More than 150 million people worldwide suffer from diabetes, and every patient with diabetes is at risk of developing a diabetic foot ulcer (DFU). More than 15% will develop such ulcers. There are different treatments used to manage DFUs that included the cautious observation, debridement of necrotic tissue, infection control, and reduction of pressure on the diabetic foot. If treatments fall short at critical times, these nonhealing, chronic wounds may lead to foot amputations.
Recent studies have explored more effective wound dressings and tissue engineering techniques. Acellular dermal matrix (ADM) is a cutaneous derivative incorporating collagens, elastin, glycosaminoglycans, and hyaluronic acids as structural elements. Clinical studies have already documented the safety and efficacy of ADM in chronic wound healing. In this study, the authors evaluated the safety and efficacy of ADM paste in treating patients with DFUs.
The authors comprehensively reviewed data from 86 consecutive patients who were potential study candidates. Patients afflicted with chronic DFUs characterized as Wagner grade 2 or 3 of at least 4 weeks’ duration were included in the study. All patients had been diagnosed with type 1 or type 2 diabetes mellitus. Doppler arterial waveforms provided adjunctive evidence, marked by triphasic or biphasic patterns at the ankle level of the extremity with the DFU
Patients with Wagner grade 2 or 3 DFUs (N = 49) received either ADM paste (treatment group; n = 23) or conventional foam dressing (control group; n = 26).
All DFUs were analyzed with regard to ulcer area, depth, progression, healing rate, and duration to complete healing. The ADM paste effectively enhanced tissue regeneration, shortening ulcer duration and preventing associated complications, while eliminating the need for supplemental ulcer management procedures.
Biologic dressings have shown promise in the setting of DFUs. In a randomized clinical trial, a single application of ADM brought improvement, reducing the area and depth of the ulcers. Ulcer healing also progressed faster by applying ADM in sheets (vs. conventional dressings)
The results of this study demonstrate the healing effects of ADM paste in Wagner grade 2 or 3 DFUs. This paste readily conforms to geometric and tunneling ulcers, and the initial acceleration of healing documented within 30 days
Authors: Myungchul Lee and coll.
Newspaper: Wounds 2020;32(2):50–56. Epub 2019 December 9
Source: https://www.hmpgloballearningnetwork.com/site/wounds/case-series/clinical-efficacy-acellular-dermal-matrix-paste-treating-diabetic-foot