Search Results (889)

Background: Diabetes mellitus (DM) is a metabolic disease with an increasing global prevalence. It is characterized by chronic and systemic complications. Due to these complications, DM significantly impacts patients’ health-related quality of life (HRQoL). One of the most critical complications of DM is diabetic foot ulcers (DFUs), which have serious consequences for patients and healthcare systems. Objective: This study aimed to investigate variables potentially associated with HRQoL in patients with DFUs presenting to our wound care unit. Methods: This prospective cross-sectional study was conducted from February to May of 2023 at the Wound Care Unit of the General Surgery Department at Eskişehir City Hospital. A total of 209 patients who agreed to participate were included in the study. Data were collected via a structured questionnaire developed based on the literature, which included the Diabetic Foot Ulcer Scale–Short Form (DFS-SF). We used the Kolmogorov–Smirnov test, univariate analyses (Mann–Whitney U and Kruskal–Wallis tests), and multiple linear regression. Results: In the multivariate analysis, receipt of foot care education (p < 0.001), frequency of hospital applications due to DFU (p = 0.008), and Wagner classification (p = 0.012) were found to be predictors of HRQoL for DFUs (Adjusted R² = 0.206, F = 4.365, p < 0.001). Conclusions: To maintain a high HRQoL among DFU patients, they should immediately apply to specialized Wound Care Units, receive education, especially regarding early diagnosis and treatment, and receive multidisciplinary management for DFU. Full article

Diabetic foot ulcers (DFUs) are among the most severe complications affecting diabetic patients, and dressing therapy is one of the standard treatments for DFUs. However, traditional dressings are inadequate for addressing the complex microenvironment of DFUs. Consequently, advanced natural polymer-based dressings have attracted extensive research attention in diabetic foot care due to their biocompatibility, low immunogenicity, and biodegradability. These natural polymer materials include collagen, gelatin, chitosan (CS), hyaluronic acid (HA), alginate, and cellulose. This review systematically analyzes the pathophysiological mechanisms underlying the difficult healing of DFUs and the advantages of natural polymer-based dressings in diabetic wound healing, highlights preclinical studies, and synthesizes evidence from clinical research. Moreover, we pinpoint the challenges associated with these dressings and propose future directions for the improvement of diabetic wound care. Full article

Background: The management of diabetic foot disease and knee osteoarthritis (OA) with smart orthotics holds significant importance during the early stages of these conditions, given their potential consequences, including functional impairment, chronic pain, and economic burden. Real-time monitoring of plantar foot pressure enables early detection of abnormal force distribution and gait biomechanics, allowing for the redirection of forces away from affected ulcers or arthritic joints. This is the first systematic review to synthesise clinical evidence for smart orthotics technology with real-time plantar pressure sensor biofeedback across both diabetic foot ulcer prevention and knee osteoarthritis management simultaneously. A search of the PROSPERO register confirmed no existing registration covers this specific combination. Objectives: To examine the clinical evidence for the use of standard and smart orthotics in the prevention and management of diabetic foot ulcers (DFUs) and knee OA, and to evaluate their impact on plantar pressure redistribution, ulcer recurrence, pain, biomechanics, and economic burden. Eligibility criteria: Studies published in English involving human adult participants (≥18 years) with a clinical diagnosis of diabetes mellitus (at risk of DFU or with peripheral neuropathy) or knee OA, where the intervention involved any orthotic device or smart/intelligent insole with clinical outcomes reported, were included. Studies on healthy individuals only, those not reporting participant age, and non-weight-bearing protocols not differentiated from weight-bearing were excluded. Information sources: Five databases were searched: CINAHL (EBSCO Information Services, Ipswich, MA, USA), PubMed Advanced (National Library of Medicine, Bethesda, MD, USA), Wiley Online Library (John Wiley & Sons, Hoboken, NJ, USA), Cochrane Library (Cochrane Collaboration, London, UK), and Google Scholar (Google LLC, Mountain View, CA, USA). Searches were completed in May 2026. Methods: We conducted a comprehensive literature review. This review was structured and reported with reference to the PRISMA 2020 statement (Preferred Reporting Items for Systematic Reviews and Meta-Analysis; University of Ottawa, Ottawa, ON, Canada) to guide transparency of reporting. It does not constitute a full Cochrane-style systematic review; risk of bias assessment was applied to key included studies and GRADE (Grading of Recommendations Assessment, Development and Evaluation; McMaster University, Hamilton, ON, Canada) certainty ratings were applied informally and narratively rather than as formal per-outcome evidence profiles. Five databases were searched yielding 92,637 records. After removal of 398 duplicates by Rayyan, 92,239 records remained. A subsequent automated keyword-based relevance filter applied within Rayyan (Rayyan AI, Doha, Qatar), prior to human screening, excluded 84,572 records that did not contain any terms related to orthotics, diabetic foot, or knee osteoarthritis, yielding 7667 records for human title/abstract screening. A narrative synthesis approach was adopted owing to the heterogeneity of study designs and outcome measures across included studies, which precluded meta-analysis. This review was not prospectively registered. A complete list of all 78 included studies, including those not individually discussed in the results and discussion. Results: The available clinical studies report promising findings for orthotics and smart orthotics in pain reduction, ulcer prevention, and potential reduction in economic burden, though conclusions are limited by small sample sizes, heterogeneity, and predominantly open-label designs. Recent research found that orthotics can be used to alter the gait pattern that influences knee OA by reducing excessive force on the affected joint. A randomised controlled trial demonstrated an 80% relative risk reduction in DFU recurrence (RR = 0.20; 95% CI: 0.06–0.79; p = 0.022), with absolute event rates of 6.3% in the intervention group versus 30.8% in controls (ARR = 24.5%); a second trial reported a 71% reduction in ulcer incidence over 18 months; and a third randomised controlled trial demonstrated statistically significant plantar pressure reduction (p < 0.01) in patients with diabetic neuropathy. Conclusions: The available evidence suggests that orthotics may be associated with improved pressure redistribution, reduced ulcer incidence, and benefit in the management of knee OA. Although the number of studies directly comparing smart orthotics with standard orthotics remains limited, the limited comparative studies suggested that smart orthotics showed promising results in reducing ulcer incidence, providing the patient with real-time feedback to offload via their electronic devices. These findings, while preliminary, highlight the potential of smart orthotic technology as an adjunct to standard orthotic care in reducing the overall burden of diabetic foot disease and knee osteoarthritis. Limitations: The primary methodological limitation of this review is the open-label design of all included smart orthotic trials, which precludes participant blinding and introduces performance bias. However, this limitation is structural and inherent to the wearable technology field—analogous to surgical trials—and is substantially mitigated by the use of objective primary outcome measures (plantar pressure and ulcer recurrence) across the three included RCTs, the consistency of effect direction across independent RCTs conducted in different countries, and a narrative sensitivity analysis confirming robustness of findings (Risk of Bias Across Studies Section). Formal per-outcome GRADE evidence profiles were not produced; overall certainty of evidence was assessed narratively with reference to GRADE domains and is judged to be low to moderate for smart orthotics in DFU prevention and low for knee OA management, consistent with the Level 2–3 evidence base and open-label study designs. Future adequately powered, multi-site RCTs with standardised outcome reporting, minimum 24-month follow-up, and integrated health economic modelling are the highest priority to extend these preliminary findings. Registration: This review was not prospectively registered. Full article

Background/Objectives: Foot and ankle presentations during Hajj occur in a dense mass-gathering environment where prolonged walking, heat exposure, crowding, variable footwear, and limited self-care can interact with chronic disease and wound vulnerability. Previous Hajj studies have described foot injuries and diabetes-related complications, but less is known about whether simple high-risk foot documentation flags identify presentation records with higher care-pathway intensity. The primary objective was to estimate the presentation-level burden of core high-risk foot profiles among pilgrims presenting with foot and ankle conditions during Hajj 2025. Secondary objectives were to evaluate associations with a surgery-coded care-intensity indicator, hospital referral, and component heterogeneity. Methods: This observational presentation-level analysis included 3957 foot and ankle presentation records. The unit of analysis was the presentation/case record, not a unique individual pilgrim. A core high-risk foot profile was defined as diabetes, neuropathy, diabetic foot ulcer, foot ulcer, complications of open wound, or osteomyelitis. The primary outcome was a surgery-coded care-intensity indicator, defined solely from treatment documentation containing “Surgery” and interpreted as a care-pathway proxy rather than confirmed operating-room surgery. Logistic regression estimated crude and adjusted odds ratios (ORs); exploratory risk-category analyses assessed heterogeneity within the composite profile. Results: Core high-risk foot profiles were identified in 1793/3957 presentations (45.3%). The primary outcome occurred in 239/1793 high-risk presentations (13.3%) and 201/2164 non-high-risk presentations (9.3%), an absolute difference of 4.0 percentage points. The crude OR was 1.50 (95% CI 1.23–1.83; p < 0.001). The association persisted in the primary adjusted model (adjusted OR 1.47; 95% CI 1.20–1.79; p < 0.001) and in the extended clinical sensitivity model (adjusted OR 1.47; 95% CI 1.20–1.80; p < 0.001). Care pathways and secondary outcomes are summarized was also more frequent in high-risk presentations (12.2% vs. 9.8%; crude OR 1.28; 95% CI 1.05–1.57; p = 0.017). Exploratory category analysis showed that chronic-risk-only presentations had a primary outcome rate similar to non-high-risk presentations (9.0% vs. 9.3%), whereas ulcer/wound/deep-infection presentations had a higher rate (17.3%; crude OR 2.04; 95% CI 1.63–2.55; p < 0.001). Model discrimination was modest (C-statistics 0.55–0.64). Conclusions: Core high-risk foot flags were common among Hajj foot and ankle presentation records and were associated with surgery-coded care-intensity and referral documentation. However, the composite was clinically heterogeneous, the outcome was not a validated surgery endpoint, and the models were not prediction tools. These findings support cautious use of high-risk foot flags as operational prompts for assessment and pathway planning rather than as standalone clinical risk estimates. Full article

Background/Objectives: Chronic diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) remain a major source of morbidity, healthcare utilization, and limb loss, despite adherence to established standards of care protocols and the widespread availability of advanced wound technologies. Many advanced modalities only target isolated aspects of wound healing and fail to address the complex, interdependent pathophysiology of chronic wounds, particularly tissue hypoxia, edema, impaired microcirculation, and persistent inflammation. Cyclical Pressurized Topical Wound Oxygen (TWO₂) therapy is a home-based, multimodal intervention that combines humidified topical oxygen delivery with cyclical non-contact compression to address these core drivers simultaneously. Methods: This review synthesizes mechanistic rationale and evidence from randomized controlled trials, long-term venous ulcer studies, and real-world comparative effectiveness analyses. Emphasis is placed on the large cohort study by Yellin et al., which directly compared TWO₂ with other advanced modalities including negative pressure wound therapy (NPWT), skin substitutes, and growth factor therapies. Results: Across these studies, TWO₂ therapy is consistently associated with improved healing durability, reduced recurrence, and substantial reductions in hospitalization and amputation rates compared with both standard care and advanced wound therapies. Conclusions: The convergence of randomized and real-world evidence supports TWO₂ therapy as a clinically meaningful and mechanism-driven adjunctive treatment option for patients with chronic, high-risk lower-extremity wounds. Full article

Introduction: Offloading adherence (OA) is critical for diabetic foot ulcer (DFU) healing. This report investigated whether DFU patients with low overall OA (<20%) limit offloading device usage to days they come to the clinic. Methods: Activity monitors measured OA 24 h/day. Daily walking and standing OA were calculated for up to four weeks, and participants self-reported their cumulative adherence. Each day was classified as to whether a DFU-related clinic visit occurred. Results: Four participants from an ongoing RCT were identified with <20% overall adherence, despite self-reporting 65–80% adherence. Most days they did not wear their devices at all, while the majority of wear-days coincided with footcare visits. Conclusions: This report describes a cohort that had low daily OA yet consistently wore their devices to the clinic and self-reported inflated OA. To improve OA and DFU healing, more research is needed to understand this phenomenon and help clinicians ascertain adherence during patient encounters. Full article

Patients with diabetes and/or peripheral artery disease (PAD) are at risk for lower limb amputation and a subsequently higher mortality risk. Peer support interventions have been shown to increase diabetes self-management and glycemic control. This scoping review aims to synthesize the current literature on peer support interventions in reducing lower limb amputations. A PubMed search was conducted in June of 2023, excluding publications prior to 2000, focusing on two themes: (1) peer support and (2) the patient population of interest (i.e., individuals with diabetic foot disease and/or PAD). Studies were included if they addressed the population of interest, involved a peer support intervention to improve lower extremity health, and had outcomes pertaining to the health of the lower extremities or programmatic metrics such as participant satisfaction or program adherence. Out of 1730 publications initially identified, six met the inclusion criteria. These six studies were categorized as group foot care education studies (n = 4) or group cognitive behavioral studies (n = 2). The group foot care education studies showed mixed results, which varied from no effect to significant improvements in foot care, self-management, and complications. There was a trend of improvement in self-management behaviors and physical activity in cognitive behavioral interventions. Despite showing promise in other settings, there have been limited investigations of peer support interventions to improve lower extremity outcomes and avert amputations in persons with diabetes and/or PAD. Further studies are required to conclusively determine the efficacy of peer support interventions to reduce lower extremity amputation rates. Full article

In 1988, plastic surgeon Lee Dellon in Annals of Plastic Surgery hypothesized that there was “A Cause for Optimism in Diabetic Neuropathy”. He noted that entrapment neuropathy is common in diabetic peripheral neuropathy (DPN) and explained that multiple sites of local nerve entrapment can also produce the classically described clinical picture of progressive and irreversible ‘length dependent axonopathy’. This observation has justified for him the use of nerve decompression (ND) surgery for beneficial treatment of DPN pain, diabetic foot ulcer (DFU), ulcer recurrences and their subsequent complications. Subsequent observational and controlled reports have consistently demonstrated post-operative benefit for these problems, but ND has not yet been widely adopted. The lack of an etiologic explanation of the physiology changes which would allow surgery to modify the metabolic disturbances of diabetes has likely been involved in such hesitance. Recent explanations that glycolysis is altered in diabetes through intensified polyol metabolism which produces swollen nerves, local peripheral entrapments and compression neuropathy now provide plausible associations of hyperglycemia with epidermal hypoxia and nutrition deficit. Recognition that nerve enlargements can create secondary fibro-osseous compressions explains the well-known association of diabetes and compression syndromes. Peripheral nerve entrapments damage small c-fibers and produce sympathetic autonomic as well as sensorimotor dysfunction. This explains the diminished skin microcirculation, epidermal hypoxia and nutrition deficit seen in diabetes, DPN, DFU and Charcot neuroarthropathy. Laboratory and clinical evidence has demonstrated that ND in diabetes rejuvenates at least two sympathetically commanded skin microcirculation processes and explains how surgery is producing beneficial results. This article recapitulates the literature which clarifies the processes by which ND surgery can modify painful DPN, DFU occurrence, ulcer healing, DFU recurrence risk, amputations after DFU healing, and bilateral pain relief after unilateral surgery. Full article

Bacterial cellulose (BC) is an emerging biopolymer for skin tissue regeneration; however, its functionalization with natural antimicrobial agents remains limited. This study reports the preclinical evaluation of a BC-based dressing for diabetic wounds. BC membranes were obtained from mango pulp agro-waste by Komagataeibacter xylinus cultivation (6.32 g/L) and functionalized with grapefruit seed oil (GSO) at three v/v ratios (1:100, 1:200 and 1:500). FTIR spectroscopy confirmed GSO incorporation into the BC matrix through physical interactions, with a dose-dependent loading. Antimicrobial activity of the BC/GSO dressings was screened against Staphylococcus aureus, Escherichia coli and Candida albicans by agar diffusion, showing dose-dependent inhibition zones. Following the minimum effective dose principle, the BC/GSO 1:500 (v/v) formulation was selected for comprehensive biocompatibility evaluation (cytotoxicity, mutagenicity, pyrogenicity and sensitization) and for in vivo wound-healing testing in a streptozotocin-induced diabetic Wistar rat model. Cell viability above 70% was achieved from membrane-extract dilution 1:100,000, while mutagenicity, pyrogenicity and sensitization assays confirmed the absence of adverse biological responses. In vivo, BC/GSO 1:500 (v/v) dressings supported wound closure comparable to nitrofurazone, with no clinical signs of infection. Overall, these results position BC/GSO dressings as a sustainable, biocompatible and antimicrobial candidate for early-stage diabetic wound regeneration and demonstrate the technical feasibility of valorizing mango pulp agro-waste into a high-value biomedical biopolymer. Full article

Diabetic foot ulcers represent a severe complication of diabetes mellitus, affecting millions of adults worldwide and often leading to hospitalization and amputation. Diabetic neuropathy increases the risk of plantar injuries, while the lack of continuous monitoring and delayed detection contributes to the progression of these lesions. This study presents a low-cost smart insole system for continuous plantar pressure monitoring and screening of plantar pressure patterns associated with diabetic neuropathy. The system integrates piezoresistive sensors distributed across key regions of the foot, connected to a low-power ESP32 microcontroller for data acquisition. Measurements are transmitted via Bluetooth Low Energy to a mobile application that enables real-time visualization, user management, and storage in a MySQL database for historical data consultation. Data processing employs a convolutional neural network configured to classify plantar pressure patterns between non-diabetic individuals and diabetic patients presenting neuropathic alterations. System validation demonstrated 88% accuracy, 88% recall, and 87% F1-score in classifying plantar pressure patterns. The results confirm that the combination of low-cost hardware and open-source software constitutes a viable and scalable solution for screening biomechanical alterations associated with diabetic foot complications. Full article

Background/Objectives: Reconstruction of defects in the ankle, foot and heel is complex because of the limited availability of local tissue and multiple comorbidities like diabetes mellitus and peripheral vascular disease. Even though free and pedicled flaps are widely used, their comparative effectiveness remains incompletely defined. Methods: This study presents a narrative analysis of 21 studies. From each study, we extracted data related to flap type, characteristics of the patient, indications, and outcomes: flap survival, limb salvage, functional recovery and complications. Results: Free flaps were mainly used for the management of large, complex, infected, or weight-bearing plantar defects and generally showed high rates of survival (~95–97%) with good functional outcomes and limb salvage rates. On the other hand, pedicled flaps and perforator-based flaps were principally used for small-to-medium defects and showed comparable survival rates in selected cohorts (up to ~98–100%), although direct comparison is limited by differences in defect complexity and patient selection. Overall, the functional outcomes appeared comparable across techniques in appropriately selected patients. However, long-term complications, such as ulceration in weight-bearing heel regions, remained frequent (reported rates were up to 39–41% in some free flap series). Sensory recovery and vascular status were key elements of long-term success, often exceeding flap type in predicting outcomes. Conclusions: Both free and pedicled flaps are effective options for reconstructing lower limb defects when appropriately indicated. While pedicled flaps remain preferred for smaller defects and high-risk patients, free flaps are generally better suited for extensive and more complex defects. The outcomes are influenced by several factors: individualized reconstruction strategy, characteristics of the defects, vascular status and patient comorbidities. Full article

Background/Objectives: Ozone therapy has been proposed across multiple clinical conditions based on hormetic, antioxidant, and immunomodulatory effects, but its efficacy and safety remain controversial. We conducted an umbrella review to appraise the effectiveness and safety of ozone therapy using evidence from meta-analyses of randomized controlled trials (RCTs). Methods: We searched MEDLINE, Web of Science, Embase, and the Cochrane Library from inception to 14 February 2025, with an updated search performed on 9 May 2026. Eligible studies were systematic reviews with meta-analyses comparing ozone therapy with non-active controls, including placebo, sham, saline, or standard care. Methodological quality was evaluated with AMSTAR-2 and certainty of evidence with GRADE. Results: Of 1243 records identified, seven meta-analyses representing four clinical indications (chronic periodontitis, COVID-19, diabetic foot ulcers, and impacted mandibular third-molar surgery) were included. In chronic periodontitis, evidence was mixed: one meta-analysis found no significant adjunctive benefit, whereas a more recent meta-analysis reported improvements in probing depth and gingival index, but not in bleeding on probing, plaque index, or clinical attachment level. For COVID-19, ozone therapy reduced PCR positivity at follow-up (RR 0.07; 95% CI 0.01–0.34), although this was considered a clinically non-important surrogate endpoint, and showed no significant benefit for hospital stay, intensive care unit admission, or mortality. For diabetic foot ulcers, ozone therapy was not superior to control treatment for ulcer healing (RR 1.69; 95% CI 0.90–3.17) or reduction in ulcer area. In third-molar surgery, ozone therapy did not reduce swelling or improve mouth opening, but was associated with improved short-term quality of life and reduced analgesic use. Safety outcomes were inconsistently reported, and available data did not allow firm conclusions regarding adverse events. The certainty of evidence was low or very low for all outcomes. Conclusions: Despite mechanistic plausibility, current meta-analytic evidence from RCTs remains inconsistent, methodologically fragile, and largely based on low- or very low-certainty findings. Routine clinical use is not justified pending adequately powered, blinded RCTs with standardized dosing and delivery, patient-centered endpoints, and rigorous safety monitoring. Full article

Diabetic foot ulceration is a severe and common chronic complication of diabetes, accompanied by excessive reactive oxygen species (ROS) accumulation, persistent bacterial infection, prolonged inflammation, and insufficient angiogenesis. Traditional single-function wound dressings fail to simultaneously resolve these pathological barriers, leading to unsatisfactory healing outcomes. In this study, we developed a multifunctional composite hydrogel (E/MGel) by introducing mussel adhesive protein (MAP) into methacrylated hyaluronic acid (mHA) to construct an antibacterial and antioxidant delivery system, which was further loaded with epidermal growth factor (EGF) to promote angiogenesis. The as-prepared E/MGel exhibited a uniform porous structure, favorable rheology, high swelling ratio, and sustained protein release behavior. In vitro results demonstrated that E/MGel exerted potent antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E.coli), high ROS scavenging efficiency, good cytocompatibility, and remarkable pro-angiogenic effect on endothelial cells. In a mouse model of diabetic MRSA-infected full-thickness skin defect, E/MGel significantly accelerated wound closure, reduced bacterial burden, downregulated pro-inflammatory cytokines, promoted collagen deposition, and enhanced neovascularization. Meanwhile, no obvious systemic toxicity was observed. Taken together, this multifunctional hydrogel integrates antibacterial, antioxidant, and pro-angiogenic capacities to break the pathological vicious cycle of diabetic wounds, providing a promising and safe strategy for the clinical treatment of diabetic infected wounds. Full article

Background/Objectives: Effective wound antisepsis and infection control remain central challenges in both acute and chronic wound management. pH-controlled sodium hypochlorite solution (HACCP’ER^®) is a novel agent that optimizes the proportion of bactericidal hypochlorous acid (HOCl) by maintaining pH at 6.0–7.3. The present preliminary study aimed to evaluate its broad-spectrum antimicrobial activity in vitro and clinical outcomes in a retrospective cohort of patients with diverse acute and chronic wounds. Methods: A retrospective observational study was conducted, involving 193 consecutive patients who received HACCP’ER-based wound care between May 2022 and February 2023. Wound categories included pressure ulcers (n = 61), foot ulcers (n = 44), burns (n = 42), acute traumatic wounds (n = 29), and other chronic wounds (n = 17). HACCP’ER was applied at a free available chlorine (FAC) concentration of 50–200 ppm at pH = 6.0–7.3. In vitro antimicrobial suspension testing against ten microbial species was performed at 57 ppm (pH = 5.2, 23 °C) according to Japanese Industrial Standards. Results: HACCP’ER at 57 ppm eliminated Escherichia coli, Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Streptococcus spp., Salmonella spp., and Pseudomonas aeruginosa to below the detection limit (<10 CFU/mL) within 1 min, Candida within 3 min, and black Aspergillus within 5 min. In clinical wound cultures, bacterial burden was reduced in 6 of 10 (60%) patients. The mean patient age was 67.4 years. No adverse events attributable to HACCP’ER were recorded. Progressive wound healing was documented across all wound categories, with representative cases achieving closure at 1–11 months. Conclusions: HACCP’ER demonstrates potent broad-spectrum antimicrobial activity at wound-relevant concentrations and is clinically safe in acute and chronic wound care. Its physiologically aligned mechanism of HOCl generation supports both efficacy and biocompatibility. Prospective randomized controlled trials are warranted to definitively establish clinical efficacy. Full article

Emerging optical technologies may offer new opportunities for the non-invasive assessment of diabetic foot ulcers (DFUs), but the role of artificial intelligence (AI)-assisted autofluorescence-based approaches remains unclear. This scoping review aimed to map and summarise the published evidence on AI-assisted analysis of autofluorescence/fluorescence-based signals for DFU assessment and management. We searched Scopus, Web of Science, Embase, PubMed, CINAHL, Google Scholar, and the SPIE Digital Library, and also considered conference proceedings. We included English-language studies published between 2010 and October 2025. Of 197 records identified through database searching, 22 full-text articles were assessed for eligibility, and 5 studies met the inclusion criteria. Four studies focused on infection-related applications, specifically bacterial burden detection and Gram-type classification, whereas one study investigated tissue oxygenation estimation using a related optical imaging approach. All included studies were published between 2022 and 2025, were conducted in India, and four of the five evaluated the same device family or related variants. Overall, the evidence base was limited, geographically restricted, and technologically narrow. In addition, reporting of participant characteristics and AI methodology was often incomplete, with several studies relying on embedded proprietary or insufficiently described algorithmic components. Taken together, the available literature supports early proof-of-feasibility in restricted and largely device-specific evaluation settings rather than robust evidence of broad clinical validity, implementation readiness, or routine-care utility. Larger, more diverse, and independently validated studies with standardised acquisition procedures and more transparent AI reporting are needed before these approaches can be meaningfully evaluated for routine DFU care. Full article