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Comparative effectiveness of skin substitutes for chronic foot ulcers in adults with diabetes mellitus: a review of reviews |
HAYES, Inc |
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Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Comparative effectiveness of skin substitutes for chronic foot ulcers in adults with diabetes mellitus: a review of reviews. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Health Problem:
Diabetes can damage blood vessels, compromising blood flow and oxygen circulation. Resulting tissue hypoxia may contribute to failure of even minor wounds to heal. Reasons are multifactorial and may include compromised sensation due to diabetes-related nerve damage and poor blood flow due to diabetes-related blood vessel damage.
Technology Description:
Skin substitutes are proposed as a treatment to cover open chronic ulcers and promote wound healing, with the goals of preventing infection and amputation. They are thought to function by physically covering the wound and providing extracellular matrices to induce regeneration and immune function. Skin substitutes, also known as bioengineered, tissue-engineered, or artificial skin, are heterogeneous and can generally be classified into 3 main types: cellular (comprised of living cells); acellular (composed of synthetic materials or tissue from which living cells have been removed); or a combination of cellular and acellular components. Regardless of the source, the skin substitute provides a matrix into which cells can migrate. Skin substitutes are characterized as autografts, allografts, xenografts, and bioengineered or artificial skin.
Controversy:
Skin substitutes are a heterogeneous group of tissue replacements and skin grafts sourced from different materials and subject to different regulatory pathways. Many are very costly. The relative value of different
skin substitutes is unclear.
Key Questions:
For the adjunct treatment of chronic foot ulcers in adults with diabetes mellitus: Compared with standard wound care alone, what is the efficacy of skin substitutes in terms of complete wound healing, incidence of amputation, and quality of life? What complications are associated with skin substitutes? Do efficacy and safety differ by skin substitute type or specific product? Have definitive patient selection criteria been established for skin substitutes for diabetes-associated foot ulcers? Indexing Status Subject indexing assigned by CRD MeSH Adult; Diabetes Mellitus; Foot Ulcer; Humans; Skin, Artificial Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: hayesinfo@hayesinc.com AccessionNumber 32018000088 Date abstract record published 15/02/2018 |
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