ABSTRACT
Objective: To compare a human fibroblast-derived dermal substitute (HFDS) to a viable cryopreserved placental membrane (vCPM) for use in diabetic foot ulcers (DFUs). Methods: An electronic medical record database of 1622 refractory DFUs with areas 1-40 cm2 was analyzed. Results: Cox estimates of wound closure for HFDS (1444 wounds) were significantly greater (p = 0.0002) by weeks 12 (31 vs 21%), 24 (55 vs 39%) and 36 (68 vs 51%) compared with vCPM (178 wounds). HFDS reduced the median time to wound closure by 55% compared with vCPM, (20 vs 36 weeks, p = 0.0002). HFDS also increased the probability of wound closure by 60% (hazard ratio = 1.60 [95% confidence interval, (1.25, 2.06)], p = 0.0002). Conclusion: HFDS improved time and frequency of wound closure in DFUs versus vCPM.
Subject(s)
Diabetic Foot/therapy , Fibroblasts , Placenta , Skin, Artificial , Aged , Cryopreservation , Female , Humans , Male , Middle Aged , Pregnancy , Retrospective Studies , Time Factors , Wound HealingABSTRACT
Hyperbaric oxygen therapy (HBOT) is a useful tool for many conditions within the scope of practice of a Doctor of Podiatric Medicine (DPM). More wound-care clinics are adding HBOT as a service line. The increasing prevalence of DPMs operating inside of these wound-care clinics has raised questions about the licensure and privileging of DPMs to supervise HBOT. This document reviews the safety of outpatient HBOT and provides guidelines for hospitals to credential DPMs to supervise treatments.
