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Originally published April 13, 2026
Last updated April 14, 2026
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Diabetic foot ulcers can be as life-threatening as cancer, but they鈥檙e not often talked about with the same urgency.
鈥淎bout 30% of people with serious foot ulcers will die within five years. For those who have had an amputation, that percentage increases to 60%-80%. This is worse than all but the most aggressive cancers,鈥� says David G. Armstrong, DPM, a podiatric surgeon with 喵咪社区 Surgery, part of 喵咪社区, and an internationally recognized leader in the field of diabetic foot ulcers, limb preservation, tissue repair and wound healing.
But innovative treatments are on the way. Below, Armstrong discusses recent developments in foot ulcer care that could help improve patient care and prevent amputations.聽
When it comes to managing diabetic foot ulcers, the first step in improving treatment is improving classification of the problem. 鈥淵ou can鈥檛 manage what you can鈥檛 measure,鈥� Armstrong says. One of the most important breakthroughs in treatments for foot ulcers has been the , which stands for Wound, Ischemia and foot Infection. Defining the type of wound precisely makes defining treatment plans easier and allows for more standardized care, Armstrong says.
Versions of gene therapy, used to stimulate tissue regeneration, have been used in the past to treat gangrene and end-stage disease, but the benefit of this was limited since it鈥檚 difficult 鈥� or impossible 鈥� to bring back 鈥渄ead鈥� tissues, Armstrong explains. But has shown some promising results for HGF gene therapy in patients with foot ulcers and peripheral artery disease.
The idea behind the study is that HGF 鈥� when inserted into wounds with mild to moderate vascular disease, rather than completely dead tissue like gangrene 鈥� would help promote angiogenesis (new blood vessel growth) and reduce inflammation, thereby aiding wound healing. In the , results showed faster healing and higher healing rates compared to placebo.
鈥淭his step back broadens the indication for this therapy and appears to show a real positive signal,鈥� says Armstrong, lead author of the study. 鈥淭hings like this are what make medicine, and scientific research, so exciting: when you鈥檙e able to use things that aren鈥檛 working as well as you鈥檇 hoped in one area, but take a step back and look at it with fresh eyes to see how it might be used to solve a different problem.鈥�
Researchers estimate that this kind of therapy could become available to people sooner rather than later because of its long existing history of safety, Armstrong says. Additionally, due to the initial successful results, the FDA has 鈥渇ast-tracked鈥� the study, meaning it will expedite the review to bring this therapy to clinics as fast as possible.
Wearable technologies are an exciting new development in the field of wound healing, Armstrong notes. For example, and insole system that monitors pressure and activity after wound healing is designed to detect early warning signs before skin breakdown occurs.
New technologies are being developed to 鈥渞eset鈥� chronic wounds so that they behave more like acute wounds, Armstrong says.
鈥淎 chronic wound is like a slow-running computer,鈥� Armstrong explains. 鈥淛ust as you would reboot a computer, we want to surgically reset the wound so that all the biological processes that are happening in the background can get set back to normal, and hopefully the wound will respond like an acute wound rather than an old, chronic wound.鈥�
Energy-based, ultrasound-based and plasma-based debridement tools are aiding in this process.
Chronic wounds are also like cancer in that they have a high prevalence of reoccurring, Armstrong says. The idea behind treating wounds and foot ulcers is to keep the possibility of recurrence top of mind: 鈥淛ust as with cancer, our patients are in remission,鈥� Armstrong says.
鈥淚f both the care team and the patient understand that it鈥檚 a certainty that someone鈥檚 going to get another wound in their long life, then that changes the way you treat someone,鈥� Armstrong says. 鈥淭hen the goal is not to get rid of a wound once, but to make that wound as uncommon and uncomplicated as possible.鈥�
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