https://doi.org/10.1007/s13346-021-00941-6
REVIEW ARTICLE
Biomedical applications of electrospun nanofibers in the management
of diabetic wounds
Divya Pamu
1
· Vyshnavi Tallapaneni
1
· Veera Venkata Satyanarayana Reddy Karri
1
· Sachin Kumar Singh
2
Accepted: 8 February 2021
© Controlled Release Society 2021
Abstract
Diabetes mellitus (DM) is a complex disease that afects almost all the body’s vital organs. Around 415 million people have
been diagnosed with DM worldwide, and most of them are due to type 2 DM. The incidence of DM is estimated to increase
by 642 million individuals by 2040. DM is considered to have many complications among which diabetic wound (DW) is
one of the most distressing complication. DW afects 15% of people with diabetes and is triggered by the loss of glycaemic
control, peripheral neuropathy, vascular diseases, and immunosuppression. For timely treatment, early detection, debride-
ment, ofoading, and controlling infection are crucial. Even though several treatments are available, the understanding
of overlying diabetes-related wound healing mechanisms as therapeutic options has increased dramatically over the past
decades. Conventional dressings are cost-efective; however, they are not productive enough to promote the overall process
of DW healing. Thanks to tissue engineering developments, one of the promising current trends in innovative wound dress-
ings such as hydrocolloids, hydrogels, scafolds, flms, and nanofbers which merges traditional healing agents and modern
products/practices. Nanofbers prepared by electrospinning with enormous porosity, excellent absorption of moisture, the
better exchange rate of oxygen, and antibacterial activities have increased interest. The application of these nanofbers can be
extended by starting with a careful selection of polymers, loading with active therapeutic moieties such as peptides, proteins,
active pharmaceutical ingredients (API), and stem cells, etc. to make them as potential dosage forms in the management of
DWs. This review explains the potential applications of electrospun nanofbers in DW healing.
Keywords Diabetic wound · Electrospinning · Nanofbers · Angiogenesis · Tissue engineering
Introduction
DM is a metabolic disorder with a very high incidence in
almost all countries globally. It was estimated that in 2019,
463 million people worldwide have been sufering from DM.
The fgure is likely to increase to 700 million, growing about
55% in the next two decades [1]. Inefectual therapeutic
involvement in diabetic patients may lead to long-term com-
plications such as neuropathy, nephropathy, and retinopathy,
leading to other comorbidities such as impaired wound heal-
ing. DW is a pathological indication of neuropathy known to
impair motor, autonomic, and sensory nerves’ functioning,
causing disability in patients [1]. A study including 2006
people with diabetes found that almost 528 (26.3%) patients
underwent minor amputation, whereas 106 (5.28%) patients
underwent major amputation. The presence of infection and
vascular diseases further increased the risk of amputation
among the DW-infected patients. Moreover, ulcers that
extended heal exhibited considerable resistance to healing
[2, 3]. These complications may increase the mortality rate
and reduce the life expectancy in DW patients than patients
without DWs [4]. Therefore, to address these above com-
plications and related challenges in DW management, there
is an urgent need for an efective drug delivery system for
localized drug delivery and better control of the DW.
Although various delivery systems such as scafolds,
hydrogels, ointments, and creams have been proposed for
DWs, nanofbers have established promising results in neo-
vascularization, tissue regeneration, reduction in scarring,
and faster healing. These nanofbers are ultrafne polymeric
* Veera Venkata Satyanarayana Reddy Karri
ksnreddy87@gmail.com
1
Department of Pharmaceutics, JSS College of Pharmacy,
JSS Academy of Higher Education & Research, Ooty,
Nilgiris, Tamil Nadu, India
2
School of Pharmaceutical Sciences, Lovely Professional
University, Phagwara, India
/ Published online: 21 March 2021
Drug Delivery and Translational Research (2022) 12:158–166