Wound Fluid Diagnostics in Diabetic Foot Ulcers

Wound fluid seems -at least theoreticallyeasily accessible and might open a new window to the local wound microenvironment that cannot be evaluated by the analysis of serum or plasma markers. Recently, this strategy has been supported by a first time wound fluid proteome analysis comparing acute and chronic wounds (Eming et al. 2010). Interestingly, there seem to be essential differences with respect to wound fluid protein composition when comparing acute and chronic wounds. The wound fluid proteome of healing tissue is characterised by proteins involved in tissue growth and protection from inflammatory activity, whereas non-healing wounds are characterised by a chronic inflammatory environment primarily consisting of leukocyte proteases and inflammatory mediators (Eming et al. 2010). This is particularly striking since the non-healing state in diabetic foot ulcers has previously been linked to persistent inflammatory activity (Acosta et al. 2008). Thus, the wound fluid of chronic wounds seems to be characterised by an altered wound micro-milieu and may, therefore, provide deeper insights into the causes of delayed wound healing.