［J］. Curr Diabetes Rev，2024，20（3）：e120623217906. DOI：10.2174/1573399820666230612161846.
［8］	Parveen K，Hussain MA，Anwar S，et al. Comprehensive review on diabetic foot ulcers and neuropathy： treatment，prevention and management ［J］. World J Diabetes，2025，16（3）：100329. DOI：10.4239/wjd.v16.i3.100329.
［9］	Lou J，Xiang Z，Zhu X，et al. Skin microbiota and diabetic foot ulcers ［J］. Front Microbiol，2025，16：1575081. DOI：10.3389/fmicb.2025.1575081.
［10］	Qin Y，Deng S. Inflammation，diabetic foot and related treatments ［J］. Front Endocrinol （Lausanne），2025，16：1676621. DOI：10.3389/fendo.2025.1676621.
［11］	张峰，王崇鹏，周志刚，等. 负压吸引联合米氏蒲花汤治疗对糖尿病足患者创面情况、中医症状评分及炎症因子的影响［J］. 中国现代药物应用，2026，20（11）：139-142. DOI：10.14164/j.cnki.cn11-5581/r.2026.11.037.
［12］	Janssen AH，Wegdam JA，Jaspar A，et al. Patient preference with regard to negative pressure wound therapy and participation in wound care： a qualitative study ［J］. J Wound Care，2025，34（5）： 340-349. DOI：10.12968/jowc.2022.0145.
［13］	林金銮，谢昀，郑力峰，等. 封闭式负压引流结合改良抗生素骨水泥体表半开放技术治疗慢性溃疡创面［J］. 中国修复重建外科杂志，2024，38（9）：1117-1122. DOI‌： 10.7507/1002-1892.202404105.
［14］	刘芳，李疆. 可调便携负压吸引装置与传统负压材料在治疗上肢皮肤缺损患者中的对比研究［J］. 临床皮肤科杂志，2022，51（4）：238-241. DOI：10.16761/j.cnki.1000-4963.2022.04.015.
［15］	Gu H，Zhao X，Sun Y，et al. Negative-pressure wound therapy compared with advanced moist wound therapy： a comparative study on healing efficacy in diabetic foot ulcers ［J］. Surgery，2025，180：109098. DOI：10.1016/j.surg.2024.109098.
［16］	Dalmedico MM，do Rocio Fedalto A，Martins WA，et al. Effectiveness of negative pressure wound therapy in treating diabetic foot ulcers： a systematic review and meta-analysis of randomized controlled trials ［J］. Wounds，2024，36（8）：281-289. DOI：10.25270/wnds/23140.
［17］	De Pellegrin L，Feltri P，Filardo G，et al. Effects of negative pressure wound therapy with instillation and dwell time （NPWTi-d） versus NPWT or standard of care in orthoplastic surgery： a systematic review and meta-analysis ［J］. Int Wound J，2023，20（6）：2402-2413. DOI：10.1111/iwj.14072.
［18］	Deng YX，Wang XC，Xia ZY，et al. Efficacy and safety of negative pressure wound therapy for the treatment of diabetic foot ulcers： a meta-analysis ［J］. World J Diabetes，2025，16（6）：103520. DOI：10.4239/wjd.v16.i6.103520.
［19］	Li X，Ai X，Wang B，et al. Application of 3D printing in the treatment of diabetic foot ulcers： current status and new insights ［J］ . Front Bioeng Biotechnol，2024，12：1475885. DOI：10.3389/fbioe.2024.1475885.
［20］	Zhao H，Wu Y，Xie Y，et al. Hydrogel dressings for diabetic foot ulcer： a systematic review and meta-analysis ［J］. Diabetes Obes Metab，2024，26（6）：2305-2317. DOI：10.1111/dom.15544.
［21］	Lu T，Zhou X，Jiang SY，et al. Natural bioactive compound-integrated nanomaterials for diabetic wound healing： synergistic effects，multifunctional designs，and challenges ［J］. Molecules，2025，30（12）：2562. DOI：10.3390/molecules30122562.
［22］	Li YR，Lai XS，Cheong HF，et al. Advances in biomaterials and regenerative medicine for diabetic foot ulcer therapy ［J］. Ageing Res Rev，2025，109：102779. DOI：10.1016/j.arr.2025.102779.
［23］	Białomyzy A，Kotrych K，Bogacz A，et al. Ozone therapy and negative pressure wound therapy in the treatment of difficult-to-heal wounds in diabetic foot syndrome and charcot neuroarthropathy ［J］. J Clin Med，2025，14（12）：4017. DOI：10.3390/jcm14124017.
［24］	徐家祥，朱勇，张玥，等. 白细胞介素-6在糖尿病足溃疡双向调控机制中的临床转化：从炎症风暴到创面修复［J］. 实用临床医药杂志，2026，30（3）：136-141，148. DOI： 10.7619/jcmp.20253775.
［25］	Wendland DM，Altenburger EA，Swen SB，et al. Diabetic foot ulcer beyond wound closure： clinical practice guideline ［J］. Phys Ther，2025，105（1）：pzae171. DOI：10.1093/ptj/pzae171.
［26］	Lim QH，Loy LC，Abdul Hadi H，et al. Diabetic foot ulcer in the western pacific region： current data on ulceration rates and microbial profiles，gaps and charting strategies ［J］. Prim Care Diabetes，2025，19（2）：133-142. DOI：10.1016/j.pcd.2024.12.012.
［27］	Villalba-Aguilar C，Laredo-Aguilera JA，Villalba-Aguilar L，et al. Comparative efficacy of negative pressure wound therapy and conventional treatments in the management of diabetic foot ulcers： a systematic review and meta-analysis ［J］ . J Clin Med，2025，14（22）：8051. DOI：10.3390/jcm14228051.
［28］	Nakamura JE，Fong AJ，Lane AD，et al. Rethinking diabetic foot ulcer care： integrating exercise and physical activity ［J］. J Diabetes Complications，2026，40（2）：109252. DOI：10.1016/j.jdiacomp.2025.109252.
［29］	Wang Q，Liu C，An J，et al. Mechanisms of microbial infection and wound healing in diabetic foot ulcer： pathogenicity in the inflammatory-proliferative phase，chronicity，and treatment strategies ［J］. Front Endocrinol （Lausanne），2025，16：1657928. DOI：10.3389/fendo.2025.1657928.
［30］	张秩，陈超，吴平平，等. 糖尿病足溃疡伤口延迟愈合的病理机制研究［J］. 临床皮肤科杂志，2025，54（1）：48-51. DOI：10.16761/j.cnki.1000-4963.2025.01.015.
［31］	Mohsin F，Javaid S，Tariq M，et al. Molecular immunological mechanisms of impaired wound healing in diabetic foot ulcers （DFU），current therapeutic strategies and future directions ［J］. Int Immunopharmacol，2024，139：112713. DOI：10.1016/j.intimp.2024.112713.
［32］	Lazzarini PA，van Netten JJ. Best practice offloading treatments for diabetic foot ulcer healing，remission，and better plans for the healing-remission transition ［J］. Semin Vasc Surg，2025，38（1）：110-120. DOI：10.1053/j.semvascsurg.2025.01.012.
［33］	Wang R，Li B，Dong M，et al. Targeting oxidative damage in diabetic foot ulcers： integrative strategies involving antioxidant drugs and nanotechnologies ［J］. Burns Trauma，2025，13：tkaf020. DOI：10.1093/burnst/tkaf020.
［34］	Boulton AJM，Viswanathan V. Evidence-based management of diabetic foot problems ［J］. Diabetes Res Clin Pract，2025，229：112932. DOI：10.1016/j.diabres.2025.112932.
［35］	Widigdo DAM，Sofro ZM，Pangastuti HS，et al. The efficacy of negative pressure wound therapy on healing of diabetic foot ulcers： a literature review ［J］. Curr Diabetes Rev，2024，20（8）：1-11. DOI：10.2174/0115733998229877230926073555.
［36］	Dawi J，Tumanyan K，Tomas K，et al. Diabetic foot ulcers： pathophysiology，immune dysregulation，and emerging therapeutic strategies ［J］. Biomedicines，2025，13（5）：1076. DOI：10.3390/biomedicines13051076.
［37］	Patel M，Patel V，Shah U，et al. Molecular pathology and therapeutics of the diabetic foot ulcer； comprehensive reviews ［J］. Arch Physiol Biochem，2024，130（5）：591-598. DOI：10.1080/13813455.2023.2219863.
［38］	Grace VM，Rajesh RP. Concomitants of diabetic foot ulcer-a review ［J］. Curr Diabetes Rev，2024，20（3）：e050523216594. DOI：10.2174/1573399819666230505142514.
［39］	Bauer TM，Moon JY，Shadiow J，et al. Mechanisms of impaired wound healing in type 2 diabetes： the role of epigenetic factors ［J］. Arterioscler Thromb Vasc Biol，2025，45（5）：632-642. DOI：10.1161/ATVBAHA.124.321446.
［40］	Janssen AH，Mommers EH，Notter J，et al. Negative pressure wound therapy versus standard wound care on quality of life： a systematic review ［J］. J Wound Care，2016，25（3）：154-159. DOI：10.12968/jowc.2016.25.3.154.
［41］	Mervis JS，Phillips TJ. Pressure ulcers： prevention and management ［J］. J Am Acad Dermatol，2019，81（4）：893-902. DOI：10.1016/j.jaad.2018.12.068.
［42］	Chaithra SR，Nair SP，Chaithanya SR，et al. Targeting diabetic foot ulcer pathophysiology： altered signaling pathways and 3D scaffold as an emerging treatment strategy ［J］. 3 Biotech，2025，15（8）：272. DOI：10.1007/s13205-025-04440-0.
［43］	Zhong Y，Ma H，Lu Y，et al. Investigation on repairing diabetic foot ulcer based on 3D bio-printing Gel/dECM/Qcs composite scaffolds ［J］. Tissue Cell，2023，85：102213. DOI：10.1016/j.tice.2023.102213.
［44］	Mallanagoudra P，M Ramakrishna SS，Jaiswal S，et al. Progressive hydrogel applications in diabetic foot ulcer management： phase-dependent healing strategies ［J］. Polymers （Basel），2025，17（17）：2303. DOI：10.3390/polym17172303.
［45］	Tan CT，Liang K，Ngo ZH，et al. Application of 3D bioprinting technologies to the management and treatment of diabetic foot ulcers ［J］. Biomedicines，2020，8（10）：441. DOI：10.3390/biomedicines8100441.
［46］	Kesavan R，Sheela Sasikumar C，Narayanamurthy VB，et al. Management of diabetic foot ulcer with MA-ECM （minimally manipulated autologous extracellular matrix） using 3D bioprinting technology - an innovative approach ［J］ . Int J Low Extrem Wounds，2024，23（1）：161-168. DOI：10.1177/15347346211045625.
［47］	Wang Z，Tan X，Xue Y，et al. Smart diabetic foot ulcer scoring system ［J］. Sci Rep，2024，14（1）：11588. DOI：10.1038/s41598-024-62076-1.
［48］	Jiang X，Han Z，Jin Y，et al. Mai Guan Fu Kang tablet （MGFK） accelerates diabetic foot ulcer healing via antioxidant defense and inflammation suppression ［J］. Phytomedicine，2025，145：157038. DOI：10.1016/j.phymed.2025.157038.

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