Treatment of A Recalcitrant Diabetic Ulcer with A Synthetic Hybrid-Scale Fiber Matrix*

Chronic wounds, including diabetic ulcers, are difficult to treat and often fail to heal with current therapies. A novel, fully synthetic hybrid-scale fiber matrix* may provide a new treatment option for difficult-to-heal wounds. The synthetic matrix is composed of polyglactin 910 and polydioxanone [1]. It has a structure similar to native extracellular matrix and allows for cellular infiltration, neovascularization, and exudate management [1]. The present report investigated the use of the synthetic hybrid-scale fiber matrix for the treatment of a diabetic foot ulcer refractory to existing therapies. A 47-year-old male presented with a draining diabetic ulcer on his left foot. The patient had multiple co-morbidities, including diabetes mellitus, morbid obesity, diabetic peripheral neuropathy, chronic kidney disease, hypertension, hyperlipidemia, and Charcot foot. The wound was debrided in the office, offloaded with the use of a wheelchair, and treated with clindamycin antibiotics and a collagenase ointment in the home health setting. After 3 weeks, the wound failed to respond. The patient was admitted and underwent surgical debridement to remove non-viable tissue, resulting in a wound that measured 7 cm x 5 cm x 1 cm. The synthetic hybrid-scale fiber matrix was applied to the wound and secured using staples. Three weeks post-operatively, the wound was also treated with negative pressure wound therapy. Wound healing progress was evaluated with follow-up office visits. Ten weeks after application of the synthetic matrix, the wound was completely healed. A diabetic foot ulcer refractory to existing treatments demonstrated complete healing following use of a synthetic hybrid-scale fiber matrix. The successful clinical outcome observed in the present case suggests that the use of the synthetic hybrid-scale fiber matrix as part of the wound care continuum is a promising treatment algorithm for chronic non-healing wounds.