What is it about?

The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra LifeScience Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in patients with diabetic foot ulcers.The Integra Flowable Wound Matrix, was significantly superior, compared to the wet dressing, by promoting the complete healing of diabetic foot ulcers. Ease of use, absence of adverse effects, and a facilitated wound healing process are among the properties of the matrix.

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Why is it important?

A significantly higher percentage of patients (86.95%) in the Integra TM Flowable Wound Matrix group achieved complete wound healing in 6 weeks, compared to the patients in the wet dressing group (52.17%). Deep structures were quickly covered with regenerated tissue. In 13.04% of patients there is no wound healing, after 6 weeks. These patients with graft failure had no clinical and/or laboratory signs to report to the inflammatory process inside. In our opinion, this dermal graft failure could be due to an inappropriate surgical timing in the first two patients; in the third patient, engraftment failure could be due to a less aggressive debridement. Healing time was significantly shorter in the first group, where the surgical breach was closed by primary intention compared to the control group, where the surgical breach healed by secondary intention. The biomaterial allows us to close the wound by primary intention, reducing the healing time. In the present study, the rate of complications such as major amputation and rehospitalization was lower in the Integra TM Flowable Wound Matrix group compared with the wet dressing: this difference was statistically significant.

Perspectives

The results of the present study demonstrated the biomaterial tested can be considered an effective adjunctive treatment in the promotion of wound healing in the patients with DFUs. The biomaterial used in this study allows the treatment of tunneling/or cavity lesions with an irregular geometry of the diabetic foot, which cannot be effectively treated using other biomaterials in the sheet form. Furthermore, easy application, the absence of adverse effects and a minimally invasive approach by primary intention closure of the lesion, make it appropriate in the management of DFUs.

dott manfredi mancone
università della campania luigi vanvitelli

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This page is a summary of: To evaluate the efficacy of an acellular Flowable matrix in comparison with a wet dressing for the treatment of patients with diabetic foot ulcers: a randomized clinical trial, Updates in Surgery, May 2017, Springer Science + Business Media,
DOI: 10.1007/s13304-017-0461-9.
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