Evolution of Technology


Dermal substitutes or surrogates are a rapidly expanding area of medical technology. Absent of the morbidity and mortality associated with skin grafting, these products confer various benefits when attempting to heal or cover large soft tissue defects or slowly healing wounds. Research has demonstrated the ability of these products to recruit stem cells, decrease wound healing time, serve as scaffolds for eventual skin graft, and prevent future surgeries or procedures, all without donor site morbidity. Sources for these grafts vary from mammalian to fish and reptilian, and vary in size, composition, and anticipated use.

Evolution of Procedure

Wound Coverage

Nonoperative wound care and coverage is the frontline treatment in the invasive management of diabetic foot wounds. While optimization of blood glucose control and other comorbidities is paramount, achieving healing of already present wounds is of paramount importance. Various modalities exist for covering already present wounds. Negative pressure wound therapy, wet-to-dry dressing, antibiotic-laden dressing, contact casting, and xenograft soft tissue coverings all offer various modalities by which providers can potentially achieve coverage of these morbid wounds in an attempt to avoid amputation or other more invasive procedures.