• Human umbilical cord mesenchymal stem cell-derived exosomes significantly improve ulcer healing rate and shorten healing time in diabetic foot ulcers compared to vacuum-assisted closure therapy.
• Exosome treatment markedly reduces serum inflammatory markers (IL-6, CRP, PCT) and increases growth factors (VEGF, bFGF, PDGF), indicating enhanced tissue repair.
• The recurrence rate of diabetic foot ulcers is significantly lower with exosome therapy (13.9%) than with vacuum-assisted closure (27.8%) during follow-up.
• Exosome therapy does not increase the risk of adverse events, supporting its safety and efficacy as a promising 'cell-free' therapeutic approach.