Autologous non-cultured keratinocyte cell suspension in non-healing diabetic ulcers: A preliminary study

Diabetic ulcers are a common morbidity associated with poorly controlled glycemic status. Most patients often have neuropathy and vasculopathy as the etiology behind such ulcers. These factors not only lead to poor wound healing but also nonhealing ulcers. Nonhealing ulcers pose therapeutic challenges as they are usually not amenable to be treated with simple wound care and hence require newer modalities to effectively cure this condition that leads to a plethora of poor health outcomes. This study was conducted to see the effect of autologous noncultured keratinocyte cell suspension in chronic nonhealing diabetic ulcers that failed to normal wound care.

It was an observational pilot study. A total of 05 patients with nonhealing ulcers, attending the tertiary care teaching hospital in North India, were included in the study. Inclusion criteria was type 2 DM with more than 5 years duration of diabetes mellitus and glycated hemoglobin (HbA1c) <9 g%. History was taken in detail; name, age, sex, address, duration of disease and various other treatments taken from outside were noted; and size of ulcer was recorded as per Proforma.

A total of 5 patients were enrolled in the study, three (60%) and two (40%) patients were male and female, respectively. Three (60%) patients were habitual for tobacco use. Mean age of patients was 45 ± 6.51 years. Mean duration of ulcers was 4.8 ± 1.48 months. Area of ulcers ranged from 31.2 to 122.2 cm². Majority of cases, three (60%) of diabetic foot ulcers, were improved at 9-12 weeks and remaining two cases with large size of ulcer were healed at 13-16 weeks and 17-20 weeks, respectively. Majority (80%) of patients revealed >50% reduction in the size of ulcer within 2 weeks.

Noncultured keratinocytes are useful in healing of nonhealing diabetic ulcer.