title: Platelet-rich plasma, bilayered acellular matrix grafting and negative pressure wound therapy in diabetic foot infection.
abstract: Management and treatment of acute severe diabetic foot disease in patients with suboptimal glycaemic control is a critical issue in wound repair. This paper discusses the clinical efficacy of an aggressive surgical intervention combined with targeted use of regenerative medical therapies in limb preservation. Negative pressure wound therapy (NPWT), platelet-rich plasma (PRP), bilayered acellular matrix grafting and split-thickness skin grafting were combined to treat a patient with diabetes, foot necrotising fasciitis and gaseous gangrene. The wound was completely healed. The clinical outcome revealed that a multi-intervention strategy could be effective for large necrotising fasciitis wounds. Early clinical observation, suggests aggresive surgical intervention preserving intact tissue and targeted use of new regenerative technologies can lead to preservation of a limb.
  
  
  BACKGROUND
  The authors have received no financial support for the material presented in this study outside of the scope of standard patient care reimbursement. This work was supported by the National Natural Science Foundation of China (NO. 81500596) awarded to Dr Wuquan Deng.
authors.affiliation: Department of Endocrinology, Diabetic Foot Center, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: W
authors.initials: W
authors.lastname: Deng
authors.affiliation: Department of Podiatry, Singapore General Hospital, Singapore.
authors.forename: J
authors.initials: J
authors.lastname: Boey
authors.affiliation: Department of Endocrinology, Diabetic Foot Center, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: B
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Surgery, Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona Health Sciences Center, Tucson, Arizona, USA.
authors.forename: S
authors.initials: S
authors.lastname: Byun
authors.affiliation: Department of Surgery, Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona Health Sciences Center, Tucson, Arizona, USA.
authors.forename: E
authors.initials: E
authors.lastname: Lew
authors.affiliation: Department of Endocrinology, Diabetic Foot Center, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Liang
authors.affiliation: Department of Surgery, Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona Health Sciences Center, Tucson, Arizona, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Armstrong
mesh_terms: D062088:Acellular Dermis; D000328:Adult; D002681:China; D017719:Diabetic Foot / Q000628:therapy*; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy; D053657:Platelet-Rich Plasma; D016038:Skin Transplantation; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
keywords: bilayered acellular matrix grafting; diabetic foot; negative pressure wound therapy; platelet-rich plasma; wound healing