Ferroptosis in infected diabetic wounds and targeted therapeutic strategies: A narrative review

Abstract

Infected diabetic wounds represent one of the most severe complications of diabetes mellitus, with complex pathological mechanisms that present significant challenges in clinical management. Ferroptosis, an emerging form of iron-dependent programmed cell death driven by excessive lipid peroxidation, plays a critical role in the progression of infected diabetic wounds. This review systematically examines the central mechanisms of ferroptosis in infected diabetic wounds from three key perspectives: dysregulation of iron metabolism, accumulation of lipid peroxidation products, and impairment of the antioxidant defense system. Moreover, it analyzes the impact of ferroptosis on various cell types—fibroblasts, macrophages, vascular endothelial cells, and keratinocytes—during the impaired healing process. Based on these mechanistic insights, the review summarizes recent advances in ferroptosis-targeted therapeutic strategies for wound repair, including ferroptosis inhibitors, cell-based therapies, and innovative hydrogel materials with promising application potential. By integrating current knowledge on the role of ferroptosis in infected diabetic wounds and associated treatment approaches, this article aims to provide new perspectives and a solid theoretical foundation for future research and the comprehensive management of this challenging condition.

Keywords

Ferroptosis / Infected diabetic wounds / Iron metabolism / Lipid peroxidation / Antioxidant defense

Conflict of interest statement

The authors report no conflict of interest.

Funding

This research was supported by the Academician Innovation Platform of Hainan Province, National Natural Science Foundation of China (82560446), Natural Science Foundation of Hainan Province (822MS174), (822RC692) and the Science and Technology Special Fund of Hainan Province (ZDYF2025SHFZ049).

Data availability statement

The data supporting the findings of this study are available from the corresponding authors upon request.

Authors’ contributions

AJG and HBD were responsible for formulating the research plan, conducting literature search and screening, and writing the first draft of the paper. JM and YYB assisted with literature search and data extraction. MTJ and XC assisted with quality assessment of included studies and figure preparation. DXW assisted in the revision of the paper and manuscript editing. SWC participated in data interpretation and paper revision. DYZ conceived and supervised the project and approved the final version of the paper. All authors have read and approved the final version of the paper.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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