Diabetic Foot: The Role of Fasciae, a Narrative Review
Wound healing is an intricate, dynamic process, in which various elements such as hyperglycemia, neuropathy, blood supply, matrix turnover, wound contraction, and the microbiome all have a role in this “out of tune” diabetic complex symphony, particularly noticeable in the complications of diabetic...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Biology |
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| Online Access: | https://www.mdpi.com/2079-7737/10/8/759 |
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| author | Carmelo Pirri Caterina Fede Nina Pirri Lucia Petrelli Chenglei Fan Raffaele De Caro Carla Stecco |
| author_facet | Carmelo Pirri Caterina Fede Nina Pirri Lucia Petrelli Chenglei Fan Raffaele De Caro Carla Stecco |
| author_sort | Carmelo Pirri |
| collection | DOAJ |
| description | Wound healing is an intricate, dynamic process, in which various elements such as hyperglycemia, neuropathy, blood supply, matrix turnover, wound contraction, and the microbiome all have a role in this “out of tune” diabetic complex symphony, particularly noticeable in the complications of diabetic foot. Recently it was demonstrated that the fasciae have a crucial role in proprioception, muscular force transmission, skin vascularization and tropism, and wound healing. Indeed, the fasciae are a dynamic multifaceted meshwork of connective tissue comprised of diverse cells settled down in the extracellular matrix and nervous fibers; each constituent plays a particular role in the fasciae adapting in various ways to the diverse stimuli. This review intends to deepen the discussion on the possible fascial role in diabetic wounds. In diabetes, the thickening of collagen, the fragmentation of elastic fibers, and the changes in glycosaminoglycans, in particular hyaluronan, leads to changes in the stiffness, gliding, and the distribution of force transmission in the fasciae, with cascading repercussions at the cellular and molecular levels, consequently feeding a vicious pathophysiological circle. A clear scientific perception of fascial role from microscopic and macroscopic points of view can facilitate the identification of appropriate treatment strategies for wounds in diabetes and create new perspectives of treatment. |
| first_indexed | 2024-03-10T09:00:52Z |
| format | Article |
| id | doaj.art-e3b509be850e490c8ab7e2ddfc054c08 |
| institution | Directory Open Access Journal |
| issn | 2079-7737 |
| language | English |
| last_indexed | 2024-03-10T09:00:52Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biology |
| spelling | doaj.art-e3b509be850e490c8ab7e2ddfc054c082023-11-22T06:50:07ZengMDPI AGBiology2079-77372021-08-0110875910.3390/biology10080759Diabetic Foot: The Role of Fasciae, a Narrative ReviewCarmelo Pirri0Caterina Fede1Nina Pirri2Lucia Petrelli3Chenglei Fan4Raffaele De Caro5Carla Stecco6Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, ItalySchool of Medicine and Surgery, University of Messina, 98125 Messina, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, ItalyDepartment of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, ItalyWound healing is an intricate, dynamic process, in which various elements such as hyperglycemia, neuropathy, blood supply, matrix turnover, wound contraction, and the microbiome all have a role in this “out of tune” diabetic complex symphony, particularly noticeable in the complications of diabetic foot. Recently it was demonstrated that the fasciae have a crucial role in proprioception, muscular force transmission, skin vascularization and tropism, and wound healing. Indeed, the fasciae are a dynamic multifaceted meshwork of connective tissue comprised of diverse cells settled down in the extracellular matrix and nervous fibers; each constituent plays a particular role in the fasciae adapting in various ways to the diverse stimuli. This review intends to deepen the discussion on the possible fascial role in diabetic wounds. In diabetes, the thickening of collagen, the fragmentation of elastic fibers, and the changes in glycosaminoglycans, in particular hyaluronan, leads to changes in the stiffness, gliding, and the distribution of force transmission in the fasciae, with cascading repercussions at the cellular and molecular levels, consequently feeding a vicious pathophysiological circle. A clear scientific perception of fascial role from microscopic and macroscopic points of view can facilitate the identification of appropriate treatment strategies for wounds in diabetes and create new perspectives of treatment.https://www.mdpi.com/2079-7737/10/8/759woundsfasciadiabetessuperficial fasciastiffnesscollagen |
| spellingShingle | Carmelo Pirri Caterina Fede Nina Pirri Lucia Petrelli Chenglei Fan Raffaele De Caro Carla Stecco Diabetic Foot: The Role of Fasciae, a Narrative Review Biology wounds fascia diabetes superficial fascia stiffness collagen |
| title | Diabetic Foot: The Role of Fasciae, a Narrative Review |
| title_full | Diabetic Foot: The Role of Fasciae, a Narrative Review |
| title_fullStr | Diabetic Foot: The Role of Fasciae, a Narrative Review |
| title_full_unstemmed | Diabetic Foot: The Role of Fasciae, a Narrative Review |
| title_short | Diabetic Foot: The Role of Fasciae, a Narrative Review |
| title_sort | diabetic foot the role of fasciae a narrative review |
| topic | wounds fascia diabetes superficial fascia stiffness collagen |
| url | https://www.mdpi.com/2079-7737/10/8/759 |
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