Chronic ulceration has been an ever increasing problem with the rise of diabetes. As time has gone on, new techniques have been developed in an effort to help ulcers heal faster and more definitively. Some techniques have lost favor in practice, while others have become standard of care. One technique has changed how we treat ulcers, and it may surprise you where this product comes from. Let’s define a few terms first.
An autograft is taking tissue from one part of the body and using it somewhere else on the same person. An example of an autograft would be taking a vein from your leg to use in the heart in bypass surgery, or taking skin from the buttock to cover a burn or ulcer. An allograft is taking living tissue from one human being and using it in on another human being. This is the principle currently being used to help heal chronic non-healing ulcers.
Dermagraft and Apligraft are examples of autografts that have been developed to help close diabetic ulcers. These two products are derived from neonatal foreskin. Yep, that’s right… we’ve taken the skin after circumcision and put it together with growth factors to make it grow. The skin is then cut into smaller squares, packaged, and sent refrigerated so that it can be used in offices across the country. These grafts contain living cells on a “scaffold” that can integrate with the patient’s skin. Studies of these products have shown that increase the likelihood of an ulcer healing.
These products are not cheap, but because of their incredible performance in helping diabetic patients, many insurances including Medicare cover anywhere up to six applications of this products. Your podiatrist can help you understand more about these treatments.