Cazzell S, Vayser D, Pham H, Walters J, Reyzelman A, Samsell B, Dorsch K, Moore M, et al.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the Eur.... Date of publication 2017 May 1;volume 25(3):483-497.
1. Wound Repair Regen. 2017 May;25(3):483-497. doi: 10.1111/wrr.12551. Epub 2017 Jun
12.
A randomized clinical trial of a human acellular dermal matrix demonstrated
superior healing rates for chronic diabetic foot ulcers over conventional care
and an active acellular dermal matrix comparator.
Cazzell S(1), Vayser D(2), Pham H(3), Walters J(4), Reyzelman A(5), Samsell B(6),
Dorsch K(6), Moore M(6).
Author information:
(1)Limb Preservation Platform, Valley Vascular Surgical Associates, Fresno,
California.
(2)ILD Research Center, San Diego, California.
(3)Boston Medical Center, Boston University School of Medicine, Boston,
Massachusetts.
(4)Southern Arizona VA Health Care System, Tucson, Arizona.
(5)UCSF Center for Limb Preservation, California School of Podiatric Medicine at
Samuel Merritt University, San Francisco, California.
(6)LifeNet Health, Virginia Beach, Virginia.
This study compared the efficacy and safety of a human acellular dermal matrix
(ADM), D-ADM, with a conventional care arm and an active comparator human ADM
arm, GJ-ADM, for the treatment of chronic diabetic foot ulcers. The study design
was a prospective, randomized controlled trial that enrolled 168 diabetic foot
ulcer subjects in 13 centers across 9 states. Subjects in the ADM arms received
one application but could receive one additional application of ADM if deemed
necessary. Screen failures and early withdrawals left 53 subjects in the D-ADM
arm, 56 in the conventional care arm, and 23 in the GJ-ADM arm (2:2:1 ratio).
Subjects were followed through 24 weeks with major endpoints at Weeks 12, 16, and
24. Single application D-ADM subjects showed significantly greater wound closure
rates than conventional care at all three endpoints while all applications D-ADM
displayed a significantly higher healing rate than conventional care at Week 16
and Week 24. GJ-ADM did not show a significantly greater healing rate over
conventional care at any of these time points. A blinded, third party adjudicator
analyzed healing at Week 12 and expressed "strong" agreement (κ = 0.837). Closed
ulcers in the single application D-ADM arm remained healed at a significantly
greater rate than the conventional care arm at 4 weeks posttermination (100% vs.
86.7%; p = 0.0435). There was no significant difference between GJ-ADM and
conventional care for healed wounds remaining closed. Single application D-ADM
demonstrated significantly greater average percent wound area reduction than
conventional care for Weeks 2-24 while single application GJ-ADM showed
significantly greater wound area reduction over conventional care for Weeks 4-6,
9, and 11-12. D-ADM demonstrated significantly greater wound healing, larger
wound area reduction, and a better capability of keeping healed wounds closed
than conventional care in the treatment of chronic DFUs.
© 2017 by the Wound Healing Society.
DOI: 10.1111/wrr.12551
PMID: 28544150 [Indexed for MEDLINE]
