Both venous leg ulcers and diabetic foot ulcers share critical pathophysiological mechanisms including microvascular dysfunction, endothelial damage, and chronic inflammation driven by mechanical stress and vascular abnormalities, suggesting a unified framework targeting these shared pathways could improve healing and prevent recurrence.
Venous leg ulcers and diabetic foot ulcers affect a substantial proportion of the global population, representing major health challenges.
Both VLUs and DFUs share critical pathophysiological mechanisms including microvascular dysfunction, endothelial damage, and chronic inflammation.
A clinical case demonstrated the coexistence of neuropathic and venous leg ulcers in a patient with diabetes, highlighting the need for comprehensive vascular and biomechanical evaluations.
Lifestyle modifications including nocturnal recumbency and increased walking can resolve hard-to-heal venous leg ulcers in patients with severe post-thrombotic syndrome.
A unified framework targeting shared vascular and mechanical pathways across VLUs and DFUs could improve healing, prevent recurrence, and optimize resource allocation.
This research suggests that two common types of chronic wounds — venous leg ulcers (VLUs), which develop due to poor blood flow in the veins, and diabetic foot ulcers (DFUs), which develop as a complication of diabetes — share many of the same underlying biological and physical mechanisms, even though they have traditionally been treated as separate conditions. By reviewing medical literature published between 2010 and 2026, the authors found that both wound types involve damage to small blood vessels, injury to the inner lining of blood vessels, and persistent inflammation, all of which are worsened by physical forces like pressure on the skin and blood vessel walls. The researchers also examined two real patient cases to illustrate their findings. In one case, a person with diabetes had both types of ulcers at the same time, suggesting that assessing patients for multiple overlapping causes of wounds is important. In another case, a patient with a severe vein condition that is typically hard to treat saw their wound heal after making lifestyle changes — specifically sleeping in certain positions and walking more — showing that targeted physical interventions can make a meaningful difference even in difficult situations. This research suggests that developing a single, unified treatment approach that addresses the shared biological and mechanical factors in both types of wounds could lead to better outcomes for patients, reduce the chance of wounds coming back, and make better use of healthcare resources. The authors call for future studies to focus on tailored physical assessments and treatments that target the biological pathways common to both conditions.
Catella J, Vouillarmet J, Sigaudo-Roussel D, Fromy B. (2026). Underlying vascular and mechanical commonalities of venous leg ulcers and diabetic foot ulcers: a unified framework for management.. Journal of wound care. https://doi.org/10.12968/jowc.2026.0331