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Case Study/Series
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Combined Therapy Using an Acellular Human Dermal Matrix in Treating Lower Extremity Ulcers: A Case Study First Author: Paul Kesselman, DPM Authors: Paul Kesselman, DPM, FACFAS, FAPWCA Due to the complexity in treating lower extremity ulcers, many treatment modalities exist today. In complex ulcers combined therapies are increasingly becoming the norm. The following is a case study review of four cases employing an acellular human dermal matrix (). A 92 non-diabetic ischemic male with chronic lymphoma and a 2 month history of multiple ulcers received an application of the dermal matrix after 6 weeks of HBO and local aggressive wound care. The wound was 95% closed within 12 days, went on to complete closure, and has not recurred. A 60-year old obese type I diabetic received treatment with the graft after previous treatments of debridement, and long period of off loading failed. The acellular dermal graft was fully incorporated within 3 weeks. The patient went on to full healing and weight bearing with a custom foot orthotic. A 38 year old obese male with poorly-controlled type II diabetes and Asperger's syndrome presented with a grade III ulcer. After 3 weeks of conservative management, the patient underwent an application of the acellular dermal matrix. Complete incorporation of the graft was achieved and the patient has not re-ulcerated. A 50 year old IDDM male with a 4ppd smoking history presented with a long history of osteomyelitis to the right foot. After 18 months of other wound care treatments, the remaining wound was treated with a flowable, acellular dermal replacement scaffold. Within 1 week, the wound began granulating and achieved complete closure within 3 months. |
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