JMIR Publications

ABSTRACT

Background:

Diabetic foot ulcer (DFU) is a severe complication of diabetes mellitus leading to, amputation and mortality. Conventional treatments may be insufficient, leading to an interest in complementary therapies such as herbal medicine, acupuncture, maggot debridement therapy (MDT), and biological therapies. These approaches are widely used in Asia, yet their effectiveness and integration into clinical practice remain underexplored.

Objective:

The scoping review aimed to map the types of complementary therapies used for DFU wound healing in Asia and to evaluate their reported effectiveness, implementation challenges, and opportunities for integration.

Methods:

A scoping review was conducted using the PRISMA-ScR framework and the methodology of Arksey and O'Malley methodology. Articles were sourced from the PubMed, Scopus, and ProQuest databases, covering studies published from 2014 to 2024. The population, concept, and context (PCC) model guided the selection of studies focusing on DFU patients, complementary therapies, and the Asian region. Eleven studies met the inclusion criteria.

Results:

The most commonly used therapies included herbal treatments (e.g., traditional Chinese medicinal foot soaks and Teucrium polium), biological therapies (MDT and platelet-rich fibrin [PRF] with hyaluronic acid [HA]), physical therapies (acupuncture), and psychological therapies (music therapy). Topical Teucrium polium significantly reduced wound size (P = .0001), and PRF combined with HA increased vascular endothelial growth factor (VEGF) levels while reducing inflammation (P = .001). Music therapy lowered the diabetes-related distress scores (P = .001). Despite these promising results, challenges remain, including limited large-scale randomized controlled trials (RCTs), regulatory barriers, and cultural perceptions that affect therapy acceptance.

Conclusions:

Complementary therapies are promising adjuncts for DFU management in Asia, where traditional medical practices are prevalent. Multidisciplinary collaboration between healthcare providers, policymakers, and traditional practitioners is essential for safe and effective integration. Further well-designed RCTs are required to confirm the efficacy and inform evidence-based policies.