First Reported Use of LHACM in Diabetic Charcot Foot

Hi, I am Megan Oltmann, DPM. I practice out of Cleveland, Ohio. I am co-owner of Foot and Ankle Associates of Cleveland. I'm also the medical Director of the University Hospitals, Bedford and Richmond Wound Centers.

What is the patient case in this poster?

This is a 65-year-old male. He is a diabetic with neuropathy, with longstanding shark neuropathy. He has hypertension, hyperlipidemia, asthma, history of a Charcot recon due to the Charcot neuropathy with breakdown. After the reconstruction, he did go on to having a wound dehiscence, which went on to having an abscess to the area, classifying him as a Wagner grade 3 patient. Socially lives alone. He is a non-smoker, non-alcohol drinker and independent, but on disability.

What made this particular case stand out?

This particular case stood out in my mind as the patient was medically optimized. His A1c has always been between 5.5 and 7. He takes good care of himself. He was offloading the area appropriately. He was in a Pegasus shoe to offload. He could not use a total contact cast due to body habitus and him driving and trying to get around. However, he was not healing with standard of care. He was not progressing through normal cycles of healing.

What do DPMs need to know about your treatment pathways in this case?

At that point, I think again, the importance is that the patient was medically optimized. He had weekly thorough debridement. He was receiving standard of care, and he was a very compliant patient with the treatment. So I think the importance of this for DPMs doing wound care and taking care of these patients potentially after having wound dehiscence, is that sometimes standard of care alone is not. It's not enough to heal these patients that we really do need to employ these therapies, these advanced therapies such as skin substitutes. Next steps in this area. So this is a foundational case. So this is the first reported case of using the lyophilized to hack, as you will. So it's a foundational research. It's a case study. So next steps would be a series of case studies, and then from there would be a retrospective

What are the next potential research steps in this area?

Randomized control trial using the product. This would allow us to look at obviously long-term results and outcomes.