Dermagraft: Use in the Treatment of Chronic Wounds

Problem: Lower limb ulceration is a common problem in clinical practice. A variety of metabolic and physical causes can lead to a diversity of chronic ulcer types, including diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). Solution: A wide variety of technologies have been developed to treat chronic wounds, with varying levels of success. Depending upon the type and severity of the wound being treated, treatments may include systemic or local antibiotic therapy, application of fillers such as collagen sponges, use of negative wound pressure, hyperbaric oxygen therapy, application of select growth factors, advanced wound dressings, and more recently, the use of cell-based tissue-engineered products. New Technology: Dermagraft (R) is a sterile, cryopreserved, human fibroblast-derived dermal substitute generated by the culture of neonatal dermal fibroblasts onto a bioabsorbable polyglactin mesh scaffold. During the product-manufacturing process, the human fibroblasts proliferate to fill the interstices of this scaffold and secrete collagen, other extracellular matrix proteins, growth factors, and cytokines, creating a three-dimensional human tissue containing metabolically active living cells. Indications for Use: Dermagraft has been approved for marketing in the United States for the treatment of DFUs. In addition, the product is in active development for the treatment of VLUs and has been clinically used in a variety of other indications to stimulate wound healing. Caution: When treating DFUs, Dermagraft should be used in conjunction with standard wound care regimens and in patients who have adequate blood supply to the involved foot.