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Cited by 56Diabetic Foot Ulcer Assessment and ManagementWound Healing and TreatmentsFoot and Ankle Surgery

Split-thickness skin grafting the high-risk diabetic foot.

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Rose, Jessica F., Giovinco, Nicholas, Mills, Joseph L., Najafi, Bijan, Pappalardo, Jennifer, Armstrong, David G.·2014·Journal of Vascular Surgery
DOI 10.1016/j.jvs.2013.12.046
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Abstract

Objective The application of split-thickness skin grafts (STSGs) to chronic extremity wounds has often been considered undesirable because of the perceived high incidence of failure, especially in neuropathic patients with plantar diabetic foot wounds. The purpose of this study was to evaluate the outcomes of STSG placement in patients with chronic lower extremity wounds.Methods We abstracted data from consecutive patients at our institution from January 2007 through April 2013 who underwent STSG placement by vascular and podiatric surgeons for chronic wounds of the lower limb and foot. Patients were monitored for at least 24 weeks, unless the wounds healed sooner.Results There were 94 patients (72% male) in the study group, with a mean age of 61.0 ± 12.8 years. Of these, 66 patients had diabetes, including 13 who were dialysis-dependent; the remaining 28 had other chronic nondiabetic wounds. The average duration of follow-up was 12.0 ± 12.9 months. After STSG placement, 65 (69.1%) experienced complete graft incorporation and healing, and 18 (19.1%) required revision, five (5.3%) of whom ultimately required major limb amputation. There were no differences in healing when wounds in patients with and without diabetes or plantar vs nonplantar wound locations were compared (P > .05). Similar results were observed after adjusting the results for initial wound size. Although dialysis patients had a threefold higher rate of STSG revision (46.2% vs 14.8%; P = .01), the cumulative rate of wound healing as a function of time was independent of end-stage renal disease (P = .83).Conclusions The results of this study suggest that STSG may be an effective method for promotion of wound healing in the management of chronic lower extremity wounds irrespective of wound location and presence of diabetes.

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  • In the EXPLORER study, healing at 20 weeks was observed among 48% of patients receiving a sucrose octasulfate dressing vs 30% among those receiving standard care (adjusted OR, 2.60; 95% CI, 1.43-4.73).

    “In the EXPLORER study, a double-blind randomized clinical trial comparing a sucrose octasulfate dressing with an identical control lipocolloid dressing in the treatment of 240 patients with diabetic foot ulcers and concomitant mild peripheral artery disease, healing at 20 weeks was observed among 48% of patients receiving active therapy vs 30% among those receiving standard care (adjusted OR, 2.60”

    From Diabetic Foot Ulcers (2023) · cites this paper as [69]

  • In a single randomized clinical trial of 240 people with diabetic foot ulcers and mild peripheral artery disease, sucrose octasulfate dressing improved healing at 20 wk compared with an identical control lipocolloid dressing (48% vs 34%; odds ratio, 2.60; 95% CI, 1.43-4.73).

    “Sucrose octasulfate dressing Used in treatment of neuroischemic diabetic foot ulcers Improved healing in a single randomized clinical trial of 240 people with diabetic foot ulcers and mild peripheral artery disease at 20 wk compared with an identical control lipocolloid dressing (48% vs 34%; odds ratio, 2.60; 95% CI, 1.43-4.73).69”

    From Diabetic Foot Ulcers (2023) · cites this paper as [69]

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Authors
Rose, J. F., Giovinco, N., Mills, J. L., Najafi, B., Pappalardo, J., & Armstrong, D. G.
Affiliations
University of Arizona (US)
ORCID
Venue
Journal of Vascular Surgery
Publisher
Elsevier BV
Published
2014-06
Volume
59
Issue
6
Pages
1657-1663
ISSN
0741-5214 (ISSN-L)
DOI
10.1016/j.jvs.2013.12.046
OpenAlex
W1976219914
Cited by
56
References
22
Citations by year
2026: 3 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 8 · 2021: 2 · 2020: 9 · 2019: 5 · 2018: 4 · 2017: 5 · 2016: 3 · 2015: 2
FWCI
2.68
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Vascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
  • Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
Keywords
split-thickness skin graft, diabetic foot, wound healing, graft integration, graft failure, end-stage renal disease, dialysis, amputation
MeSH terms
Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Wound Healing, Skin Transplantation, Treatment Outcome, Diabetic Foot

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