Diabetic Foot Ulcers

Written by Kristin Della Volpe

A new treatment for diabetic foot ulcers is one of “The Top 10 Innovations in Podiatry” in 2014, as rated in the July issue of Podiatry Today. The device—called CelluTome Epidermal Harvesting System—allows doctors to remove a thin layer of healthy skin from people with diabetes and create a skin graft for repair of foot ulcers.

Foot ulcers are a common complications of diabetic neuropathy and poor blood sugar control. Nerve damage can lead to a loss of feeling and sensation in the feet, which makes you more prone to injuries and other foot problems.

“CelluTome is a new device to consistently harvest the top layer of the skin, the epidermis,” explained Robert Kirsner, MD, PhD, Professor and Vice Chairman, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine. “Previous devices were cumbersome and not appropriate for routine practice. By transferring patients' own skin, these grafts have the potential to both serve as a replacement for missing skin (including pigment producing cells), and serve a stimulus for healing through the growth promoting factors they secrete,” Dr. Kirsner explained.

As opposed to deeper grafts, which have been used in the past, the CelluTome system removes a thin layer of skin with little or no pain. The graft is then ready for immediate use to repair diabetic foot ulcers. The procedure can take place in the office setting, with no anesthesia needed. 

“Cellutome uses heat, suction, and time to harvest a type of skin graft,” said Lee C. Rogers, DPM, Medical Director, Amputation Prevention Center, Sherman Oaks Hospital, Los Angeles, CA. “Since epidermal grafts can be harvested in the clinic and in most cases with no pain, the biggest advantage of Cellutome is that it avoids a trip to the operating room. Another benefit is that Cellutome harvests the patient’s own skin for transplant, meaning another donor is not required,” Dr. Rogers said.

“How these superficial grafts compare to deeper grafts is not completely known, and likely both benefits and limitations exist,” Dr. Kirsner said. “However, epidermal grafts donor site, because of their superficial nature, heal very quickly within days, which is a clear benefit to deeper grafts. Therefore epidermal autografts represent a ‘low-risk’ method, with little donor site morbidity, to use patients' own skin to facilitate healing,” he said.

Dr. Rogers noted that, in general, diabetic ulcers heal best when they are shallow and have good blood flow. Epidermal grafts may not be best for wounds that are infected or very deep.

Thus, it is important for people with diabetes to check their feet every day and see their doctor immediately if they have any foot injuries, cuts, redness, cracks, blisters/calluses, corns, ingrown nails, or ulcers. The best treatment for foot ulcers is preventing them from happening in the first place. Talk to your doctor and podiatrist about proper foot care.

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Diabetes Foot Care