DOI QR코드

DOI QR Code

Treatment of Diabetic Foot Ulcer Using Matriderm In Comparison with a Skin Graft

  • Jeon, Hyojin (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Kim, Junhyung (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Yeo, Hyeonjung (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Jeong, Hoijoon (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Son, Daegu (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine) ;
  • Han, Kihwan (Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine)
  • Received : 2013.03.19
  • Accepted : 2013.06.20
  • Published : 2013.07.15

Abstract

Background For patients with neuropathy, vasculopathy, and impairment of wound healing, treatment of a diabetic foot ulcer poses many challenges. A large number of dermal analogues have been invented in an effort to overcome these challenges. Matriderm, a dermal analogue, is made from bovine collagen and elastin. This study was conducted in order to evaluate the effectiveness of Matriderm for treatment of diabetic foot ulcers, in comparison with skin grafting. Methods Sixty patients with diabetic foot ulcer were included in this prospective study. The average age of the patients, who had type II diabetes mellitus, was 58 years old. The patients were allocated to an experimental or control group with their consents. The patients were selected with their consent for inclusion in an experimental group and a control group. Patients in the experimental group received a Matriderm appliance and a split-thickness skin graft, while those in the control group received only a split-thickness skin graft. Results A shorter hospitalization period (7.52 weeks) was observed in the experimental group than in the control group (9.22 weeks), and a shorter period of time (8.61 weeks) was required for complete healing, compared with the control group (12.94 weeks), with statistical significance (P<0.05). A higher elasticity ratio of the affected side to the non-affected side was observed in the experimental group, compared with the control group (P<0.01). Conclusions Matriderm enables effective healing and improves elasticity in treatment of patients with diabetic foot ulcer.

Keywords

References

  1. Chung CH, Kim DJ, Kim J, et al. Current status of diabetic foot in Korean patients using national health insurance database. J Korean Diabetes Assoc 2006;30:372-6. https://doi.org/10.4093/jkda.2006.30.5.372
  2. Greenhalgh DG. Wound healing and diabetes mellitus. Clin Plast Surg 2003;30:37-45. https://doi.org/10.1016/S0094-1298(02)00066-4
  3. Kim SH, Kim JW, Kim JB, et al. Multifactorial factors of diabetic foot on diabetes mellitus comparative clinical study. J Korean Soc Plast Reconstr Surg 2002;29:83-90.
  4. Hanft JR, Surprenant MS. Healing of chronic foot ulcers in diabetic patients treated with a human fibroblast-derived dermis. J Foot Ankle Surg 2002;41:291-9. https://doi.org/10.1016/S1067-2516(02)80047-3
  5. Wetzig T, Gebhardt C, Simon JC. New indications for artificial collagen-elastin matrices? Covering exposed tendons. Dermatology 2009;219:272-3. https://doi.org/10.1159/000232387
  6. Wagner FW Jr. The diabetic foot. Orthopedics 1987;10:163-72.
  7. Lavery LA, Armstrong DG, Murdoch DP, et al. Validation of the Infectious Diseases Society of America's diabetic foot infection classification system. Clin Infect Dis 2007;44:562-5. https://doi.org/10.1086/511036
  8. Hashmi F, Malone-Lee J. Measurement of skin elasticity on the foot. Skin Res Technol 2007;13:252-8. https://doi.org/10.1111/j.1600-0846.2007.00216.x
  9. Eum SJ, Han SK, Gu JH, et al. Treatment of diabetic ulcer using autologous fibroblast-hyaluronic acid complex. J Korean Soc Plast Reconstr Surg 2009;36:548-54.
  10. Cuono C, Langdon R, McGuire J. Use of cultured epidermal autografts and dermal allografts as skin replacement after burn injury. Lancet 1986;1:1123-4.
  11. Hamuy R, Kinoshita N, Yoshimoto H, et al. One-stage, simultaneous skin grafting with artificial dermis and basic fibroblast growth factor successfully improves elasticity with maturation of scar formation. Wound Repair Regen 2013;21:141-54. https://doi.org/10.1111/j.1524-475X.2012.00864.x
  12. Han SK, You HJ. Wound coverage using advanced technology in Korea. J Korean Med Assoc 2011;54:594-603. https://doi.org/10.5124/jkma.2011.54.6.594
  13. Young MJ, Adams JE, Anderson GF, et al. Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects. Diabetologia 1993;36:615-21. https://doi.org/10.1007/BF00404070
  14. Weiner RD, Hlad LM, McKenna DR. Recurrence of diabetic pedal ulcerations following tendo-achilles lengthening. Diabet Foot Ankle 2011;2:6417. https://doi.org/10.3402/dfa.v2i0.6417
  15. Reddy GK. Cross-linking in collagen by nonenzymatic glycation increases the matrix stiffness in rabbit achilles tendon. Exp Diabesity Res 2004;5:143-53. https://doi.org/10.1080/15438600490277860

Cited by

  1. Intraoperative use of enriched collagen and elastin matrices with freshly isolated adipose-derived stem/stromal cells: a potential clinical approach for soft tissue reconstruction vol.14, pp.None, 2013, https://doi.org/10.1186/1471-2482-14-10
  2. Clinical Application of Adipose Stem Cells in Plastic Surgery vol.29, pp.4, 2014, https://doi.org/10.3346/jkms.2014.29.4.462
  3. The principles of tissue engineering and its recent advances and future prospects vol.57, pp.2, 2013, https://doi.org/10.5124/jkma.2014.57.2.145
  4. Acellular Dermal Matrix to Treat Full Thickness Skin Defects: Follow-Up Subjective and Objective Skin Quality Assessments vol.15, pp.1, 2013, https://doi.org/10.7181/acfs.2014.15.1.14
  5. The Use of Matriderm and Autologous Skin Graft in the Treatment of Full Thickness Skin Defects vol.41, pp.4, 2013, https://doi.org/10.5999/aps.2014.41.4.330
  6. Retrospective analysis of 56 soft tissue defects treated with one‐stage reconstruction using dermal skin substitutes vol.14, pp.6, 2016, https://doi.org/10.1111/ddg.12874
  7. Retrospektive Analyse von56 Weichteildefekten nach einzeitiger Rekonstruktion unter Verwendung von Dermisersatzpräparaten vol.14, pp.6, 2013, https://doi.org/10.1111/ddg.12874_g
  8. Development of Synthetic and Natural Materials for Tissue Engineering Applications Using Adipose Stem Cells vol.2016, pp.None, 2013, https://doi.org/10.1155/2016/5786257
  9. Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review vol.32, pp.suppl1, 2016, https://doi.org/10.1002/dmrr.2707
  10. Immediate Near-Total Scalp Reconstruction with Artificial Dermis on Exposed Calvarium vol.17, pp.4, 2013, https://doi.org/10.7181/acfs.2016.17.4.233
  11. Therapeutic strategies for skin regeneration based on biomedical substitutes vol.33, pp.3, 2019, https://doi.org/10.1111/jdv.15391
  12. A Meta-Analysis of the Outcomes of Split-Thickness Skin Graft on Diabetic Leg and Foot Ulcers vol.18, pp.1, 2013, https://doi.org/10.1177/1534734619832123
  13. Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: a systematic review vol.36, pp.suppl, 2013, https://doi.org/10.1002/dmrr.3284
  14. Fillet Flap Coverage for Closure of Diabetic Foot Amputation vol.24, pp.4, 2013, https://doi.org/10.14193/jkfas.2020.24.4.148
  15. Nanotherapeutic approach to treat diabetic foot ulcers using tissue-engineered nanofiber skin substitutes: A review vol.15, pp.2, 2013, https://doi.org/10.1016/j.dsx.2021.02.025
  16. Association between socioeconomic position and diabetic foot ulcer outcomes: a population-based cohort study in South Korea vol.21, pp.1, 2021, https://doi.org/10.1186/s12889-021-11406-3
  17. A Comparative Assessment of Scars Resulting From Skin Grafts in Facial Defects vol.33, pp.1, 2013, https://doi.org/10.1097/scs.0000000000007684
  18. Bioactive wound dressings for the management of chronic non healing ulcers (CNHU) - A review of clinical and translational studies vol.21, pp.None, 2013, https://doi.org/10.1016/j.mtla.2021.101269