Abstract: BACKGROUND: Exosomes derived from mesenchymal stem cells play an important role in regulating apoptosis, promoting cell regeneration, and improving the wound microenvironment, making them a hot research topic in the treatment of diabetic foot ulcers.
OBJECTIVE: To explore the clinical application value of exosomes derived from human umbilical cord mesenchymal stem cells in the repair of diabetic foot ulcers.
METHODS: A retrospective analysis was conducted on the data from 72 patients with diabetic foot ulcers treated between May 2022 and April 2025. Thirty-six patients received treatment with exosomes derived from human umbilical cord mesenchymal stem cells (observation group), and 36 patients were managed with vacuum-assisted closure therapy (control group). Ulcer healing rate, incidence of adverse events, serum inflammatory markers, growth factor levels, total wound healing time, and ulcer recurrence rate during follow-up were compared between the two groups after 2 weeks of treatment.
RESULTS AND CONCLUSION: (1) After 2 weeks of treatment, the ulcer healing rate in the observation group (48.03±6.12)% was significantly higher than that in the control group (30.13±6.38)%, with a statistically significant difference (P < 0.05). (2) All patients in both groups achieved ulcer healing. The healing time was significantly shorter in the observation group than in the control group (30.42±2.30 versus 43.94±3.46 days), with a statistically significant difference (P < 0.05). (3) The incidence of adverse events during treatment was 13.89% in the control group and 19.44% in the observation group, with no significant difference (P > 0.05). (4) Serum interleukin-6, C-reactive protein, and procalcitonin levels decreased significantly in both groups, with greater reductions in the observation group, with a statistically significant difference (P < 0.01). Serum vascular endothelial growth factor, basic fibroblast growth factor, and platelet-derived growth factor levels increased significantly in both groups, with greater increases in the observation group, with a statistically significant difference (P < 0.01). (5) Following ulcer healing, the mean follow-up durations were 9.4 months in the observation group and 9.8 months in the control group; ulcer recurrence occurred in 5 and 10 patients, respectively, with a significantly lower recurrence rate in the observation group than in the control group (13.9% versus 27.8%), with a statistically significant difference (P < 0.05). These findings indicate that compared with the use of closed negative pressure drainage, the application of exosomes derived from mesenchymal stem cells for treating diabetic foot ulcers effectively suppresses inflammation, promotes ulcers healing, reduces recurrence rates, and does not increase the risk of related adverse events. This approach exhibits both clinical efficacy and safety.

Key words: diabetic foot ulcers, human umbilical cord mesenchymal stem cells, exosomes, vacuum sealing drainage, ulcer healing rate, serum interleukin-6, vascular endothelial growth factor, platelet-derived growth factor