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

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.