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Equine Pericardium as a Biological Covering for the Treatment of Diabetic Foot Wounds

A Prospective Study

Jeffery H. Alexander Department of Orthopedic Surgery, Rush University Medical Center, Oak Park, IL.

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David A. Yeager Department of Surgery, KSB Hospital, Dixon, IL.

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Dean S. Stern Department of Orthopedic Surgery, Rush University Medical Center, Oak Park, IL.

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Carlo A. Messina Department of Orthopedic Surgery, Rush University Medical Center, Oak Park, IL.

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Brian J. Griffeth Department of Orthopedic Surgery, Podiatry Section, St. Joseph Hospital, Chicago, IL.

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Elizabeth Pacocha Department of Orthopedic Surgery, Podiatry Section, St. Joseph Hospital, Chicago, IL.

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Mark Barakat Synovis Orthopedic and Woundcare Inc, Irvine, CA.

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Background:

Diabetic foot wounds remain a significant health-care issue. Healing these wounds in a timely manner is of paramount importance because the duration of ulceration correlates with increased rates of infection and amputation, costing billions of dollars yearly. Collagen-based matrices have been used as wound covers and have been shown to improve and expedite healing. We present our experience with equine pericardium biomatrix for the treatment of neuropathic foot wounds.

Methods:

Thirty-four patients with 37 diabetic foot wounds were evaluated at two institutions prospectively. All of the wounds were debrided, and equine pericardium biomatrix was applied. Secondary dressings were changed every 48 to 72 hours until healed or for 12 weeks after application. Healing rate at 12 weeks, time to wound closure, and complications were evaluated.

Results:

Twenty-two men and 12 women (mean age, 56.9 years) were treated and evaluated. Mean and median wound sizes at initial treatment were 715.8 and 440 mm2, respectively. The overall wound healing rate by 12 weeks was 75.7% (n =28). Mean and median times to wound closure were 7.2 and 7.0 weeks, respectively. No device or procedure-related complications were reported.

Conclusions:

The use of equine pericardium as a temporary biological scaffold is safe and effective for the treatment of chronic neuropathic foot wounds. (J Am Podiatr Med Assoc 102(5): 352–358, 2012)

Corresponding author: Jeffery H. Alexander, DPM, Department of Orthopedic Surgery, Rush University Medical Center, 610 S Maple Ave, Suite 2550, Oak Park, IL 60304. (E-mail: jeffery_alexander@rush.edu)