糖尿病足溃疡（Diabetic foot ulcer, DFU）是糖尿病的主要并发症，与较高的下肢截肢和死亡风险相关。有19%-34%的糖尿病患者在其一生中可能出现DFU。估计61%的DFU会感染，其中15%的DFU患者需要截肢。此外，DFU的发生增加了5年内死亡风险50%-68%，高于某些癌症。当前DFU标准管理包括手术清创、局部敷料和伤口减压、血管评估和血糖控制。其中，局部敷料治疗能够建立保护性物理屏障，保持湿润环境，并从DFU伤口排出渗出物。本综述总结了DFU的发展、病理生理和愈合机制。还总结了实验室和临床阶段敷料的最新研究进展和主要应用。本综述讨论的敷料包括传统敷料（纱布、纱线、中药及其他）、基础敷料（水凝胶、羟基胶体、海绵、泡沫、膜剂及其他）、抑菌敷料、复合敷料（胶原蛋白、纳米材料、壳聚糖敷料及其他）、生物活性敷料（含干细胞支架敷料、去细胞化伤口基质、自体富血小板等）、以及利用现代技术的敷料（3D生物打印、光热效应、生物电敷料、微针敷料、智能绷带、骨科假肢和再生医学）。本综述还总结了敷料管理面临的挑战和局限。本综述的目的是帮助读者了解DFU的发病机制和愈合机制，帮助医生正确选择敷料，提供生物材料和设备在DFU管理中的潜力和最新进展概述，并提供敷料进一步探索和发展的思路。正确使用敷料可以促进DFU愈合，降低治疗成本，并减轻患者疼痛。 版权所有 © 2023 江、李、罗、罗、车、卢、杨、杨、陈和蔡。

Diabetic foot ulcer (DFU) is a major complication of diabetes and is associated with a high risk of lower limb amputation and mortality. During their lifetime, 19%-34% of patients with diabetes can develop DFU. It is estimated that 61% of DFU become infected and 15% of those with DFU require amputation. Furthermore, developing a DFU increases the risk of mortality by 50%-68% at 5 years, higher than some cancers. Current standard management of DFU includes surgical debridement, the use of topical dressings and wound decompression, vascular assessment, and glycemic control. Among these methods, local treatment with dressings builds a protective physical barrier, maintains a moist environment, and drains the exudate from DFU wounds. This review summarizes the development, pathophysiology, and healing mechanisms of DFU. The latest research progress and the main application of dressings in laboratory and clinical stage are also summarized. The dressings discussed in this review include traditional dressings (gauze, oil yarn, traditional Chinese medicine, and others), basic dressings (hydrogel, hydrocolloid, sponge, foam, film agents, and others), bacteriostatic dressings, composite dressings (collagen, nanomaterials, chitosan dressings, and others), bioactive dressings (scaffold dressings with stem cells, decellularized wound matrix, autologous platelet enrichment plasma, and others), and dressings that use modern technology (3D bioprinting, photothermal effects, bioelectric dressings, microneedle dressings, smart bandages, orthopedic prosthetics and regenerative medicine). The dressing management challenges and limitations are also summarized. The purpose of this review is to help readers understand the pathogenesis and healing mechanism of DFU, help physicians select dressings correctly, provide an updated overview of the potential of biomaterials and devices and their application in DFU management, and provide ideas for further exploration and development of dressings. Proper use of dressings can promote DFU healing, reduce the cost of treating DFU, and reduce patient pain.Copyright © 2023 Jiang, Li, Luo, Luo, Che, Lu, Yang, Yang, Chen and Cai.