Clinical Application of Fresh Fibroblast Allograft for the Treatment of Diabetic Foot Ulcers

ABSTRACT

Diabetic foot ulcers often causes a difficult problem for health care professionals because of the defects associated with fibroblast functioning. Although there has been much interest recently in the use of topical growth factors for the treatment of diabetic foot ulcers, the effects are generally not very dramatic. The purpose of this study is to assess the effects of clinical application of fresh fibroblast allograft for the treatment of diabetic foot ulcers. Eight patients with diabetic foot ulcers ranging from 6 to 17 weeks in duration were treated. The size of the wounds ranged from 2.0 to 6.0 cm2 with 3 patients exhibiting exposed bones. Human dermal fibroblasts from healthy teenagers were cultured in DMEM/F-12 medium supplemented with 10% autologous serum. The cultured cells were applied over the wounds immediately following debridement, with fibrin being used as a cell carrier. A dressing was then applied with Tegaderm and kept moist until healing was complete. The progress and time for complete wound closure and patient satisfaction were assessed, with follow- up time ranging from 6 to 18 months. Complete wound healing occurred in all patients. Eleven to twenty-one days were needed for complete reepithelization of the wound and no clinical or laboratory abnormalities were noted. Patient satisfaction was also very positive. In this study, the use of fresh human fibroblast allografts was found to be a safe and effective treatment for diabetic foot ulcers.