Meta-Analysis of Herbal Hydrogel Therapeutics for Diabetic Foot Ulcers

Abstract

Diabetic foot ulcers (DFUs) are complex chronic wounds frequently complicating diabetes, posing risks of infection and amputation. Conventional dressings often fail to adequately support healing due to their limited therapeutic functions. Herbal hydrogels have emerged as advanced wound dressings, combining natural bioactive compounds like curcumin, Centella asiatica, Aloe vera, and honey within biocompatible polymer matrices. These hydrogels offer multiple benefits: they maintain a moist wound environment, provide controlled and sustained release of antioxidant, anti-inflammatory, antimicrobial, and pro-angiogenic agents, and support tissue regeneration processes critical for DFU healing.

This meta-analysis of 8 studies with 449 participants demonstrated that herbal hydrogel treatment significantly increases the likelihood of complete wound healing by 70% compared to conventional care. Healing time was reduced by about seven days, wound size contracted more efficiently, and infection rates decreased, all with an excellent safety profile and minimal adverse events. Mechanistically, these hydrogels mitigate oxidative stress, suppress chronic inflammation, stimulate new blood vessel formation, and promote extracellular matrix remodelling, addressing the multifactorial pathophysiology of diabetic wounds.

While most data came from animal models with fewer clinical trials, translational evidence supports these benefits in humans. Future directions include large, multicenter clinical trials to establish optimal herbal formulations, dosing regimens, and personalized treatment protocols. Herbal hydrogels hold promise as effective, affordable, and accessible interventions to improve DFU outcomes, reduce healthcare costs, and lower morbidity globally.