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Case Series/Study
The use of keratin based dressings in the setting of difficult to heal wounds in patients with type II diabetes mellitus have shown to be effective in decreasing healing times, despite the small cohorts of patients in the literature. The use of these keratin dressings is a novel approach to facilitate wound closure in these limb-threatening ulcerations. The use of a keratin dressing facilitates wound closure by increasing keratinocyte proliferation and migration in a wound bed.
Methods:
The authors in this investigation provide their findings with the use of a human keratin wound matrix in a small cohort of six patients. The patients have type II diabetes mellitus, peripheral arterial disease and peripheral neuropathy. These patients present with a wound with less than 30% of wound closure at four weeks duration. All patients failed conventional wound therapy consisting of sharp debridement, local wound care and offloading. All patients present with a HBA1C of less than 9.0% within three months prior to treatment and a wound size greater than one square centimeter. TCPO2 values for all patients were greater than 60 mmHg with satisfactory perfusion.
Results:
Prior to the initial application of the keratin dressing, the patients have had the wound for more than twenty weeks duration. The patients received consecutive, weekly applications of the human keratin wound matrix. Since initial application, the wound volume showed a decrease on a weekly basis.
Discussion: The use of a human keratin wound matrix may have an advantageous wound healing effect by increasing keratinocyte proliferation to the wound base. The use of the novel treatment shows evidence of decreasing wound volume, especially in the setting of chronic diabetic foot wounds. Of the patients evaluated, there was a decrease in overall volume of the wound size after weekly applications.
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