European Journal of Molecular & Clinical Medicine

Abstract

Because the process of healing chronic wounds is more challenging and requires more comprehensive treatment, patients with diabetes mellitus are at a higher risk of infection in their feet due to recurrent trauma and inadequate cleanliness. This can lead to a chronic problem. Hyaluronic acid (HA) is a component of the extracellular matrix in connective tissue that can help the wound healing process, thus providing the right conditions for the tissue regeneration process. Topical use of HA is considered effective in treating chronic wounds. The anti-inflammatory effect of HA works by inhibiting TNF-alpha, thereby preventing the increase in IL-6 and IL-8, which are pro-inflammatory cytokines. Patients with diabetic foot ulcers have higher plasma IL-6 levels compared to patients without diabetic foot ulcers. IL-6 is also an inflammatory marker that can differentiate infected diabetic foot ulcers (IDFU) from non-infected diabetic foot ulcers (NIDFU). Disturbance in the IL-6 pathway can cause delayed wound healing. Normally, IL-6 decreases significantly in the remodeling phase. This article was created to see how the effects of hyaluronic acid on reducing the time it takes for diabetic foot ulcers to heal and decreasing blood interleukin-6 levels from several studies that had been done previously.