Abstract / Summary
Diabetic wounds (DWs) pose a life-threatening global health problem because they are associated with impaired angiogenesis, chronic inflammation, oxidative stress, and defective tissue regeneration. These nonhealing chronic ulcers, which affect approximately 15-25% of diabetic patients during their lifetime, significantly increase the risk of infection and amputation. This review highlights the role of major phytochemical classes, including flavonoids (e.g., quercetin, apigenin), terpenoids, and alkaloids, in balancing redox homeostasis and enhancing vascularization. These are observed through the modulation of key signalling pathways, such as nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), vascular endothelial growth factor (VEGF), and transforming growth factor beta (TGF-β). This systematic review was conducted for evidence-based synthesis and critical analysis of plant-based interventions for DW management. Although strong preclinical evidence has indicated that these botanicals promote the proliferation and collagen deposition of fibroblasts, this study indicates that there is a major translational gap between laboratory results and standard clinical validation.