SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1627558
This article is part of the Research TopicInnovative Therapeutic Strategies for Managing Diabetic Foot Ulcers and Mitigating Associated ComplicationsView all 16 articles
Effectiveness of hyaluronic acid and its derivatives on diabetic foot ulcer: a systematic review and meta-analysis
Provisionally accepted
- 1The Affiliated Hospital (GROUP) of Putian University, putian, China
- 2Jinjiang Municipal Hospital, Jinjiang, China
- 3Shanghai Jiao Tong University, Shanghai, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background：In this study, we aim to evaluate the effects of hyaluronic acid and its derivatives on wound healing in diabetic foot ulcer.Methods: The electronic databases included PubMed, BIOSIS, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar internet. The final search was updated on Aug 31, 2024. We assessed eligible studies that comparing the effects of hyaluronic acid and its derivatives with other dressings on wound healing in diabetic foot ulcer. The primary outcomes included the rate of ulcers completely healed, time to healing and adverse event. The standard mean differences (SMDs) or the odds ratios (ORs) were calculated for continuous or dichotomous data, respectively. Data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software.We assessed each included study with the Cochrane 'Risk of bias' tool.Seven RCTs involving 444 patients and 456 ulcers were included in our study.Hyaluronic acid may improve the complete ulcer healing rate (OR 3.92, 95% CI 1.74 to 8.81, P = 0.02, I 2 = 62%) and shorten the time to ulcer healing (SMD = -0.83, 95% CI -1.13 to -0.53, P = 0.24, I 2 =28%), with no increasing the incidence of adverse events (OR = 0.79, 95% CI 0.46 to 1.35, P = 0.31, I 2 = 16%).In conclusion, HA and its derivatives could be a potentially beneficial therapy for DFU treatment that promotes the complete ulcer healing rate, shortens healing time, without increasing incidence of adverse events.
Keywords: Diabetic Foot, Hyaluronic Acid, Wound Healing, Meta-analysis, chronic wound
Received: 13 May 2025; Accepted: 12 Sep 2025.
Copyright: © 2025 Yao, Xie, Dai and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiezhi Dai, daijiezhi@aliyun.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.