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Autologous Skin Fibroblast and Keratinocyte Grafts in the Treatment of Chronic Foot Ulcers in Aging Type 2 Diabetic Patients

Matteo Monami Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy.

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Maria Vivarelli Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy.

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Carla Maria Desideri Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy.

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Giulio Ippolito Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy.

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Niccolò Marchionni Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy.

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Edoardo Mannucci Unit of Geriatric Medicine, Department of Cardiovascular Medicine, University of Florence and Azienda Ospedaliera Careggi, Florence, Italy.

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Background: We assessed the tolerability and efficacy of autologous skin cell grafts in older type 2 diabetic patients with chronic foot ulcers.

Methods: Treatment with Hyalograft 3D and Laserskin Autograft was proposed to a consecutive series of type 2 diabetic patients older than 65 years affected by long-standing (>6 months) foot ulcers with an area greater than 15 cm2. Ulcer healing rates and measurements of ulcer area were determined monthly for 12 months.

Results: Seven patients with 12 ulcers, nine of which received the described treatment, were enrolled. During 12-month follow-up, all of the ulcers healed except one. In the remaining eight ulcers, the median healing time was 21 weeks (interquartile range, 4–29 weeks).

Conclusions: Autologous skin cell grafts are feasible, well tolerated, and apparently effective in the treatment of diabetic ulcers of the lower limbs in advanced age. Age did not seem to moderate healing times. (J Am Podiatr Med Assoc 101(1): 55–58, 2011)

Corresponding author: Matteo Monami, MD, PhD, Geriatric Unit, Department of Critical Care, Ospedale di Careggi, Via delle Oblate, 4 – 50141 Florence, Italy. (E-mail: mmonami@libero.it)
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