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Healing of the Human Kind A Dermagraft ® Case Study Presented by: Brian D. Sigal, DPM, CWS Patient History Patient is a 68 year old non-insulin dependent diabetic male, 6’2’’, 225 lbs, having just completed a study for diabetic foot ulcers with a juvenile nutritional shake. Diagnosis Neuropathic DFU, open approximately four months, measuring 1.3cm x .7cm x .2cm, on the left great toe. Wound has plateaued despite advanced wound care, offloading, and nutrition. No exposed muscle, tendon, or bone and no signs of infection noted. Date: 04-01-09 1 st Dermagraft Application Wound Size: 1.3cm x .7cm x .2cm Wound Treatment & Outcome 7 Dermagrafts were applied weekly to achieve wound closure. Patient was switched from Pegasus shoe to DH Walker boot prior to first Dermagraft application. Each weekly visit included #15 blade debridements of devitalized tissue, fibrin, and slough prior to graft application. Dermagraft was cut to the size of the ulceration and covered with Mepitel as per Directions for Use. Mepilex foam with dry dressing was then applied, and patient was instructed to replace outer dressings down to Mepitel halfway through each week. Date: 04-08-09 2 nd Dermagraft Application Wound Size: 1.2cm x .5cm x .2cm Date: 04-15-09 3 rd Dermagraft Application Wound Size: 1.2cm x .5cm x .1cm Date: 04-22-09 4 th Dermagraft Application Wound Size: 1.0cm x .4cm x .1cm Date: 04-28-09 5 th Dermagraft Application Wound Size: .8cm x .4cm x .1cm Date: 05-12-09 6 th Dermagraft Application Wound Size: .5cm x .3cm x .1cm Date: 05-19-09 7 th Dermagraft Application Wound Size: .3cm x .2cm x .05cm Date: 06-02-09 Healed
