Dermal regeneration template in the surgical management of diabetic foot ulcers: a series of five cases.

Soft-tissue defects in the feet of patients with diabetes continue to pose a challenge because adequate debridement often leaves an extensive defect with exposed bone, tendon, and cartilage. The use of a dermal regeneration template followed by split-thickness skin grafts in the treatment of recalcitrant diabetic foot wounds was retrospectively reviewed. In a case series of 5 patients with diabetes and extensive tissue deficits of the foot, the use of a dermal regeneration template and split-thickness skin graft enabled closure of the lower-extremity defect. All patients completely healed and were able to resume ambulation with the aid of extradepth shoes and multidensity insoles. The take of the dermal regeneration template was excellent in all patients, and the grafts (dermal regeneration templates and split-thickness skin) were durable even when placed on difficult areas such as the plantar surface and heel. No infections occurred. Exposed bone, tendon, cartilage, and fascia were successfully covered. The experience in this case series suggests that the use of the dermal regeneration template followed by split-thickness skin graft offers an option for patients with diabetes with chronic wounds that have foot defects as a result of extensive tissue loss resulting from infection.