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2022, Vol. 26 ›› Issue (14): 2138-2143Co-transplantation of acellular allogeneic dermis and autologous split-thickness skin for repairing diabetic foot woundGao Lei, Qin Xinyuan, Li Tianbo, Wang Shuo, Yu Zeyang, Wang Jiangning
Abstract: BACKGROUND: In recent years, the combined transplantation of acellular allogeneic dermis and autologous split-thickness skin has achieved good results in burn wound repair at functional sites; however, few reports have documented the application of this technology in the repair of diabetic foot wounds. OBJECTIVE: To evaluate the clinical value of co-transplantation of acellular allogeneic dermis and autologous split-thickness skin in the repair of diabetic foot wound. METHODS: A retrospective analysis was made on the clinical data of 52 patients with diabetic foot wound who were treated with co-transplantation of acellular allogeneic dermis and autologous split-thickness skin (experimental group, n=26) or with autologous split-thickness skin (control group, n=26) between May 2017 and April 2020. The number of postoperative wound infection, skin graft survival rate, reoperation rate, wound healing time and wound recurrence rate during the 1-year follow-up period were compared between the two groups. An approval was obtained from the Ethics Committee of Beijing Shijitan Hospital, Capital Medical University. Informed consent was obtained from all patients and their relatives. RESULTS AND CONCLUSION: In the control group, eight patients developed infection in the skin graft area after operation, and among them, six patients had skin graft necrosis. After secondary operation, 2 out of the 6 patients healed after dressing treatment. In the experimental group, two patients developed infection after operation, and their wounds failed to be repaired but healed after dressing. The survival rate of skin graft in the experimental group (92.3%) was significantly higher than that in the control group (69.2%; P < 0.05). The reoperation rate of the experimental group was significantly lower than that of the control group (0 vs. 23.1%; P < 0.05). The wound healing time in the experimental group was (16.15±2.68) days, which was significantly shorter than that in the control group [(21.92±3.05) days; t=-7.25, P < 0.05]. The patients in both groups were followed up for 3 months to 1 year after operation. During the follow-up period, two patients in the experimental group and nine patients in the control group were re-hospitalized after wound recurrence. The wound recurrence rate in the experimental group was significantly lower than that in the control group (7.7% vs. 34.6%; P < 0.05). Therefore, compared with autologous split-thickness skin graft, the co-transplantation of acellular allogeneic dermis and autologous split-thickness skin can promote the survival of the skin and shorten the healing time of the wound. The repaired wound is friction-resistant, which reduces the recurrence of diabetic foot wound, even though there is an increase in hospital cost. Key words:diabetic foot, acellular allogeneic dermis, autologous split-thickness skin graft, wound repair |