Dermagraft, a bioengineered human dermal equivalent for the treatment of chronic nonhealing diabetic foot ulcer.
Chronic nonhealing diabetic foot ulcers are a common medical problem that may precede severe complications such as infection, sepsis and limb loss. Current standard methods of treatment are aimed at removing necrotic debris, controlling infection, and relieving chronic pressure on the wound. Unfortunately, healing rates are poor with standard treatment, averaging 12-20 weeks in clinical trials. A new strategy for the treatment of diabetic foot ulcers has been developed through tissue engineering, allowing the application of healthy living skin cells to assist in the healing process. It is hoped that the living tissue will release appropriate quantities of growth factors, cytokines and other proteins to stimulate the chronic wound bed and accelerate healing. Dermagraft (Smith & Nephew) is a neonatal-derived bioengineered tissue comprised of dermal fibroblasts. In this article, the structure and behavior of this tissue will be examined, focusing particularly on the randomized clinical trials performed to justify its use in diabetic foot ulcers.
Marston
William A
WA
Division of Vascular Surgery, University of North Carolina School of Medicine, University of North Carolina Wound Management Center, Campus Box 7212, 130 Mason Farm Road, 2146 Bioinformatics building, Chapel Hill, NC 27599-7212, USA. sky@med.unc.edu
D001705:Bioprosthesis; D002908:Chronic Disease; D017719:Diabetic Foot / Q000601:surgery*; D048091:Guided Tissue Regeneration / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D011474:Prosthesis Design; D012008:Recurrence; D017768:Skin, Artificial; D023822:Tissue Engineering / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome