Dr. Tyson Green, Podiatric Specialist
Imagine getting a blister from an ill-fitting shoe, nicking your skin when you trim your nails, or stepping on a sharp object. For most, these would be a minor annoyance. But for someone with diabetes, any of these incidents could lead to a diabetic foot ulcer, a potential complication of the disease that can have very serious consequences.
Diabetic foot ulcers are actually the most common reason people with diabetes are hospitalized. Studies show that an alarming one out of five people with an infected ulcer ends up undergoing amputation. Diabetic foot ulcers often develop due to complications of diabetes, specifically, peripheral neuropathy, a condition in which feeling, or sensation, is lost due to reduced blood flow to the lower extremities. This interferes with the normal healing process, which can lead to infection and, in many cases, a non-healing wound. Finding the best way to promote healing has always been one of the biggest challenges in the care of diabetic patients. Fortunately, today we have new options for wound healing that are helping us achieve remarkable results.
One of the most successful options is regenerative medicine therapies, such as Dermagraft, a substitute for human skin. Dermagraft is not a skin graft, but instead works as a bio-delivery scaffold for healing. Dermagraft is manufactured from human fibroblast cells derived from newborn foreskin tissue. Fibroblasts are the most common type of cell found in connective tissue and play an important role in healing. During the manufacturing process, the human fibroblasts are seeded onto a bioabsorbable mesh scaffold. The fibroblasts multiply throughout the scaffold and secrete human dermal collagen, matrix proteins, growth factors, and cytokines to create a three-dimensional human dermal substitute containing metabolically active, living cells. Each single-use application is just a few square inches in size and is cryopreserved.
Dermagraft allows us to deliver proteins, growth factors and matrix directly to a wound that can't heal because the body can't produce and deliver these healing substances efficiently on its own. This can help jump start a stalled healing process, which is critical for a condition that could otherwise lead to infection or amputation if it remains open too long. Wounds that are older than four weeks old have about an 80 percent chance of increased complications. Therefore, if you are not rapidly reducing the wound size, you will inevitably encounter more complications.
Dermagraft is not indicated for use on all diabetic non-healing wounds, and is designed to treat full-thickness diabetic foot ulcers, which extend through the dermis, but without deeper tissue or bone involvement. Adequate blood supply is also required. Dermagraft should also always be used in conjunction with standard wound care regimens.
After years of struggling to find a solution for what can be one of the most tragic complications of diabetes – amputation – science had delivered a very successful solution. With Dermagraft, we are saving limbs and restoring mobility for our patients.