FIG. 2.

Wound healing in diabetes. In contrast to normal healing, wound healing in diabetes is uncoordinated and spatiotemporally disorganized. Chronic diabetic wounds do not progress smoothly through inflammation, proliferation, and remodeling; they are instead characterized by an extended inflammation phase, a limited proliferation phase, and irregular remodeling. The critical changes in each phase of healing in diabetes are identified. Healing processes that involve ECM, a critical facilitator of healing because of its role as structural support and a mediator of cellular interactions, are indicated by asterisk (*). IGF-1, insulin-like growth factor-1; IL-6, interleukin-6; MCP-1, macrophage chemoattractant protein-1; MMP, matrix metalloproteinase; PDGF, platelet-derived growth factor; TGF-β1, transforming growth factor-β1; TIMP, tissue inhibitors of metalloproteinase; TNF-α, tumor necrosis factor-α; VEGF, vascular endothelial growth factor. To see this illustration in color, the reader is referred to the web version of this article at www.liebertpub.com/ars