Innovations in Gene and Growth Factor delivery systems for Diabetic Wound Healing.

The rise in lower extremity amputations (LEAs) due to non-healing of foot ulcers in diabetic patients calls for rapid improvement in effective treatment regimens. Administration of growth factors (GFs) are thought to offer an off-the-shelf treatment however, the dose- and time-dependent efficacy of the GFs together with the hostile environment of diabetic wound beds impose a major hindrance in the selection of an ideal route for GFs delivery. As an alternative, the delivery of therapeutic genes using viral and non-viral vectors, capable of transiently expressing the genes until the recovery of the wounded tissue offers promise. The development of implantable biomaterial dressings capable of modulating the release of either single or combinatorial GFs/genes may offer solutions to this overgrowing problem. This article reviews the state of the art on genes and proteins delivery and the strategic optimization of clinically adopted delivery strategies for the healing of diabetic wounds.