Healing diabetic foot ulcers using cortical bone fenestration and cell therapy

Area of Science:

• Orthopedic Surgery
• Wound Healing Research
• Regenerative Medicine

Background:

• Chronic wounds with exposed bone pose significant clinical challenges due to poor vascularity and limited healing potential.
• The periosteum's absence compromises cortical bone's ability to support wound healing and skin grafting.
• Previous studies demonstrated fenestration and decortication expedite healing in exposed calvarial bone.

Observation:

• A case study involving a chronic lower extremity wound with exposed cortical bone was presented.
• The treatment involved cortical bone fenestration followed by the application of a human skin equivalent.
• This intervention aimed to create a viable bed for wound closure.

Findings:

• Cortical bone fenestration facilitated the development of granulation tissue in the lower extremity wound.
• The human skin equivalent integrated successfully, contributing to wound closure.
• The technique demonstrated potential in managing complex lower extremity wounds.

Implications:

• Cortical bone fenestration is a viable technique for managing chronic lower extremity wounds with exposed bone.
• This approach may enhance granulation tissue formation, improving outcomes for challenging wounds.
• The findings suggest a potential new strategy for reconstructive surgery in lower limb trauma and chronic wound care.