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Use of Subatmospheric (VAC) Therapy to Improve Bioengineered Tissue Grafting in Diabetic Foot Wounds

Eric H. Espensen Attending Physician, Diabetic Foot Center, Providence St Joseph Medical Center, Burbank, CA.

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Brent P. Nixon Chief, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson.

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Lawrence A. Lavery Associate Professor, Department of Orthopaedics, Loyola University, Chicago, IL.

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David G. Armstrong Director of Research and Education, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson; Visiting Senior Lecturer of Medicine, Department of Medicine, Manchester Royal Infirmary, Manchester, England. Mailing address:Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, 3601 S Sixth Ave, Tucson, AZ 85723.

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The use of bioengineered tissue and topical subatmospheric pressure therapy have both been widely accepted as adjunctive therapies for the treatment of noninfected, nonischemic diabetic foot wounds. This article describes a temporally overlapping method of care that includes a period of simultaneous application of bioengineered tissue (Apligraf, Novartis Pharmaceuticals Corp, East Hanover, New Jersey) and subatmospheric pressure therapy delivered through the VAC (Vacuum Assisted Closure) system (KCI, Inc, San Antonio, Texas). Future descriptive and analytic works may test the hypothesis that combined therapies used at different and often overlapping periods during the wound-healing cycle may be more effective than a single modality. (J Am Podiatr Med Assoc 92(7): 395-397, 2002)