title: Using hyaluronic acid derivatives and cultured autologous fibroblasts and keratinocytes in a lower limb wound in a patient with diabetes: a case report.
abstract: Patients with diabetes have an impaired wound healing process that contributes to the pathophysiology that may lead to amputation. In this case study, an extensive (103.49 cm2) full-thickness cutaneous wound with exposure of a necrotic Achilles' tendon in a patient with diabetes, neuropathy, and infrapopliteal vascular disease of the lower limbs was healed using a two-stage autologous skin substitute technique. The scaffolds on which the autologous fibroblasts and keratinocytes were grown comprised an ester derivative of hyaluronic acid. Two applications of the cultured autologous fibroblasts and one of the cultured autologous keratinocytes were placed on the wound at 7-day intervals. The ulcer healed completely 60 days following the first fibroblast graft application. After 16 months of follow-up, no recurrence was noted and the patient can walk without ancillary support. This novel tissue engineering technique is a promising treatment for wound healing.
authors.affiliation: Diabetic Foot Unit, Department of Endocrinology and Metabolism, Villa Berica Hospital, Vicenza, Italy. ldallapaola@libero.it
authors.forename: Luca
authors.initials: L
authors.lastname: Dalla Paola
authors.forename: Alberto
authors.initials: A
authors.lastname: Cogo
authors.forename: Walter
authors.initials: W
authors.lastname: Deanesi
authors.forename: Cristina
authors.initials: C
authors.lastname: Stocchiero
authors.forename: Valerie Carmela
authors.initials: VC
authors.lastname: Colletta
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000368:Aged; D002478:Cells, Cultured; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005347:Fibroblasts; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use*; D015603:Keratinocytes; D008297:Male; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid