title: Human Reticular Acellular Dermal Matrix in the Healing of Chronic Diabetic Foot Ulcerations that Failed Standard Conservative Treatment: A Retrospective Crossover Study.
abstract: BACKGROUND
  Acellular matrices have been successfully used to heal indolent diabetic foot ulcers (DFUs). These tissues include allogenic dermis as well as xenograft dermis, pericardium, and small intestine submucosa. While all of these tissues show promise for healing DFUs, dermal-derived matrices have shown considerable potential.
  
  
  METHODS
  The authors retrospectively reviewed healing in patients with DFUs that failed the standard of care (SOC) treatment from a previous prospective randomized, controlled trial (RCT). That trial compared the efficacy of human reticular acellular dermal matrices (HR-ADMs) with the SOC. Of the 16 out of 20 patients who did not heal in the SOC group, 12 were eligible for crossover treatment with the HR-ADM. The authors studied the rate of complete healing in that specific cohort after 12 weeks of crossover treatment.
  
  
  RESULTS
  Of the 12 patients who were eligible for the HR-ADM, 10 (83%) achieved complete wound healing, with a mean healing time of 21 days to closure. The corresponding wound area reduction was from 1.7 cm2 to 0.6 cm2. The mean product cost to closure was $800/patient.
  
  
  CONCLUSIONS
  This study further demonstrates the effectiveness of the HR-ADM in facilitating the closure of nonhealing DFUs refractory to SOC.
authors.affiliation: Professional Education and Research Institute, Roanoke, VA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Zelen
authors.affiliation: Brigham and Women's Hospital, Boston, MA.
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Orgill
authors.affiliation: Serena Group, Cambridge, MA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Serena
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Galiano
authors.affiliation: Strategic Solutions, Inc, Cody, Wyoming.
authors.forename: Marissa J
authors.initials: MJ
authors.lastname: Carter
authors.affiliation: Lower Extremity Institute of Research and Therapy, Youngstown, OH.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: DiDomenico
authors.affiliation: Premier Surgical, Brick, NJ.
authors.forename: Jarrod P
authors.initials: JP
authors.lastname: Kaufman
authors.affiliation: Shenandoah Lower Extremity Research Institute, Troutville, VA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Keller
authors.affiliation: Martinsville Research Institute, Martinsville, VA.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Young
authors.affiliation: Angiogenesis Foundation, Cambridge, MA.
authors.forename: William W
authors.initials: WW
authors.lastname: Li
mesh_terms: D062088:Acellular Dermis; D003094:Collagen / Q000378:metabolism*; D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D017719:Diabetic Foot / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
chemical_list: D003094:Collagen