Clinical usefulness of acellular dermal matrix combined negative pressure wound therapy in diabetic foot amputee

Category: DiabetesIntroduction/Purpose: Negative pressure wound therapies (NPWT) have been useful to prevent further amputation by filling defect with granulation in diabetic foot amputee. However the hospitalized period have been prolonged to complete filling defect with NPWT. There were many efforts to accelerate rate of granulation filling using dermal matrix in NPWT. We hypothesized outcomes of acellular dermal matrix combined negative pressure wound therapy (NPWT) can be useful in comparison of exclusive usage of NPWT. The aim of this study was to investigate clinical outcomes of acellular dermal matrix of combined negative pressure wound therapy in DM foot amputee.Methods: This study included 40 patients of 40 ischemic diabetic feet. We divide these diabetic feet into two groups: 20 cases of acellular dermal matrix combined NPWT and 20 cases of exclusive usage of NPWT. We performed the amputation and combined NPWT at a mean age of 50.7 years (26 to 75) with the mean 12 months follow-up between June, 2014, and January, 2017. FTSG was performed after sufficient granulation healing of DM foot amputee in case of need. We evaluated multiple risk factors preoperatively and postoperatively. The wound healing after FTSG was evaluated during the followup. Number of NPWT was checked during the hospitalized period. Necessity of further amputation was decided as failed cases. Success rate of NPWT was evaluated in two groups. Multiple risk factors were evaluated.Results: Failed case was 3 cases (exclusive usage of NPWT) and 2 cases (acellular dermal matrix usage combined NPWT). Other feet showed complete healing of wound. Mean NPWT number of times to complete filling of granulation were significantly lesser in acellular dermal matrix combined NPWT group. Decreasing rate of wound defect was significantly shorter in acellular dermal matrix combined NPWT group. There were no significant correlations between wound healing and risk factors (CRP, HbA1C) (p=0.223, p=0.175).Conclusion: Acellular dermal matrix usage combined negative pressure wound therapy in DM foot amputee can be helpful to improve filling granulation filling rate with NPWT than exclusive usage of NPWT.