Abstract
Diabetic foot ulcer (DFU) remains a serious complication of diabetes, with a significant prevalence of peripheral artery disease (PAD) in affected patients. PAD complicates DFU healing, reducing recovery rates significantly. In other settings, cilostazol, a phosphodiesterase-3 inhibitor, has shown promise in reducing the risk of arterial thrombosis more effectively than aspirin, despite the traditional recommendation of aspirin to mitigate the heightened cardiovascular risk associated with diabetes. This study retrospectively compared the effects of cilostazol and aspirin on wound healing and PAD symptoms in patients with DFU. We evaluated 60 patients with DFU and PAD treated with either cilostazol or aspirin retrospectively for wound healing progression, clinical improvement, and alleviation of PAD symptoms. As 10 patients' data were incomplete, it included 50 patients from two cohorts. There were 30 patients in the cilostazol cohort and 20 in the aspirin cohort. We assessed the wound using Wagner's classification and planimetric techniques and classified the PAD stages using the Fontaine classification. Results indicated that cilostazol treatment led to a significantly higher rate of complete wound healing (90%) compared to aspirin (55%) and a faster healing timeline. Cilostazol also demonstrated a more effective improvement in PAD symptoms, facilitating a better quality of life for patients. These findings suggest that cilostazol may offer a more effective treatment option for promoting wound healing and managing PAD in DFU patients than aspirin. We recommend further randomized and controlled studies to validate these results and refine DFU treatment protocols. Protocols that incorporate cilostazol could lead to significant advancements in patient care, ultimately reducing the burden of diabetic foot ulcers. As healthcare providers seek more effective therapies, understanding the mechanisms behind cilostazol's efficacy will be crucial for optimizing treatment strategies.