Healing in the Foot Skin of Type 2 Diabetic Subjects

W e agree with Catrina and Brismar(1) that the main stimulus for hy-poxia-inducible factor-1 (HIF-1) is hypoxia. Thus, in view of the normal blood vessel density, one would not expect hypoxia, which would be com-patible with the normal levels of HIF-1 observed in our subjects (2). We also agree that the situation may be different in chronic potentially hypoxic wounds. With regard to our statement in the introduction that vascular endothelial growth factor levels are reduced in the skin of diabetic animals, this should actu-ally read as follows: “in the skin wounds of diabetic animals. ” This is in keeping with the correspondents ’ comments, and in the CONCLUSIONS we state that “the [vascular endothelial growth factor] expression is normally increased during the granula-tion phase of wound healing, and this re-sponse is diminished in diabetic mice” (3). The aim of our study was to quantify the rate of wound healing in acute dia-betic wounds in foot skin of humans and to examine its relationship to skin neuro-vascular function and structure. The most pertinent finding was the normal wound healing rate despite the significant func-tional and structural neurovascular ab-normalities found