Treatment for Diabetic Foot Ulcers

Diabetics who have foot ulcers may need a skin graft.

Synthetic grafts are made from bovine tissue, but now there's another kind being used in Evansville that's actually made from human cells.

Jeff Stevens can't get adequate circulation to his lower extremities because of severe diabetes, which can lead to foot ulcers. Stevens says, "I can't feel hot or cold water. I can't feel if my feet are wet or not. And the only time I notice a blister is if I see it or someone else sees it." For two years now, he's had the same sore on his foot. Podiatrist, Dr. Brandt Dodson states, "What happens a lot of time, his body will tend to accept these wounds as normal. There's less impetus for the immune system to kick in and try to stimulate healing tissue because it's been there so long and that's kind of where he's at."

Ointments and other treatments haven't worked, so Dodson is trying something called Dermagraft. It's a bioengineered skin graft made from human cells called fibroblasts that stimulate healing tissue. "We're going to apply this directly over the wound," Dodson explained, "we don't want any air bubbles. We want this graft here to make full contact with the ulcer, which it's doing." The fibroblasts are introduced to the skin by a dissolvable suture-like material that serves as a second skin. Jeff needs to keep dressings on his foot, and try not to put pressure on it or bump it.

Underneath, the Dermagraft is helping his own skin regenerate. "Now over the next seven days or so, Jeff's body will break down this tissue and try to stimulate some of the fibroblasts to do their job and we'll get some of this, if not all of this healed up. We may have to do it again. We'll just see how we do," Dodson says. For most patients, it takes eight applications for a sore to heal. However, Dodson thinks Jeff will be walking again with just three applications.

The first Dermagrafts were derived from infant foreskin and since then have been reproduced in a lab. Because it's real human tissue, it's shipped to the clinic in dry ice, then warmed to room temperature in preparation.