Therapeutic Potential of Hyaluronic Acid in Diabetic Foot Ulcer Healing:

Abstract

Diabetic foot ulcers are one of the most difficult chronic complications to treat in patients with diabetes mellitus, with a high risk of amputation and long-term morbidity. Wound healing in diabetic patients is often hampered by poor vascular conditions, chronic inflammation, and impaired tissue regeneration. In recent years, hyaluronic acid (HA) has been increasingly studied for its potential to accelerate wound healing, especially through its role in tissue hydration, cell proliferation, regulation of inflammation, and stimulation of angiogenesis. The purpose of this study was to systematically analyze the publication trends and scientific findings regarding the effect of hyaluronic acid on accelerating diabetic foot healing during the period 2020 to 2024. This study used the Systematic Literature Review (SLR) method with a combination of analysis tools such as Publish or Perish for bibliometric data collection, NVivo for thematic classification, and VOSviewer for visual mapping of relationships between keywords. The keywords used in the literature search included “hyaluronic acid” OR “HA” AND (“diabetic foot ulcer” OR “diabetic foot” OR “DFU”) AND (healing OR regeneration OR “wound healing”) with the exception of cosmetic, dermatological, aesthetic, and ophthalmological topics. The results showed that HA has been shown to significantly accelerate the healing process of diabetic foot wounds, especially when combined with biomaterials or stem cells, and when used in the form of smart hydrogels that are adaptive to the wound environment. The majority of publications came from China and Indonesia, with research focusing on the regenerative and anti-inflammatory aspects of HA. This study confirms the strategic position of HA as a modern therapeutic agent in the management of diabetic foot wounds and opens up exploration space for more innovative and precise advanced formulations.