# Complementary Therapies for Diabetic Foot Ulcer Healing Among Patients in Asia: Scoping Review

## TL;DR

This review explores complementary therapies for diabetic foot ulcers in Asia, highlighting their potential and challenges in integration with conventional care.

## Contribution

The study maps complementary therapies for DFUs in Asia and evaluates their effectiveness and integration challenges.

## Key findings

- Herbal treatments and biological therapies showed promise in reducing wound size and inflammation.
- Music therapy reduced diabetes-related distress among patients.
- Implementation challenges include limited large-scale trials and cultural barriers.

## Abstract

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

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

A scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews) framework and the methodology of Arksey and O’Malley. Articles were sourced from the PubMed, Scopus, and ProQuest databases, covering studies published from 2014 to 2024. The population, concept, and context model guided the selection of studies, focusing on patients with DFUs, complementary therapies, and the Asian region.

Eight studies met the inclusion criteria. The most commonly used therapies included herbal treatments (eg, traditional Chinese medicinal foot soaks and Teucrium polium), biological therapies, including maggot debridement therapy and platelet-rich fibrin with hyaluronic acid), physical therapy (acupuncture), and psychological therapies (music therapy). Topical T polium significantly reduced wound size, and platelet-rich fibrin combined with hyaluronic acid increased vascular endothelial growth factor levels while reducing inflammation. Music therapy lowered the diabetes-related distress score. Despite these promising results, challenges remain, including a limited number of large-scale randomized controlled trials, regulatory barriers, and cultural perceptions affecting therapy acceptance.

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