Wound Center
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	Closing Wounds by Rebuilding Skin
	Diabetic Foot Wounds
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Wound Center
240-313-9580

Individuals with diabetes know that keeping a close eye on your feet becomes a part of daily living. Foot ulcers are a diabetes-related complication stemming from nerve damage that can cause numbness in the feet. Diabetic patients with little sensation in their feet can step on an object or suffer from tight-fitting shoes and not feel the effects until a wound has developed.

“Diabetics are prone to foot and bone infections that can, down the road, lead to amputation,” warned Thomas Gilbert, III, DO, FACEP, FAPWCA, UHM, and medical director for the Wound Center. Among people with diabetes, 15% will experience a chronic wound (or foot ulcer) in their lifetime. These ulcers are often slow—or even fail—to heal using conventional antimicrobial treatments. And the longer a wound remains open, the greater the likelihood of tissue and bone infection.

For patients with a diabetic foot ulcer (DFU) lasting longer than six weeks, Meritus Medical Center is one of the few area hospitals offering new hope. Dermagraft is an FDA-approved “skin substitute” that helps heal DFUs faster than standard treatment. Dermagraft is a mesh fabric or scaffold of living human cells placed directly on a wound. The cells are absorbed into the body, triggering the body to rebuild the patient’s skin. Dermagraft’s specialized connective tissue cells, combined with weekly applications, result in a faster healing process. “It [the reapplication] continues to let the wound bed be stimulated,” explained Dr. Gilbert.

How it works
Your skin is composed of a protective outer layer (epidermis), an elastic inner layer (dermis), and a base layer of fatty tissue (the subcutaneous layer). Repeated applications of Dermagraft stimulate the wound bed with a new healthy dermal layer. Before treatment begins, a physician thoroughly examines the wound for infection and removes old and dead tissue. Once the wound is cleaned, the physician cuts the Dermagraft mesh to fit the wound, and applies it with staples or sutures. A second dressing covers the Dermagraft fabric. The process takes just ten to fifteen minutes and can be repeated once a week for up to eight weeks.

As with managing diabetes, compliance is key to a successful treatment program. Janet Jenkins, RN, BSN, CHRN, and outpatient program manager for the Wound Center, stresses the importance of controlling blood sugar levels, keeping weight off the wound, and watching for infection. “If blood sugars are not in control, the wound will not heal,” cautioned Jenkins.

For patients with a DFU and bone infection, the Wound Center offers Dermagraft with hyperbaric oxygen therapy—the breathing in of 100% oxygen to enrich the bloodstream. Saving a patient’s limb by offering advanced therapies such as Dermagraft and hyperbaric oxygen therapy help the Wound Center achieve a 1% amputation rate, significantly better than the national average of 3%.

Chronic foot ulcers often precede diabetic-related amputations. If you are concerned about your feet, contact your primary care physician for a referral, or call Meritus Medical Center’s Wound Center at 240-313-9580 for more information. Dermagraft is reimbursable through Medicare and many private insurance companies.