Bioengineered alternative tissues in diabetic wound healing.

New advances in medicine and technology continually change how clinicians treat patients with the aim of improving outcomes. As technology continues to improve, the ability to treat patients will improve as well. Great progress has been made in diabetic wound healing with BATs and there will continue to be improvement with new products in the future. However, the current literature is replete with small case series and small cohort studies. With the exception of the pivotal trials conducted more than a decade ago, there is a lack of robust evidence for the use of BATs. More advanced BATs, including the use of MSCs, show promise but have yet to be studied in a rigid manner. It is important to apply fundamental principles of DFU care, including maximizing perfusion, off-loading, and debridement, before using of these more advanced therapies.