Early experience on injectable micronized putty type human-derived acellular dermal matrix (ADM) in management of diabetic foot wounds in Singapore

Abstract

Diabetic foot wounds (DFW) are notoriously difficult to treat owing to poor vascularity, delayed healing and higher rates of infection. Human-derived acellular dermal matrices (ADM) have been used in DFW treatment, utilizing a matrix scaffold for new tissue generation. We investigate the efficacy of a micronized injectable human-derived ADM in the treatment of DFW. We retrospectively recruited 13 patients with diabetic foot wounds. Wounds were adequately debrided, and a micronized injectable ADM was applied. Wound sizes were recorded prior to treatment, at 2 and 4 weeks post-treatment. The mean defect of wounds treated was 19.21 cm³. Our results showed a statistically significant reduction in wound size of 45% and 59% at 2 and 4 weeks post-treatment, respectively (p < 0.01). ADM was also effective in infected DFW as 84% of our wounds had positive tissue cultures at the time of application. Micronized injectable ADM has proven to be an effective treatment for DFW. Advantages include a ready-to-use injectable, single-stage treatment, minimal pain, mouldable matrix to fit any wound shape, allows for outpatient treatment and simple wound dressings.

Keywords: acelluar dermal matrix; diabetic foot wounds; lower limb wounds; paste; putty matrix; wound healing.