Human acellular dermal wound matrix for complex diabetic wounds.

OBJECTIVE: Diabetic ulcers are the most common foot injuries leading to lower-extremity amputation and the most common cause of non-traumatic lower extremity amputations in the industrialised world. Approximately 85% of all diabetes-related lower-extremity amputations are preceded by foot ulcers. When foot ulcers develop despite preventive measures, early and appropriate treatment should be initiated to help reduce the burden of diabetes-related amputations. Recent advances now offer these patients a regenerative process of restoring the wound with human integument by replacing damaged or missing tissue with similar tissue rather than scar formation. The aim of this product evaluation was to test the efficacy of regenerative products on complex diabetic wounds.

METHOD: Before wound intervention, the underlying comorbidities of type II diabetes mellitus and osteomyelitis were treated. In the operating room, the wounds received a sterile surgical scrub and were treated with either regenerative tissue matrix sutured over the open wounds or regenerative flowable soft tissue scaffold placed in a plantar tunnelled wound. Negative pressure wound therapy (NPWT) was applied for 10-14 days to create an environment that promotes wound healing, to secure the grafts, and to facilitate adhesion of the matrix to the wound bed.

RESULTS: All wounds, three in two patients, completely epithelialised without any complications at the end of the 17-week follow-up period.

CONCLUSION: With the absence of complications and successful wound epithelialisation in a variety of diabetic wounds, regenerative tissue matrix products have taken the next step forward in wound healing.