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A Value Analysis of Biologic Products in Diabetic Foot Wounds
Olatunde Bashorun BS
Alex Moradian BS
R. Michael Johnson MD MPH FACS
Wright State University
Miami Valley Hospital
2022-01-15
Presenter: Olatunde Bashorun
Affidavit:
I attest this is the principally the original work of the medical students involved in the project
Director Name: R. Michael Johnson MD MPH FACS
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Diabetic foot wounds cause significant morbidity and resource utilization. Multiple factors may prevent patients from being candidates for major reconstructive surgery. Advanced biologic products have sources from urinary bladder, submucosa, dermis or amniotic membrane. The current study is a case series of the use of biologic products in diabetic foot ulcers. The purpose of this study was to provide a value analysis of these products at our institution.
Chart review was completed from 2017 to 2021. Thirty-nine patients with lower extremity wounds secondary to type 2 diabetes mellitus who received a biologic for adjunctive treatment of surgical wound healing or closure were identified. Baseline clinical data included age, race, sex, kind of biologic product used, mortality, development of osteomyelitis, and ulcer recurrence.
The mortality rate was 18%. The patients 62% were male 38%female 75 % were Caucasian and 25% African- American. Median age was 60 years old. 17 patients did not have any ulcer recurrence, while 22 did experience ulcer recurrence. The majority of patients were treated with porcine urinary bladder matrix. 15 patients had a history of or development of osteomyelitis, while 24 patients did not develop osteomyelitis.
This subset of patients had advanced disease as designated by the high short term mortality, Despite this, biologic products appear to be useful adjuncts for diabetic foot wounds. In particular, those patients in need of palliative wound care who may not be candidates for major surgery.
