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Case Study
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Bilayered cell therapy* utilization in heel ulcerations Jeffrey C. Karr, DPM, ACCPPS, CWS, FAPWCA, Karr Foot and Leg Centers, Lakeland, FL Among several commercially available bioengineered tissue grafts, there is only one bi-layered cell therapy* that is approved by the FDA for the use with standard therapeutic compression in the treatment of non-infected partial- and full- thickness venous stasis ulcers as well as full thickness neuropathic diabetic foot ulcers. The bi-layered cell therapy expresses multiple growth factors found in normal skin, and provides a biologically active matrix. This manuscript looks at the possibility of this bi-layered cell therapy being beneficial in the management of heel ulcerations of the lower extremity. The bi-layered cell therapy was utilized in 10 heel ulcerations of the lower extremity. The bi-layered cell therapy was an extremely useful in healing these heel ulcerations. The results suggest that bi-layered cell therapy is beneficial in heel ulcers *Apligraf, Organogenesis, Canton, MA Long RE, et al. Treatment of refractory, atypical lower-extremity ulcers with tissue-enginered skin (Apligraf) (letter). Arch Dermatol. 2001;137:1660Ð1661 Falabella AF, et al. The use of tissue-engineered skin (Apligraf) to treat a newborn with epidermolysis bullosa. Arch Dermatol 1999;135:1219Ð1222 Wilkins LM, et al. Development of a bilayered living skin construct for clinical applications. Biotechnol Bioeng. 1994;43:747Ð756 Falanga V, et al. A bilayered living skin construct (Apligraf) accelerates complete closure of hard-to-heal venous ulcers. Wound Repair Regen. 1999;7:201Ð207 Margolis DJ et al. Which venous leg ulcers will heal with limb compression bandages? Am J Med. 2000;109:15Ð19 Falanga V, et al. Rapid healing of venous ulcers and lack of clinical rejection with an allogenic cultured human skin equivalent. Arch Dermatol. 1998;134:293Ð300 Kirsner RS, et al. The development of bioengineered skin. Trends Biotechnol. 1998;16:246Ð249 Bell ,et al. Living tissue formed in vitro and accepted as skin-equivilant tissue of full thickness. Science. 1981;211:1052Ð1054 Beless DJ, et al. Effects of living skin equivalent on calciphylaxis-induced skin necrosis wounds-case studies. WOUNDS. 2001;13(4);165Ð170 Bui D, et al. Reconstruction of aplasia cutis congenital (group V) of the trunk in a newborn. Plast Reconstr Surg. 2003;111(6):2119Ð2120. |
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