The use of autologous epidermal grafts for diabetic foot ulcer emergencies: A clinical study.

Mehmet Saydam, Kerim Bora Yılmaz, Mustafa Taner Bostancı, Müjdat Turan, Melih Akıncı, İbrahim Yılmaz, Muharrem Öztas, Hikmet Erhan Güven
Author Information
  1. Mehmet Saydam: Department of General Surgery, Institute of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara-Turkey.
  2. Kerim Bora Yılmaz: Department of General Surgery, Institute of Health Sciences, Gülhane Training and Research Hospital, Ankara-Turkey.
  3. Mustafa Taner Bostancı: Department of General Surgery, Institute of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara-Turkey.
  4. Müjdat Turan: Department of General Surgery, Institute of Health Sciences, Gülhane Training and Research Hospital, Ankara-Turkey.
  5. Melih Akıncı: Department of General Surgery, Institute of Health Sciences, Gülhane Training and Research Hospital, Ankara-Turkey.
  6. İbrahim Yılmaz: Department of General Surgery, Institute of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara-Turkey.
  7. Muharrem Öztas: Department of General Surgery, Institute of Health Sciences, Gülhane Training and Research Hospital, Ankara-Turkey.
  8. Hikmet Erhan Güven: Department of General Surgery, Institute of Health Sciences, Gülhane Training and Research Hospital, Ankara-Turkey.

Abstract

BACKGROUND: There are various surgical and invasive treatment systems such as conservative skin grafts and autologous epider-mal grafting (AEG) for diabetic foot ulcers. This study aims to evaluate the feasibility of using a novel epidermal graft harvesting system in diabetic foot ulcer emergencies.
METHODS: A retrospective clinical study was conducted with 15 diabetic foot ulcer patients, and after written and signed consent forms were taken, AEG system was applied to all patients. All of the clinical data of the patients such as their American Society of Anesthesiologists (ASA) Physical Status Classification System scores, size of pre-application wound area (cm2), time to complete re-epithelization of the wound, pain scores using the visual analog scale (VAS) for both donor and recipient sites, changes in size of wound, complete dermal response time, and patients' demographics, comorbidities were recorded. The age, gender, pre-post appli-cation wound area (cm2), time of healing, ASA, and VAS variables were compared each other and analyzed statistically. P<0.05 was considered as statistically significant.
RESULTS: The mean of time for complete wound healing was 5.9 (range 4-8) weeks. There was no statistically difference between recipient wound size and patient's age; size of both types of wounds (cm2) and time (weeks) for complete reduction for both types of wounds; and time to complete both types of wound healing and gender (p=0.509, 0.788, and 0.233, respectively). ASA scores did not impact the time required for complete healing of the wound (p=0.749).
CONCLUSION: The current study has tried to evaluate the efficacy of the AEG system in a homogenous population with diabetic foot ulcers. An epidermal harvesting system may be used effectively and safely in patients with diabetic foot ulcer emergencies.

References

  1. Surg Technol Int. 2014 Nov;25:55-61 [PMID: 25433225]
  2. Burns. 2010 Nov;36(7):999-1005 [PMID: 20381967]
  3. Adv Skin Wound Care. 2015 Sep;28(9):397-405 [PMID: 26258460]
  4. Burns. 2007 Nov;33(7):850-4 [PMID: 17493762]
  5. J Am Acad Dermatol. 2005 Feb;52(2):348-50 [PMID: 15692484]
  6. J Am Podiatr Med Assoc. 2013 May-Jun;103(3):223-32 [PMID: 23697729]
  7. Diabetologia. 2007 Jan;50(1):18-25 [PMID: 17093942]
  8. Lancet. 1964 Jun 27;2(7348):1444-5 [PMID: 14149183]
  9. J Am Podiatr Med Assoc. 2017 Sep;107(5):365-368 [PMID: 29077498]
  10. Virchows Arch A Pathol Anat Histol. 1981;392(2):217-30 [PMID: 6169192]
  11. Plast Surg Int. 2012;2012:715273 [PMID: 22666573]
  12. Adv Ther. 2017 Mar;34(3):599-610 [PMID: 28108895]
  13. Dermatol Surg. 2008 Sep;34(9):1186-92; discussion 1192-3 [PMID: 18537996]
  14. Chirurgia (Bucur). 2018 Sept-Oct;113(5):644-650 [PMID: 30383991]
  15. Diabet Foot Ankle. 2012;3: [PMID: 22403742]
  16. Plast Reconstr Surg. 2009 Jul;124(1):307-308 [PMID: 19568093]
  17. JAMA Dermatol. 2014 Sep;150(9):999-1000 [PMID: 25104506]
  18. Mol Med. 2007 Jan-Feb;13(1-2):30-9 [PMID: 17515955]
  19. J Eur Acad Dermatol Venereol. 2008 Jan;22(1):7-10 [PMID: 18181967]
  20. Int J Low Extrem Wounds. 2020 Jun;19(2):112-119 [PMID: 31744347]
  21. Int J Dermatol. 2014 Aug;53(8):e384-6 [PMID: 24738744]
  22. Int Wound J. 2017 Feb;14(1):241-249 [PMID: 26997204]
  23. Protoplasma. 2004 Jun;223(2-4):67-78 [PMID: 15221512]
  24. Adv Skin Wound Care. 2015 Mar;28(3):107-12 [PMID: 25658643]
  25. Int Wound J. 2017 Jun;14(3):555-560 [PMID: 27488934]
  26. Adv Skin Wound Care. 2016 Feb;29(2):57-64 [PMID: 26765157]
  27. Ann Plast Surg. 2003 Feb;50(2):212-4 [PMID: 12567064]
  28. Int Rev Cytol. 1981;69:271-318 [PMID: 6163744]

MeSH Term

Diabetes Mellitus
Diabetic Foot
Emergencies
Humans
Infant, Newborn
Retrospective Studies
Skin Transplantation
Wound Healing

Word Cloud

Created with Highcharts 10.0.0woundtimediabeticfootcompletestudysystemulcerpatientssizehealingAEGepidermalclinicalASAscorescm2statisticallytypesgraftsautologousulcersevaluateusingharvestingemergenciesareaVASrecipientagegenderweekswoundsp=00BACKGROUND:varioussurgicalinvasivetreatmentsystemsconservativeskinepider-malgraftingaimsfeasibilitynovelgraftMETHODS:retrospectiveconducted15writtensignedconsentformstakenapplieddataAmericanSocietyAnesthesiologistsPhysicalStatusClassificationSystempre-applicationre-epithelizationpainvisualanalogscaledonorsiteschangesdermalresponsepatients'demographicscomorbiditiesrecordedpre-postappli-cationvariablescomparedanalyzedP<005consideredsignificantRESULTS:mean59range4-8differencepatient'sreduction509788233respectivelyimpactrequired749CONCLUSION:currenttriedefficacyhomogenouspopulationmayusedeffectivelysafelyuseemergencies:

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