Autologous skin fibroblast and keratinocyte grafts in the treatment of chronic foot ulcers in aging type 2 diabetic patients.
BACKGROUND
we assessed the tolerability and efficacy of autologous skin cell grafts in older type 2 diabetic patients with chronic foot ulcers.


METHODS
treatment with Hyalograft 3D and Laserskin Autograft was proposed to a consecutive series of type 2 diabetic patients older than 65 years affected by long-standing (>6 months) foot ulcers with an area greater than 15 cm(2). Ulcer healing rates and measurements of ulcer area were determined monthly for 12 months.


RESULTS
seven patients with 12 ulcers, nine of which received the described treatment, were enrolled. During 12-month follow-up, all of the ulcers healed except one. In the remaining eight ulcers, the median healing time was 21 weeks (interquartile range, 4-29 weeks).


CONCLUSIONS
autologous skin cell grafts are feasible, well tolerated, and apparently effective in the treatment of diabetic ulcers of the lower limbs in advanced age. Age did not seem to moderate healing times.
Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy. mmonami@libero.it
Matteo
M
Monami
Maria
M
Vivarelli
Carla Maria
CM
Desideri
Giulio
G
Ippolito
Niccolò
N
Marchionni
Edoardo
E
Mannucci
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005347:Fibroblasts / Q000637:transplantation*; D016523:Foot Ulcer / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015603:Keratinocytes / Q000637:transplantation*; D008297:Male; D016038:Skin Transplantation; D016896:Treatment Outcome