The use of cultured dermis in the treatment of diabetic foot ulcers.

The aim of this open, non-comparative study was to assess the potential benefit of tissue-engineered human dermis (Dermagraft) in healing long-standing, difficult-to-heal diabetic foot ulcers, and the practicality of its use in the UK. Six patients with full-thickness neuropathic diabetic foot ulcers which extended into subcutaneous tissue and had an area > 1 cm2 were included. The treatment was applied weekly for eight weeks and the patients were followed for a total of 24 weeks. Four patients completed the study, showing improvement ranging from a reduction of 26% in ulcer area to complete healing. Two patients were withdrawn after developing complications not associated with the treatment. We conclude that this tissue-engineered human dermis has a role in the treatment of diabetic foot ulcers as part of a comprehensive treatment package. A study to confirm effectiveness in a comparative trial and optimise patient selection is indicated.